VSP fee filing question

[snowmonster]

I'm looking to raise our prices will also need to do the VSP update thing.

I always get confused with VSP though. When they ask for your U&C price and average cost (from a lab) for CR39 in SV, FT, TF and PAL, are you wanting your calulated markup (U&C - cost from lab) to be higher or lower to get you a higher reimbursement?

Thanks!

[Jubilee]

Higher markup. They base their payouts on a flat percentage of your U&C. They have a max cap for each area.. but if enough people show similar or at least higher markups than their cap, they will raise it.

[opticat]

For VSP your Usual and Customary should be high. Remember you can charge $500 for an exam to all your patients but each Insurance VSP, Eye Med, United Health CCare, Aetna, etc will only pay on the contracted rate. For your cash customers- not using any insurance you can discount whatever you like. Your Exams fee and all product fee must be the same across the board to everyone, Itf your VSP exam billed is $500 VSP will only pay you the make for your area less the copay if anyponsible for the difference.

[cocoisland58]

When you update your fees you should have your regular lab's price book in hand. Even if you are at a discounted rate use the top price that they charge for a lens and then calculate your retail fee as if you did pay that top price. I just re-did ours and the difference is going to add up pretty quick.

[snowmonster]

When you update your fees you should have your regular lab's price book in hand. Even if you are at a discounted rate use the top price that they charge for a lens and then calculate your retail fee as if you did pay that top price. I just re-did ours and the difference is going to add up pretty quick.

This contradicts Jubilee's statement that you want your profit to be as high as possible. In her example, you want to give the lower of the rates your paying for lenses.

Any comments?

[Jubilee]

When I attended a VSP seminar and this topic came up, the representitive focused on the mark-up. If you think about it, cost of the lenses doesn't really matter to them, cause they use their own negotiated rates anyway. It is the markup that represents what your usual profit is, and thus will calculate your "dispensing" fee.

I redid ours early this year. I used our typical Lens cost, and our new rates..making our usual lens mark up almost 1.5 times what it was since the last update (3 years ago)

The difference is adding up quite quickly. We are averaging about $25 more per patient...

Cassandra

[1968]

This contradicts Jubilee's statement that you want your profit to be as high as possible. In her example, you want to give the lower of the rates your paying for lenses.

Any comments?

I agree with Jubilee. In order to get the highest reimbursement, you want to provide VSP with the lowest price you pay.

[cocoisland58]

I thought you might want them to consider the higher wholesale. Our dispensing fees went up when I did this.

[snowmonster]

I thought you might want them to consider the higher wholesale. Our dispensing fees went up when I did this.

But did you also raise your prices when you did this?

[optical24/7]

All this is what infuriates me with VSP. My last office took VSP for about 7 years (we droped it in 2001). We had no idea that you must do a song and dance to get reasonable reimbursement. They make no allowance for an office that already discounts, to a degree, their services. They cut you xx percent on a reimburesement. Back then, they were giving us almost half what other offices in our area were getting from them. They sure don't reward you for effciency! I am so glad I don't take it here.

[1968]

I thought you might want them to consider the higher wholesale. Our dispensing fees went up when I did this.

If you look at your filed fees over multiple years, I think you will find that they reimburse you a certain percentage of your U&C dispensing fee... up to a certain amount.

They sure don't reward you for effciency!

No, they don't. To an extent, I have figured out VSP's song and dance and I would say it has contributed to the increase of fees in our office.

[cocoisland58]

But did you also raise your prices when you did this?

For some things yes. This was part of an overall price change on certain items and services that was overdue. Many things stayed the same or very close to the same. Exam price was raised.

[obxeyeguy]

This tread has really re-inforced to me why I don't take VSP. They seem to make it so difficult that even you guys and gals that take it can't seem to figure out how to get paid what you should.

[Johns]

This tread has really re-inforced to me why I don't take VSP. They seem to make it so difficult that even you guys and gals that take it can't seem to figure out how to get paid what you should.

Well maybe, but don't stop posting. I'm sure VSP is hanging on every word to see how they can close the loopholes even more.

[snowmonster]

I don't think it's that complex, I'm just making sure I've got it right in my head. I think we're already maxing the reimbursements out, but we need to keep posting our charges so we can eventually get better reimbursements.