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Optical Voucher System

It includes the following features:

  • The system handles multiple fee schedules - whether for Preferred Provider Organization (PPO) or non-PPO providers.

  • The system permits the user to manage different plans; each with their own frequency limits, dollar maximums, plan years, individual maximums, and deductibles, etc.

  • The system checks and verifies family eligibility and, where applicable, the eligibility of the dependent. When the member/dependent is not eligible the system will, if desired, produce a rejection letter/Explanation of Benefits (EOB).

  • The system also tracks and manages usage within Plan guidelines so that the new printed voucher will allow for full or partial optical services based upon the patient's history. When the member/dependent is not entitled, the system will, if desired, produce a rejection letter/EOB.

  • The system handles the printing of tan individual voucher, for immediate distribution or batch printing for group mailing.

  • The system efficiently allows the creation and printing of vouchers for multiple family members.

  • The system restricts voucher creation so that no new voucher is created if another voucher remains unused.

  • Voucher creation data is maintained to permit easy entry of the final claim using the fewest keystrokes.

  • The system has state-of-the-art capabilities to manage and handle electronic voucher submission and claim processing.

  • The system has a full letter-writing feature with automatic follow-ups.

  • The system's check-writing feature can produce singular payments to members or providers or a "combined" check, which groups many different members' payments into one check.

  • The system has a full reporting feature which includes claim utilization (for PPO or non-PPO groups) and financial re-caps.

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