The following doctor redo policies and procedures apply to all plans requiring the use of a contract lab. Acceptable first-time doctor redos for lenses only maybe done at your discretion without pre-certification:

• Your patient cannot be charged for redos required because you or your office staff made errors.
• A frame change alone is not an acceptable first-time redo (see Frame Changes, below).
• Second or subsequent requests for a lens redo are private transactions between you, the lab, and your patient.
• Providers are not paid any additional service fees when an additional covered lens enhancement is added to the lens redo.

For Signature and Choice single vision stock lenses finished in your office through the VSP In-Office Finishing Program, refer to the VSP In-Office Finishing Program section for information and requirements regarding first-time doctor redos of these lenses.

The following criteria must be met to qualify as a first-time doctor redo:

• The same doctor and lab must be used for both the original and redo prescriptions.
• The redo must be requested within six months from the date of service.
• The redo is for lenses only.
• One of the following requirements is met:

• Lenses covered by a manufacturer’s non-adapt warranty (e.g., photochromics, aspheric lenses) are not considered a first-time doctor re-do. Resubmit lenses to the original lab for replacement consideration.

Redos on progressive lenses under our first-time doctor redo guidelines are not covered. These lenses must be covered under the lab’s private progressive warranty or the manufacturer’s progressive warranty, then applied to the same VSP patient in the form of replacement lenses. The same doctor must be used for both the original and redo prescriptions. Any redo on a progressive lens must be handled as a private transaction between the doctor, lab, and patient.

If the progressive lens is covered by a manufacturer’s warranty or lab guarantee, submit the lens to the original lab on a private invoice for replacement consideration. Lens enhancements or materials not covered by the manufacturer or lab are a private transaction between you and your patient.

1. First-time doctor redos must be for lenses only and submitted within six months of the original order.
2. Order the redo from the same lab that made the original prescription. Complete the lab’s private invoice, clearly indicating a “VSP Doctor Redo” is requested.
3. Submit the invoice to the lab with a copy of the original lab order form or Eyefinity Service Report and the patient’s original lenses. If you submit an Eyefinity Service Report, please remove procedure and diagnosis information.
4. The lab will send the new lenses to you and keep the original lenses.
5. Redo transactions are between you and the lab. No paperwork needs to be sent to us except for Covered Lens Enhancements.

On acceptable first-time doctor redo prescriptions, we’ll cover lens enhancements ordered on the original prescription. Follow the procedures below in cases where a new lens enhancement is added on a redo:

A frame change alone is not an acceptable condition for a first-time doctor redo. At least one of the requirements listed above must be met in order for a job to qualify as a first-time doctor redo. If such a valid redo reason exists, the patient may select another frame at that time.

Redo of lenses is not covered for frame changes due to your error or your patient’s dissatisfaction with the style, shape, size, or fit. Any exchange of materials under these circumstances is a private transaction between you and your patient.

Lens redos may be approved if your patient has an allergic reaction to the material in the original frame. Call the Provider Services Support Line at 800.615.1883 to request redo of lenses in this case. If lenses are approved, the frame exchange is a private transaction between you and your patient.

Doctor redos requested more than six months from the original date of service may be approved for a first-time doctor redo only if your patient was physically unable to visit your office to request the redo earlier (e.g., the patient was ill or out of town for an extended period). Call the Provider Services Support Line at 800.615.1883 to request redo of lenses in this case.

If you need to order a doctor redo from a different contract lab, you must submit the order to your state-routed VSPOne lab with a First-Time Doctor Redo Verification form indicating that the redo lab has changed. Clearly explain the reason(s) for the lab change on the verification form. We will only honor doctor redos at a VSPOne lab under the following circumstances:

• The original lab is out of business.
• The original lab could not redo the job because of a change in the original order (e.g., could not accommodate a brand or material change, etc.).
• The original lab cannot complete the job to your satisfaction.