Continuity and Coordination of Eye Care


We appreciate the care and services you provide to our Blue Cross and Blue Shield of Texas (BCBSTX) members.  Many Primary Care Providers refer diabetic patients to eye care specialists for annual eye examinations.  PCPs need to know details about the care their patients receive and to receive communications from their patients’ eye care specialists.  We want to encourage eye care specialists to share results routinely and promptly with PCPs.

How can you help?

1) Communicate the date and results of diabetic patient eye exams to the referring practitioner as one of the essentials for quality care.

2) Educate your patients by helping them understand why a retinal exam for diabetics is different than an eye exam for glasses and is essential to help prevent future problems with vision. Many patients without vision problems feel they don’t need an exam.

3) Reassure your patients with diabetes that a yearly retinal exam may be covered by medical insurance.

4) Submit claims correctly for a diabetic patient eye exam, be sure to include “diabetes” as a diagnosis to ensure correct payment. Code your claims with the appropriate code.

We applaud those practices that have processes in place to send exam reports to the referring practitioners. We encourage those who do not routinely share results to consider adopting this practice. Thank you for collaborating with us in the care of our members. With your help, we can improve the care of people with diabetes.