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  1. #1
    OptiBoardaholic
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    VSP and Costco

    One of my frame reps is visiting and just let me know that Costco and VSP have signed a deal to work together.
    Has any one heard more on this?

    Add to that with Safilo and Marchon selling direct to Costco ... Pennies on the Dollar ...

    ... Great ...

    Sphinx
    Last edited by Sphinxsmith; 07-23-2010 at 11:50 AM.

  2. #2
    Optician Extraordinaire
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    No, I hope it isn't true.

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    I actually like this. You should be allowed to use your insurance anywhere without having to worry about being in-network. But this deal will really suck for the private practice. Well hopefully Costco will cross-train all their cashiers and cart pushers as opticians for all the business they will get.

    Sidebar:
    What is the rule between membership and insurance? If I remember correctly you(the store) cannot deny a guest or member their right to use insurance(that your store is in-network for) to where their insurance would be relevant. If I am correct, that is why Sam's Club or Costco cannot deny you the use of their pharmacy or optometrist.

  4. #4
    ABOC-NCLEC tigerlilly's Avatar
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    Quote Originally Posted by Leonazium View Post
    Well hopefully Costco will cross-train all their cashiers and cart pushers as opticians for all the business they will get.
    Considering that Costco is the only national optical retailer that requires ABO and NCLE certification of its opticians, even in unlicensed states, I don't see this happening. I don't think membership and insurance ahve anything to do with one another, either. You do need a membership to buy contacts or glasses, and none of the Costcos near me take any insurance.

    I keep hearing all these VSP + Costco= BFF rumors, and I just don't believe it. I thought it turned out there was one particular VSP plan in one particular location serving one particular employer, rather than some sort of a widespread rollout of Costco as a new VSP provider? Particularly since the doctors are independent and control which insurance they take (if they choose to take any at all), I don't see how an agreement would work all that well.

  5. #5
    Doh! braheem24's Avatar
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    Costco is not doctor owned, allowing them to be in-network providers would be a good precedence for opticians.

  6. #6
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    You no longer have to be doctor owned to be a VSP provider. This long time rule was quietly dropped last year. No reason opticians could not be providers as well one would think.

  7. #7
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    Quote Originally Posted by cocoisland58 View Post
    You no longer have to be doctor owned to be a VSP provider. This long time rule was quietly dropped last year. No reason opticians could not be providers as well one would think.
    Sorry, not true. They denied my office (3 months ago) when the OD tried to sign up. They sited the OD owner clause.
    Ophthalmic Optician, Society to Advance Opticianry

  8. #8
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    Quote Originally Posted by Johns View Post
    Sorry, not true. They denied my office (3 months ago) when the OD tried to sign up. They sited the OD owner clause.
    No doubt only because you are too small to buy enough Marchon product (or boycott said product) to make them bend their rules.

  9. #9
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    Quote Originally Posted by cocoisland58 View Post
    No doubt only because you are too small to buy enough Marchon product...
    Yeah...that's probably it.
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  10. #10
    Optiboard Professional Bill West's Avatar
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    Quote Originally Posted by Johns View Post
    Sorry, not true. They denied my office (3 months ago) when the OD tried to sign up. They sited the OD owner clause.
    Ouch! Hey friend, are you fixing to give up the ship and sign on with these optical pirates? Guess things are getting tough all around. I wish you the best however you choose.
    Your friend, the original O.D.,[ Optical Devil ]

  11. #11
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    Quote Originally Posted by Bill West View Post
    Ouch! Hey friend, are you fixing to give up the ship and sign on with these optical pirates? Guess things are getting tough all around. I wish you the best however you choose.
    Your friend, the original O.D.,[ Optical Devil ]
    No, not at all. However, I just opened up 2 new offices, and I have the same OD working both of them. Although he is booking nicely, he thought he had more room on his schedule, so he thought he'd add "another 3rd party plan". Little did he know that this is not just "another 3rd party plan".

