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Provider Notice Issued 11/02/2017
Date: November 2, 2017
To: Enrolled Optometrists; Optical Companies; Physicians; and Local Health Departments
Re: Chapter O-200, Handbook for Providers of Optometric Services
Additional Pair of Adult Eyeglasses Following Eye Surgery
Correction to Lens Type Available through IDOC
Per Public Act 100-0135, adults age 21 and older may receive an additional pair of eyeglasses within a two-year period, if a patient has had a surgical procedure such as cataract surgery that necessitates a new pair.
In order to be eligible to receive an additional pair of eyeglasses, the patient must have a new spectacle lens prescription established with a date of service on or after August 18, 2017.
Requests for an additional pair of eyeglasses will be subject to the prior approval requirements outlined in Topic O-211.1 of the Handbook for Providers of Optometric Services. Topics O-211.1 and O-212.7.1 have both been updated.
Topic O-212 has been corrected to remove the reference to photogray glass lenses. The Illinois Department of Corrections eyeglasses laboratory does not provide this type of lens.
The Handbook for Providers of Optometric Services has been revised and is available on the Department’s website.
This policy applies to fee-for-service billing. For Managed Care Organization (MCO)-enrolled members, providers must submit all prior approval requests and claims for services directly to the appropriate MCO and adhere to the MCO’s claim submission and timeliness guidelines.
Questions regarding this bulletin should be directed to a medical assistance consultant in the Bureau of Professional and Ancillary Services at 877-782-5565.
Instructions for updating the Handbook for Providers of Optometric Services:
Topic O-211 Prior Approval
Remove page HFS O-211 (1) and insert revised page HFS O-211 (1).
Topic O-212 Limitations and Considerations on Specific Items
Remove pages HFS O-212 (1) and (3) and insert revised pages HFS O-212 (1) and (3).
Topics O-211 and O-212 Revision Pages