Policyholder Services



I would like to use the Implantable Miniature Telescope for treatment of macular degeneration. Do I need a special endorsement on my policy?

Treatment of macular degeneration with the Implantable Miniature Telescope is automatically included within OMIC’s standard Surgery Class 3 rating classification. No special endorsement or underwriting approval is required.

The Implantable Miniature Telescope received FDA approval in June 2010 for monocular implantation to improve vision in qualified patients with end-stage age-related macular degeneration (AMD). This device, which replaces the natural lens, improves central vision in the implanted eye by providing an image that has been magnified more than two times. The non-operated eye provides peripheral vision.

To qualify for the implant, patients must meet all of the following conditions in accordance with FDA guidelines:

  • Be age 65 or older;
  • Have stable, severe to profound visual impairment (BCVA 20/160 to 20/800) caused by bilateral central scotomas associated with end-stage AMD;
  • Have retinal findings of geographic atrophy or disciform scar with fovial involvement, as determined by fluorescein angiography;
  • Have evidence of visually significant cataract (greater than or equal to Grade 2);
  • Agree to undergo pre-surgery training and assessment with low vision specialists in the use of an external telescope;
  • Achieve at least a 5-letter improvement on the ETDRS chart with an external telescope;
  • Have adequate peripheral vision in the eye not scheduled for surgery;
  • Agree to participate in postoperative visual training with a low vision specialist; and
  • Complete an Acceptance of Risk and Informed Decision Agreement.

 

Effective October 1, 2011, CMS established a transitional pass-through billing code for the device to enable outpatient facilities to obtain reimbursement for the implant for covered procedures. Eligible patients must have associated central vision blindness and either have stopped responding to AMD medications or have a form of the disease for which no treatment is available.

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Six reasons OMIC is the best choice for ophthalmologists in America.

#3. Best at defending claims.

An ophthalmologist pays nearly half a million dollars in premiums over the course of a career. Premium paid is directly related to your carrier’s claims experience. OMIC has a higher win rate taking tough cases to trial, full consent to settle (no hammer) clause, and access to the best experts. OMIC pays 25% less per claim than other carriers. As a result, OMIC’s base rates have consistently averaged approximately 15% lower than multispecialty carriers in the U.S.

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