Insurance companies, Like Anthem, are refusing to pay for vision therapy for the diagnosis of convergence insufficiency. Anthem wants 12 weeks of home-based vision therapy documented (pencil push-ups) before they will consider in-office treatment.
This is ridiculous! See letter below to insurance companies:
It is VERY clear in the literature that “home-based therapy” is INSUFFICIENT to replace office-based vision therapy in patients with symptomatic convergence insufficiency. What is the rationale to delay treatment for patients with convergence insufficiency, when appropriate treatment (office-based vision therapy) is well documented in the literature? This only keeps the patient unnecessarily in the symptomology stage for an additional 12 weeks. There is NO BASIS or support to request 12 weeks of home-based therapy prior to the well-documented treatment of choice for this condition.
Optometric vision therapy is based upon a medically necessary plan of treatment, which is designed to improve specific vision dysfunctions determined by standardized diagnostic criteria. Treatment plans encompass lenses, prisms, occlusion and other appropriate materials, modalities and equipment.
Studies in peer reviewed journals document the treatment of choice for convergence insufficiency is office-based vision therapy, and that home-based vision therapy is NOT effective. Click Home_Based_Therapy_for_Symptomatic_Convergence, CITT_Arch_2008, CI-Major-Review-copy, Vision Therapy and Convergence Insufficiency What Parents Need to Know – NCLD.
Founder and co-owner of Hellerstein & Brenner Vision Center, Dr. Lynn Hellerstein is the author of an award-winning book series, SEE IT. SAY IT.DO IT!
Dynamic and engaging, Dr. Hellerstein is a popular speaker nationally and internationally.
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