Frequently Asked Questions
How do I become a member?
To become a member, please complete our online membership application, then sign and return to PEN by mail or fax. A PEN representative will notify you with your new PEN account number.
What does it cost to be a member?
There are no direct costs to beign a PEN member. We do ask that you spend an average monthly minimum of $1,400 (CA, AZ, NV) and $1,000 (remaining states). If you are a new doctor opening up a new location, we understand circumstances may fluctuate. Please speak with the Membership Coordinator to discuss a plan that fits your office.
What if I want to transfer a vendor but I don't see them on your list?
We are always looking for vendors to help enhance your practice. Please send an email to email@example.com and let us know who/what you would like to add. From there we will see if they are a good fit for PEN.
How do I add a vendor onto my PEN account?
You can add a vendor by filling out an Account Transfer Form. After we process the form, you can then expect the vendor purchases to be reflected on your next PEN statement.
How do I know if I am eligible for the Cooperative Bonus Program?
Please review your Purchase Summary report to see if you are eligible for the Cooperative Bonus Program. To be qualified to receive up to 0.5% of your total annual purchases, your average monthly purchase amount must be between $4,000 and $4,999. To receive 1%, your average monthly amount must be at least $5,000.
PEN Members, transfer your vendor accounts to your PEN statement to maximize your qualifying purchases. Click here for an account transfer form.
Can I deduct pending credits off my account to reduce my statement balance?
Yes, you may calculate your reduced balance by deducting the amount of the pending credit from the balance shown (Current Balance – Amount of Pending Credit = Balance Due).
You may then pay the modified total to account for the pending credit.
What services are offered through PEN’s Optometric Billing & Consulting Services?
to find out more about PEN's Optometric Billing and Consulting Services.
To which insurance companies does PEN submit claims?
PEN has the ability to submit claims to over 2000 insurance companies. Please click here to view a complete payer list.
What is the cost to submit claims through PEN?
There is a one time $50 set-up fee for PEN members and a $100 set-up fee for non-PEN members. The per claim fee is $2.75 for PEN members and $2.95 for non-PEN members.
How long does it take before I can start submitting claims?
It usually takes 24 hours after receipt of your enrollment form until a PEN representative notifies you that your account has been set-up.
Note: Insurances that require pre-enrollment (indicated on the PEN payer list with *****) can take up to 3-4 weeks to process your enrollment forms. Please click here to view a complete list.
Why should I use PEN’s Optometric Services for claim submission?
PEN provides fast, efficient electronic claim submission in a HIPAA compliant format.
PEN reviews each claim before submission for errors that will cause your claim to be denied or underpaid. If an error is identified your claim will be returned to you for correction with specific notation on how to correct the error. Clearinghouses will not identify when a claim will be denied for issues that are specific to optometry.
PEN will research denials for you, make any necessary corrections to your claim, and resubmit it at no extra charge. Clearinghouses are not available to research denials. They are used for claim submission only and may charge you for claim resubmissions.
PEN’s knowledgeable staff is available to answer your questions regarding claim coding, CPT and ICD descriptions, modifier usage, insurance policy, denials, and much more.
PEN charges a low-cost per claim fee of $2.75 for PEN members and $2.95 for non-PEN members. Most billing services charge a percentage of 4-6% of all recovered payments.
PEN offers Quantity Discounts. Submit a designated number of claims in any month and receive up to a 15% discount on that month’s statement.
Why should I check Medicare eligibility?
Medicare patients retain their Medicare card showing eligibility even after they sign over their benefits. Know in advance if your patient has signed over their Medicare benefits to an HMO or indemnity plan. Then you can inform the patient whether your practice is or is not on their insurance plan…the patient is responsible for payment in advance if the practice is not. Also, avoid unnecessary denials by submitting the claim to the correct insurance the first time. Click here to find out more about PEN’s Medicare Eligibility Service.
Why do I need PEN’s Medicare Fee Schedule?