    It was actually humorous to watch him sputter when they told him that he couldn't be on the panel due to his association with me...an optician! I told him the problem could be easily remedied by simply giving me $200k (I gave him the discounted rate:bbg:) and taking over ownership of the practice. He wasn't amused.
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  12. #12
    Optiboard Professional Bill West's Avatar
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    Quote Originally Posted by Johns View Post
    No, not at all. However, I just opened up 2 new offices, and I have the same OD working both of them. Although he is booking nicely, he thought he had more room on his schedule, so he thought he'd add "another 3rd party plan". Little did he know that this is not just "another 3rd party plan".

    It was actually humorous to watch him sputter when they told him that he couldn't be on the panel due to his association with me...an optician! I told him the problem could be easily remedied by simply giving me $200k (I gave him the discounted rate:bbg:) and taking over ownership of the practice. He wasn't amused.
    WHEW!!!! Shame on me for even thinking you would do this. Hey, he can buy me out for less but I've always been CHEAP or is that CHEEP?

  13. #13
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    This is a confirmed rumor. VSP is downplaying it as merely a test with several (as many as 8) clients. They lost a large corporate client to Davis, and the reason given was that their members desired access to more retail locations with 'Sunday' hours. Having worked commercial, I call BS on the Sunday thing, but that's what has come out so far. They hope to show that members are not seeking retail or Sunday services.

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    So the latest Ive heard on this is that VSP is loosing contracts to Eyemed/Lux because their clients want more retail options.
    VSP is test-bedding it with Trader Joes and Costco right now. If the client decides to go to Costco then they will have their benefit available though diminished.
    Also Ive been told that Marchon is not selling current product to Costco direct.

    That's the latest scuttle-butt so take for what it's worth.

    Sphinx

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    Here's the scoop... VSP got the Trader Joe's account by agreeing to allow Costco to file claims on behalf of the patient. At Costco, the patient will receive a higher out-of-network benefit. Costco is NOT in-network.

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    OptiWizard OptiBoard Bronze Supporter pezfaerie's Avatar
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    All I can say is that there's a program through Marchon that allows them to act as in-network providers and they can tell the pt "yes we accept VSP" but their reimbursement is much less than that of an in network VSP provider. And the Costco 30miles away from here takes VSP so I don't think its much of a rumor anymore.
    Pez:D

  17. #17
    ABOC-NCLEC tigerlilly's Avatar
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    Quote Originally Posted by inslady View Post
    Here's the scoop... VSP got the Trader Joe's account by agreeing to allow Costco to file claims on behalf of the patient. At Costco, the patient will receive a higher out-of-network benefit. Costco is NOT in-network.
    There used to be an arrangement with VSP that allowed Costco to provide patients with a form that would enable them to get a higher reimbursement rate. This is not a new thing - who knows how long it went on? - but VSP got shirty and demanded an end to that a while back. If that's what's going on with Trader Joe's, then this rumor is not all it's cracked up to be.

  18. #18
    OptiBoardaholic a1vo's Avatar
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    Oh! That's why now I can send in CMS1500 to VSP and get paid directly and I do not need to ask my "out-of-network" VSP patients to pickup their eyeglasses AFTER they receive the VSP check.

    Haleluya
    Paul @ Silicon Valley California

  19. #19
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    Quote Originally Posted by a1vo View Post
    Oh! That's why now I can send in CMS1500 to VSP and get paid directly and I do not need to ask my "out-of-network" VSP patients to pickup their eyeglasses AFTER they receive the VSP check.

    Haleluya

    But how would you know how much VSP reimburses to calculate how much the patient needs to pay beyond what is covered? Each plan reimburses a little differently, don't they? Besides, I thought all out-of-network payments go directly to the patients, not providers.

  20. #20
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    Quote Originally Posted by Eyeball View Post
    But how would you know how much VSP reimburses to calculate how much the patient needs to pay beyond what is covered? Each plan reimburses a little differently, don't they? Besides, I thought all out-of-network payments go directly to the patients, not providers.
    "patients to pickup their eyeglasses AFTER they receive the VSP check."
    It looks like this is VSP's way of weaning the patients away from the traditional type (OD) providers. And why not? If VSP can reimburse a lower rate to the pt. then they would to an OD, that's more money in their pocket. If they can give even less to Costco, and less still to Frames Direct, why in the world would they promote their panel ODs?

    I see this as phase 3 (of 5). The traditional VSP providers were the vehicle to capture market share. For the most part, that has been accomplished. Now, the search (and they don't have to search far) for avenues that will net them more profit is on. Non traditional providers (lowest overhead) are lined up ready to take over.

