Research on Convergence Insufficiency: Insurance Companies Fail to Think of the Welfare of their Customers

It is important that we know and understand this research for our patients' benefit. The research clearly shows that in-office optometric vision therapy is the most efficacious treatment for convergence insufficiency. Major insurance companies are denying in-office vision therapy unless you conduct out of office/home therapy first. This rational for the patient having 12 out of office vision/home based therapy sessions before in office therapy is inappropriate, unsubstantiated by research and potentially harmful to our patient's well being and quality of life.They are recommending the least effective, most time consuming, and costly methodology of treatment. I respectfully request that these insurance companies reconsider this ill advised policy immediately.

If you are a patient reading this, go to your employer and ask them to support vision therapy by telling your insurance company to do no harm, to waste no money, and to support treatments shown to be effective. DM

Tags: convergence, insufficiency, insurance

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Comment by Dominick M. Maino, OD, MEd, FAAO on June 19, 2012 at 10:33am: Dr. Fortenbacher.... My next step is to bring this policy to the attention of the insurance board in Illinois and the Illinois Optometric Association. Obviously this policy has the potential to harm the patient, to be quite costly, and to extend any treatment program beyond what is necessary. It is also against dictates of the Gold Standard of practice and flies in the face of clinical trial outcomes. It is utterly unacceptable. It is my hope that COVD and OEPF will also immediately act on this bad health policy as well.

Frances...as far as vision therapy at home...yes the pt receives instructions from the doctor often in writing and verbal. I do not know if the visit is paid for by the insurance company. I do not know how the insurance company knows if the home therapy has been done. They are using this as an excuse to make this care less accessible...and so they do not have to pay. It is the patient, the consumer who has power here....usually thru their employer....the person who pays for the insurance. Each individual must get that person/company to complain to the insurer...and must send complaints to the right governmental/oversight body.

Comment by Dr. Dan L. Fortenbacher on June 19, 2012 at 12:12am: Dr. Maino,

Thank you for sharing this post. It is a real problem that has recently emerged. I have seen several patients recently whose insurer, including Blue Cross Blue Shield, has stated in writing that they will only cover a home-based vision therapy program like you described above. Even though I have fought on behalf of my patients in the appeals process, showing them the research papers that conclude that home-based vision therapy is no more effective than a placebo, the insurance insists on putting the patient through the delay of effective care, the added stress upon the family to become their own "doctor" and work at a program to heal thyself. It makes one wonder why bother with research in health care when the insurance company will dictate to the patient treatment that has either been unproven or this case, proven to be ineffective for the majority of patients who are given it?

Comment by Frances McIntosh on June 18, 2012 at 9:54am: This sounds odd. Does the patient receive instructions from an optometrist? If so, is *that* visit payed for by the insurance company? How does the insurance company know that the sessions have actually been conducted?

Frances (Whose therapy is being covered...)

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