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Eyesight is the ability to see clearly at a distance. 20/20 is the measurement for visual acuity. Vision encompasses much more – it encompasses skills such as eye tracking, eye teaming, focusing and visual perceptual abilities.
Think of it as physical therapy for the eyes and brain together. Vision therapy is an individualized treatment program designed to remediate binocular vision dysfunctions and/or visual processing delays. Vision therapy trains or retrains the brain to effectively use the eyes to gather and respond to visual information.
A comprehensive program of vision therapy involves a progression of procedures designed to enhance a patient’s ability to control eye alignment, eye movements, focusing ability and eye teaming. Special lenses, prisms, colored filters, equipment (such as balance boards) and computer programs are used to deliver therapy activities. A well planned program of care, including scheduled homework activities, will develop a high level of visual-motor efficiency and endurance. Each stage of progress is monitored until the new vision skills are automatic.
Vision therapy has been around for over 80 years, but unfortunately not enough doctors provide quality programs of vision therapy. Optometrists learn about vision therapy in school. However, putting it into a practice setting is a very different thing. It takes a great deal of time, equipment, staff, and special training to provide the service. Fortunately, there are many optometrists and other professionals that are aware of the symptoms of binocular vision problems and refer for care when appropriate.
Each vision therapy program is customized to that particular patient’s needs. A comprehensive therapy program may last between 15 and 40 weeks – however it’s really up to the patient and family to choose the number and frequency of sessions. A patient typically has weekly, one-on-one in-office sessions for 60 minutes. The patient will also be assigned homework activities to be completed four times between in-office sessions. Homework participation is critical to each program and shows more rapid results and sometimes shorter programs of therapy.
The cost of a vision therapy program is similar to the cost of braces for the teeth. Office-based vision therapy requires a great deal of organization and planning time. Each hour-long session of treatment requires at least an additional hour of staff time and office resources.
It’s possible. The ability to see letters clearly on a chart 20 feet away does not guarantee good binocular vision skills. Problems with eye teaming, tracking, focusing, alignment, endurance and visual processing may still be present and affect reading, learning, and performance in daily life.
Generally, you do not need a referral to be seen at our office, especially if you are insured by “Original” Medicare or a BlueCross BlueShield plan. However, you may call your insurance provider to be certain.
Most patients who successfully incorporate their new vision skills into daily life enjoy long-term resolution of their visual problems. Depending on the severity of the case, patients with strabismus, amblyopia or traumatic brain injury may benefit from maintenance therapy activities to sustain their new visual abilities.
Testing performed by a developmental optometrist differs greatly from a general care optometrist. During a functional (AKA developmental) vision evaluation, the doctor and a therapist will complete a battery of tests for vision skills and visual processing proficiency. The tests are then scored and put into a report which the doctor will go over with you during a separately scheduled consultation.
Due to the specialized nature of our care, we only participate with a few insurance providers: BlueCross BlueShield plans (Except Blue Select, which is an exclusive plan that our office was not asked to participate in) and Original Medicare+Your Supplement. However because of this, we are able to spend a great deal more time with patients than typical optometric practices, which is the nature of treatment with any therapy.
If you do not have participating insurance coverage, we request full payment at the time of service. Payment arrangements may be made upon request. If you wish to file a claim for reimbursement of out-of-network coverage, we can help you locate the right form to self-submit to your insurance company.
Some insurance providers cover a portion of vision therapy costs, but many policies exclude it altogether. Coverage determination can depend on several factors, especially diagnosis. We ask that you contact your insurance provider for eligibility – the service code for vision therapy is CPT #92065, usually called visual training or orthopics.
Not all therapy programs are alike. When choosing a vision therapy provider, make sure you are informed about your needs and expectations for a plan of therapy based on the experience of the doctor and staff, facility, equipment, and comprehensive scope of programs delivered.
We only file insurance claims for plans which we are contracted through our private practice. You may self-submit claims using the statement we’ll provide you after each therapy session. Most insurance providers have an out-of-network claim form on their website for you to download, print and mail in with the statement we give you.
Yes! Many patients use flexible spending accounts to cover therapy costs.
As a policy holder, you have every right to file an appeal. In some cases, you can request a benefit exception request or review for medical necessity. For more information on gaining insurance coverage for vision therapy, please read the College of Vision Development Guide to Vision Therapy Coverage (PDF) and the American Optometric Association Vision Therapy Reimbursement Packet (PDF).