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Some items are not currently available and are in the process of being update. These specific items will ship at a later date.
Superbill: Not available in ICD-10
Acknowledgement of Receipt of Glasses - Medicare & Medicaid: 100 labels
Using these labels will ensure proper payment, Verify the receipt of dispensed glasses and help prevent fraud.
CMS-1500: 100 forms (1-Part)
Medicare approved manual claim submission form.
Customized Medicare Fee Schedule: (Separate Shipment)
Easily determine Medicare coverage on procedures applicable to optometry without searching the entire Medicare fee schedule.
Evaluation & Management Worksheet: 1 laminated card
Quickly and efficiently choose the appropriate coding level for each patient.
Examination Form: 100 forms
Includes clear references to all 14 elements of an eye exam and provides thorough and compliant documentation.
Examination: Supplementary Tests Form: 50 forms
Quick and easy way to comply with documentation regulations when performing special tests.
Insurance Signature-on-File Labels: 100 labels (Separate Shipment)
Legally submit patients’ claims without having them sign each individual claim form.
Medical History Questionnaire: 100 forms
Complete health history questionnaire designed to elicit all of the data HCFA demands.
Physicians Quality Reporting System Quick-Reference (PQRS):
1 laminated card. Handy card that keeps details of the measures that apply to optometrists at your fingertips for quick reference.