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Frequently Asked Questions
To help you find the information you need quickly, we've collected answers to some of the most frequently asked questions about Ocular Benefits. Click on a question to have the answer drop down below.
- How is Ocular Benefits able to reduce overall cost?
Our operations are built on a state-of-the-art technology platform developed by our sister company, Wonderbox Technologies. The Enterprise System is flexible, customizable, and designed to efficiently administer managed eye care programs. Our solution brings automation to claims management, provider credentialing, network management, utilization management and other administrative functions. We accept full health plan delegation for these functions.
- Do you have flexibility with reimbursement models?
Yes. We currently administer many different fee models ranging from traditional fee-for-service to full-risk capitation with many variations and reimbursement hybrids. We will customize the medical delivery and fee model to meet the specific needs of the health plan or payer.
- How can Ocular Benefits compete in the fast-paced retail environment?
We offer a unique, web-based portal for providers to manage administrative tasks associated with patient care with accuracy and efficiency. Our portal enables providers to verify specific patient benefits, submit claims for eye exams and enter prescription information. They’re also able to order vision supplies, such as eye glasses and contact lens, for members at the point of purchase. Our system transmits all of this information directly to a designated lab for fulfillment.
- How can Ocular Benefits help improve our HEDIS scores?
Our solution provides several strategies that lead to a healthier member population and improved health plan performance, including wellness programs, access to preventative tests and prevention of redundant tests as well as comprehensive, customizable reporting.
- Can you really create a paperless process?
Yes. The Enterprise System is designed to support paperless workflows through web-based architecture, built-in document management system, and fully integrated self-service web portals. Our paperless environment is one of the fundamental ways we maintain low administrative costs.
- What steps do you take to prevent fraud?
All providers complete a fraud prevention training course. In addition, we leverage our innovative technology platform for further analysis of fraud circumvention and to detect utilization outliers.
Our sister companies are proud leaders in the delivery of specialty benefit management through state-of-the-art technology and best-in-class benefit administration.