Volume I Issue 20

Originally published, May 20, 2001

Independence Blue Cross pays for LASIK

Blue Cross of Pennsylvania offers laser vision correction as a benefit to select employers and their employees. Is this a blessing or a curse?

Area’s largest health insurance carrier adds LASIK to its list of covered services

EDITORIAL
by James S. Lewis, MD

In the last few months nearly a dozen discount LASIK corporations have declared bankruptcy. Employees were fired, doctors were left unpaid, and lasers were repossessed. Patients who gave these companies deposits where stranded without surgery, without a doctor, and without legal recourse.
In my opinion, this is the result of a LASIK price so low it makes quality care impossible. iHateMyglasses.com has always charged $2500.00 for both eyes, lifetime enhancements, and a year of post-operative examinations. This cost allows us to provide excellent staff, state-of-the-art equipment, and top surgical talent. We know we couldn’t have charged less without cutting corners. While I am Medical Director, that just isn’t going to happen.
I welcome the help insurance companies can provide but I worry they will fall victim to the same problems that befell those now defunct LASIK companies. Worse, they may be forced to restrict patient choice in order to compete for corporate contracts.
In my experience, LASIK patients are highly motivated, well informed, and driven to find the best doctor, the best staff, and the best equipment available.
I have researched the experiences in South Carolina, Idaho, North Carolina, and South Carolina involving independent Blue Cross companies. In most cases, exclusive arrangements were made. Patients could not choose their doctor, they could not select their laser, and they could not select the location for their care.
Many of the exclusive arrangements were made with corporations who used lasers that were transported daily by truck. These extremely delicate machines would arrive at a specific location once a week or once a month for surgery. Often a small group of surgeons provided care for an entire state.
Employers who were generous enough to offer this “rider” in their Blue Cross policies may not have realized what they were getting for their employees.
In my experience, patients go to a LASIK provider based on reputation, experience, community standing, and references from family, friends, and co-workers. This can not occur when Blue Cross or any other insurance company makes exclusive contracts with corporations.
Joseph Bilson, Director of the Wills Eye Surgical Network told me he was asked by Independence Blue Cross to charge their patients half his established price. “I sent them packing”, he told me by phone. Mr. Bilson and the Wills Eye Surgical Network have a strong commitment to quality care in LASIK and all areas of Ophthalmology.
Another internationally known LASIK provider was approached by Blue Cross. Reputedly, he politely showed them the exit.
Employers can best help employees who desire LASIK by encouraging flexible medical savings accounts or providing credit or loan programs.
When it comes to LASIK, patients know there are differences among surgeons, equipment, and staff. When an insurance company or employer provides benefits to retain and attract outstanding personnel they must recognize the importance of choice.
I have spent the last six weeks trying to speak with someone in authority at Blue Cross. Only today was I allowed to speak with Dr. Kerr, National Director of Network Services. He was unable to shed additional light on their plans.
I recommend all patients contact their insurance company and their benefits counsellor.
When the Ophthalmologists in Tennessee exposed the facts to their political leaders, Blue Cross withdrew from its participation in LASIK entirely. We can learn something here.

Explanation of medical benefits sent to James S. Lewis, MD showing multiple errors, inconsistencies, and omissions by Blue Cross.

claims to major medical require PTM code: S0800-RT and S0800-51LT along with an ICD 9 code 367.1

Call member services TODAY. Check your LASIK benefits.
turn your card over to find the telephone number

Volume I Issue 19

Originally published, May 13, 2001

Is there something better than LASIK?

STAAR Surigal’s Implantable Contact Lens. This UV-absorbing lens is constructed of a biocompatible material known as collamar.

Implantable contact lenses may replace laser vision correction in special cases

Intraocular lenses (IOLs) have been used for years following the removal of cataracts. New designs have been recently developed for patients who do not have cataracts.
These IOLs provide an alternative to LASIK for the correction of refractive errors. In some severe cases these IOLs can be used in conjunction with LASIK. (This concept is known as bioptics.)
Staar Surgical has been developing their Implantable Contact Lenses (ICL) for several years.
In August, 2000, Dr. James Lewis and three other US surgeons travelled to the Centro de Microcirugia Ocular y Laser in Santo Domingo for special training with this implant. Under the direction of Juan Batlle, MD, Dr. Lewis became one of a handful of surgeons certified in the use of the Implantable Contact Lens.
“LASIK changes the shape of the cornea. The ICL can correct patients we can’t help with laser surgery”, Lewis claims. “It is possible that the ICL might be a better choice for some of the patients we now treat with LASIK.”
Under the direction of the Internationally respected refractive surgeon, Juan Battle, MD, Dr. Lewis performed four ICL procedures in August, 2000. All patients were extremely nearsighted and could not benefit from LASIK. The power of the ICL used in one surgery shown at the right was minus 19.5 diopters. Standard intraocular lenses powers range from plus 6 to plus 32 diopters!
“As ICL technology improves we may find that it encroaches on the higher refractive errors we now treat with LASIK”, Lewis continues. “Once the FDA approves this technology an even greater segment of the population will benefit from refractive surgery.”
Ciba Vision recently obtained exclusive marketing rights for Medennium’s Phakic Refractive Lens (PRL), a competitor of Staar. The founder of Medennium, George Rozakis, MD, of Cleveland, Ohio, is the driving force behind the PRL.
Almost twenty years ago Dr. Lewis and Dr. Rozakis were Ophthalmology residents together at the Duke University Eye Center in Durham, North Carolina. They have collaborated on a number of projects during the last two decades.
“George has always been a visionary. This was true in the early 1980’s and it is true today. I think his PRL has major implications for refractive surgery”, Lewis commented.
Several other companies throughout Europe are working on similar technologies.
The LASIK surgeon of tomorrow may have several additional tools at his or her disposal for the correction of refractive errors.

Myopic eyes (nearsighted) are too long. Without correction, objects focus before the retina and appear blurred.

Implantable contact lenses may replace laser vision correction in special cases

Medennium’s Phakic Refractive Lens also corrects refractive errors when placed behind the iris.