One package, many lenses
Payer packages price the procedure with a standard lens. Premium lenses ride as patient top-ups — legitimately, when the choice is documented before surgery with the price gap signed. Undocumented, the same top-up reads as overbilling.
Bilateral timing
Same-sitting versus staged bilateral surgery is priced differently across payers and schemes. The scheduling decision is a payer-rules decision as much as a clinical one; check before listing.
| Item | Standard | Consequence / owner |
|---|---|---|
| Lens class chosen | Documented, price gap signed | Pre-op, always |
| Package vs top-up split | Stated on the estimate | Billing |
| Bilateral plan | Payer rules checked | Scheduling |
| Day-care format | Timestamps + tariff | File assembly |
| Post-op medication | Package inclusion verified | Pharmacy + billing |
Day-care by default
Cataract is the archetypal day-care procedure. The file should look like one: three timestamps, day-care tariff, discharge same day — inpatient-styled cataract files invite queries they never needed.
What to do on Monday
- Create the signed lens-choice form with the price gap.
- Print your top payers’ bilateral rules for the scheduler.
- Move cataract billing to the day-care template.
Worked examples on this page are illustrative arithmetic on stated assumptions, not measured market statistics.