VSP, EyeMed, Davis Vision, Medicare and the commercial medical plans, verified and documented in your practice software 48 hours before the patient walks in. One trained person, a flat $10 an hour.
Almost every eye care patient carries two kinds of coverage, and the practice has to work out which one applies before the visit. The AOA's practice income survey puts the revenue mix of owner optometrists at 30 percent vision plans, 23 percent private medical insurance, 16 percent government programs and 31 percent direct patient payment (AOA, 2022 Survey of Optometric Practice Income). The routine exam and materials run through the vision plan. Anything with a medical diagnosis runs through the medical plan. Get the determination wrong and the claim comes back, or the patient gets a balance at checkout that nobody warned them about.
The vision plans are large enough that this is most of your schedule. The CDC notes that more than one in four Americans have VSP coverage alone (CDC Vision and Eye Health Surveillance System). Each plan has its own provider portal, its own benefit structure, and its own allowances for frames, lenses and contact lenses, and the answer has to be pulled and written down for every patient, every visit.
The 2024 CAQH Index, which measures administrative transactions across health plans covering most insured Americans, puts the industry cost of a manual eligibility and benefits check at $12.95, a portal or IVR check at $4.50, and a fully electronic check at $2.04, with an average time saving opportunity of 12 minutes per transaction. Across the medical industry it estimates the savings opportunity on eligibility verification alone at $11.7 billion a year (CAQH Index, 2024). In eye care, the allowance detail that decides the sale, frames, lenses and contact lenses, comes from each vision plan's own provider portal, which is the $4.50 tier, and the exceptions end up on the phone, which is the $12.95 tier.
The time shows up on the phone. In MGMA's March 2026 poll of practice leaders, eligibility and prior authorization accounted for 45 percent of staff phone call time, the largest single category, ahead of scheduling at 31 percent (MGMA Stat, 2026). And it shows up in denials: the Optum 2024 Denials Index found that 24 percent of denials were caused by registration and eligibility, up from 2022, with 44 percent of all denials originating at the front end (Optum, 2024).
None of this is hard work. It is repetitive, portal based, detail heavy work that has to be finished before the schedule starts, which is precisely the work a front desk cannot finish while checking patients in.
An EyeCareWorks verification assistant works your schedule two days ahead, in your practice management system, and documents the answer where your team will see it at check in.
Practices searching for vision insurance eligibility software usually find three kinds of answers. Each is a fair choice for a different practice.
| Factor | Eligibility software | Verification service | Verification virtual assistant (EyeCareWorks) |
|---|---|---|---|
| Pricing model | Monthly subscription per practice or location; one optometry focused tool lists plans at $199 to $299 a month, with per user and per location add ons (EligiVue) | Weekly rate per specialist; one eye care service lists $299 to $399 a week (published pricing) | Flat $10 an hour for tracked hours, billed weekly, no contracts; part time seats available |
| What it covers | The portals it integrates with; exceptions go back to your front desk | Verification only | Verification, plus prior authorizations, recalls, confirmations and phones in the hours that remain |
| Who handles the exceptions | Your staff | The vendor's team | The same assistant, by phone, the same day |
| Where the data lands | The software's dashboard, sometimes synced to your PM system | The vendor's report | Directly in your practice management system, in the field your team already reads |
| Best for | High volume practices with mostly standard plans | Practices that want verification and nothing else | Practices that want one person who owns verification and can also cover the front desk |
BLS Occupational Employment and Wage Statistics for May 2025, as reported by O*NET, put the median wage for a medical secretary at $22.08 an hour and for an insurance claims and policy processing clerk at $23.67 an hour (O*NET, 43-6013, O*NET, 43-9041). Those are wages before payroll taxes, benefits and recruiting. An EyeCareWorks verification assistant is a flat $10 an hour for tracked hours, billed weekly, with no setup fees, no contracts, and a free replacement if the fit is wrong.
Every assistant holds a HIPAA Certificate of Completion, passes a background check, and signs a Business Associate Agreement directly with your practice before any portal or system access. Work happens over an encrypted remote session into your own systems, with individual credentials, multi-factor authentication, and no patient data stored on the assistant's workstation. Time and activity are tracked to the minute. The full arrangement is on our HIPAA compliant virtual assistant page.
No contracts. No setup fees. Cancel anytime.
Works your schedule two days ahead in your practice management system, verifies vision plan and medical eligibility and benefits for every patient, documents the routine versus medical determination, captures frame, lens and contact lens allowances, flags prior authorization needs, and calls the plan or the patient when the portal does not have the answer.
VSP through Eyefinity and VSPOnline, EyeMed through the provider portal, Davis Vision through iDoc, Spectera, and the other plans you are contracted with, plus Medicare and commercial medical payers. Assistants are trained on the eye care portals before placement.
Two business days ahead as the standard, which leaves time to call a plan, correct a patient's coverage on file, or start a prior authorization before the visit. Same day add ons are checked as they are booked.
They solve different problems. Software returns what the connected portals return, quickly, and hands exceptions back to your front desk. A verification assistant handles the exceptions, calls the plan, updates the patient, and documents the answer in your system, and can cover prior authorizations and phones in the remaining hours. Many practices run both.
A flat $10 an hour for tracked hours, billed weekly, with no setup fees and no contracts. Part time seats are available for practices that only need the schedule verified. For comparison, the BLS May 2025 median wage is $22.08 an hour for a medical secretary before payroll costs, and one eye care verification service lists $299 to $399 a week per specialist.
Into your practice management system, in the field or note your front desk already reads at check in, so nothing has to be looked up twice. Reports of what was verified and what needs attention come to you weekly, or daily if you prefer.
Every assistant holds a HIPAA Certificate of Completion and signs a Business Associate Agreement directly with your practice. They work over an encrypted session with individual credentials and multi-factor authentication, and no patient data is stored on their workstation.
A short call to list your plans and portals, decide the documentation format your team wants, and set the first week's schedule.