PEN’s Medicare Fee Schedule includes only the most commonly used codes in optometry. For participating providers it lists the definition, Medicare allowed amount, and Medicare paid amount. For non-participating providers it lists the Medicare non-par allowed amount and limiting charge. The Medicare fee schedule is updated yearly and will allow you view what Medicare will reimburse you as well as allow you to evaluate your current fee structure. Click here for more information about our optometric office forms, including PEN’s Medicare Fee Schedule.
What is the Physician Quality Reporting Initiative (PQRI)?
The PQRI is a CMS program that reimburses up to 2% of total allowed charges for covered Medicare physician fee schedule services when the quality codes are reported successfully. Click here for more information about our optometric office forms, including PEN’s PQRI Quick Reference Card.
What do I do if I have a denial?
Denial resolution is as simple as faxing your denial to PEN at 888-400-0436. A PEN representative will do the research and respond as to the reason for the denial, indicate any action that is required by your practice, and/or any action that has been taken by PEN to get your claim paid.
Who do I contact if I have a question about insurance policy or claim coding?
PEN’s knowledgeable staff is available to answer all of your questions. Click here to view the contact information for PEN’s Optometric Billing & Consulting Services staff.
Can I register for classes online?
Yes you can register for classes online. To register today, click here.
Where do I find the location (hotel address) for the class I’m registered for?
To find the hotel address for a class you have registered for, please contact our Education department at 800-444-9230.
When will the next class be held in my area?
To find the availability of upcoming courses in your area, visit our Education Calendar or call (800) 444-9230.
Is there a discount for additional class attendees?
Registration fees vary by course offering, as do promotional discounts. Please inquire about available discounts in Education at 800-444-9230.
Will I receive confirmation that I have registered for a class?
You should receive a faxed confirmation within 48 business hours of completing your registration. If you have not received a confirmation by then, please email us to verify your enrollment.
Am I already registered for a class?
Please allow 48 business hours to receive a confirmation of your class registration. If you have still not received a confirmation, please contact 800.444.9230 to verify your enrollment.
How will I know if a class has been cancelled?
All registered students will be notified in advance if a class has been cancelled or rescheduled.
Can I still order publications if I'm not a PEN Member?
Yes, you can order without being a PEN Member. However, PEN Members receive discounts on all PEN products and services. Click here to learn more about the benefits of PEN Membership.
How long will it take to receive my order for PEN Guidebooks & Office Forms?
Please allow 48 business hours to process your order. All products are shipped via UPS ground and may take 7-10 business days to arrive, depending on your location.
Are PEN Office Forms compliant with Medicare?
Yes, all of our Medicare-related forms are compliant. We also update our forms whenever Medicare makes a change.
Click here to view or order PEN Office Forms.
Can I pay for PEN Guidebooks & Office Forms by check?
Yes, you can pay by check but we cannot send the product out until we receive your check. Please make checks payable to:
Primary Eyecare Network
P.O. Box 433
San Ramon, CA 94583
What was my last PEN Publications order?
Order history is not currently available to be viewed online. Please call PEN at 800-444-9230 and we’ll be happy to look up your previous order for you. Please have your PEN ID or practice phone number available when you call.
Can you customize forms for our practice?
The following office forms are customizable:
- Rx Pads
- Lifetime Signature-on-File Labels
- HIPAA Labels (Acknowledgment of Receipt)
- Medicare Fee Schedule
- YourLens* Counter Cards
After you place your order, a PEN representative will contact you regarding the custom information.
*For more about YourLens, please speak with your ABB-CONCISE sales representative or contact PEN at 800-444-9230.
What is the turn-around time for a Yourlens order?
If you can provide us with a hi-resolution file for your practice's logo (300dpi or higher), a single order can be completed in as little as one day for the practice to proof.
Do I have to have a logo to order Yourlens counter cards?
No, you need not have a logo on your counter cards. PEN will work with you to provide alternative design options.