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Thread: Spectera?

  1. #1
    Bad address email on file
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    Crier Spectera?

    Any Spectera providers out there?
    My office recently had a rash of calls asking if we participated, some of our Eyemed and Vsp pts had there plans change. We decided to join there panel but damn amd I getting sick of sending them checks. They make there own glasses and charge quite the fee. At least with Vsp there is a profit margin. It is appearing our only salvation with this insurance is multiple pairs and possible non spectera refferals. I hate to say it but this might quite possibly be the junkiest insurance I have ever seen. So any opinions on the ins? Any tips to maximize?

  2. #2
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    RUN-- don't walk!-- away from Spectera

    Dealt with it several years ago so maybe its changed but from your post I doubt it. We nicknamed the display case "The Coffin". The only thing cheaper than the wooden box it came in was the product itself!! Attracted patients who's only concern was price. Bookkeeper determined at best we broke even. Nutshell- not worth the headache :o

  3. #3
    What's up? drk's Avatar
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    Just say "NO" to Spectera. Just got a solicitation to be a provider today.

    Tell members that you can't be a provider and provide the quality of care you are used to providing.

    Tell them that they can see you "out of network" and submit themselves for reimbursement for out-of-pocket expenses.

    I was going to post the fee schedule, but I probably shouldn't, it's so obscene.

    Suffice it to say that while they reimburse slightly less unfairly for a comprehensive eye examination, they reimburse an such an absurdly low amount for CL services and materials, I shudder to think of the quality of care that is provided for that pittance.

    The most absurd fee schedule item is the "spectacle dispensing fee", which is vanishingly small. You'd lose money in the amount of time invested that it takes to say "hello", let alone measure, adjust, trouble-shoot, etc, etc. (all the "valuable" professional optical services that make a good optician.)

    Hey, they'd reimburse more to providers if no one signed up! Just a thought!

  4. #4
    Optical Clairvoyant OptiBoard Bronze Supporter Andrew Weiss's Avatar
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    Another "no" vote from Uncle Fester's compadre . . .

    We recently got news that United Health Care and Harvard Pilgrim have hooked up with Spectera through a program called "Passport." Beware: if a patient has Passport and is covered through Spectera, and if you are not an optometrist on the Spectera program, you cannot be paid by the patient's health insurance for an eye examination, even if the patient has a referral!

    Another good reason to keep your distance . . .

  5. #5
    OptiWizard
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    Pays less than medicaid with more paperwork, we have to sell you unnessary add ons to keep from losing money.

    That's what we tell patients who complain we don't take some of the low end plans.

  6. #6
    Rising Star
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    Quote Originally Posted by harry888
    Pays less than medicaid with more paperwork, we have to sell you unnessary add ons to keep from losing money.

    That's what we tell patients who complain we don't take some of the low end plans.
    It was my impression that you don't get paid by Spectera, even for the necessary add ons.

  7. #7
    What's up? drk's Avatar
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    Quote Originally Posted by AEOC
    It was my impression that you don't get paid by Spectera, even for the necessary add ons.
    A cursory read of the last fee schedule says you keep, as a service fee, 20% of the fee for the upgrade.

    I think this is where the "check cutting" to Crown via Spectera begins. At least VSP withholds it from your reimbursement. I don't think there's enough reimbursement to withhold "lab fees" from with Specterrible.:finger:

  8. #8
    What's up? drk's Avatar
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    I just checked to see if Specterrible members have an out-of-network benefit. The phone lady said it depends on the group.

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