    I'd hold the "Haleluya"...unless of course you are Costco, or Frames Direct.
    Ophthalmic Optician, Society to Advance Opticianry

  21. #21
    OptiBoardaholic a1vo's Avatar
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    Quote Originally Posted by Eyeball View Post
    But how would you know how much VSP reimburses to calculate how much the patient needs to pay beyond what is covered? Each plan reimburses a little differently, don't they? Besides, I thought all out-of-network payments go directly to the patients, not providers.
    Well, VSP rep now tell me how much they pay (to out-of-network providers like us) over the phone. This is different. In past they won't even talk to us.

    I just did my first CMS 1500 claim to VSP about 2~3 weeks ago. Unfortunately, the check still went to the patient's home probably because VSP do not have my tax information on file yet. Hope that the next check will come to my store.
    Paul @ Silicon Valley California

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    Had not heard as fact they were allowing Costco to be in network... thanks for the info.

  23. #23
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    I would go out on a limb here and say that in a few years if not less anyone but anyone who cares to jump on the VSP wagon will be welcomed with open arms. As of this year there are two chains (yes corporate chains and one is multi-state) that are VSP providers and are allowed to use their own private labs. One of these is owned by ODs who still do not work the required hours in their offices (or any office for that matter) that the contract states is necessary and the other is owned by a medical conglomerate hospital system. VSP has no allegiance to private practice believe me.

  24. #24
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    Quote Originally Posted by cocoisland58 View Post
    I would go out on a limb here and say that in a few years if not less anyone but anyone who cares to jump on the VSP wagon will be welcomed with open arms. As of this year there are two chains (yes corporate chains and one is multi-state) that are VSP providers and are allowed to use their own private labs. One of these is owned by ODs who still do not work the required hours in their offices (or any office for that matter) that the contract states is necessary VSP has no allegiance to private practice believe me.
    So then you're familiar with the court case that was filed against VSP due to them having initially dropped this OD from their panel and how the courts in one state ruled against VSP and forced them to reinstate the practice in their home state ? Doesn't sound like you are. It's an interesting court ruling.
    Last edited by racethe1320; 09-28-2010 at 07:46 PM.

  25. #25
    Master OptiBoarder OptiBoard Silver Supporter Jubilee's Avatar
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    Ok.. I have no horse in this race. I am a managing optician of a practice who happens to do 90% of the insurance stuff. If I were an OD, I would also be waving the VSP flag. I know my rep will drop here in mere minutes because through my husband's employer (fed) we have VSP as well.

    The reimbursements we receive from VSP signature plan far exceeds what we receive from the average Eyemed plan. The exam portion alone is $xx more. Single vision lenses, my dispensing fee from VSP is higher than the reimbursement from Eyemed, though I have to pay for the cost of goods through Eyemed. When you upgrade from the basic there is a chance you can make more money, however it all depends on your ability to control the cost of goods. In essence, my belief is that the IOF program is to allow us to make up the differential in those costs, if we are willing to do some of the work ourselves. The info I heard was the cost of the lenses were on par with the major stock houses, and the main reason they require you to buy them from VSP was make sure you gave that patient the poly with advance, not the somo with generic AR.. though you charged them for a cat D ARC. I am sure that another factor was that it would help offset some of the additional provider reimbursements by having us give them money back in return. ..

    As a client, I like VSP because they offer more for their plans. Sure, I pay $10 more a month to have VSP compared to Davis or Specterra. I am also a lot more confident in the product, and my costs in the end are significantly less. (Even if I were paying the full copays ;) !)
    $xxx for a FF lens, compared to 80% of U&C -$xxx. In most offices their would be a significant cost difference both to the patient and to the provider. My FEP plan covers photo, poly, ARC, and many other options for that $120 more a year. Davis charges for each of these items. Manufactures them in their own lab, to provide a reduced warranty compared to the manufacturer's warranty.

    In some of the more recent Eyemed plans, they now have set copays for certain progressives. Usually they are about $10-15 more compared to VSP's copays. However on a Panamic I can't make nearly as much money selling it for their price and paying for the cost of goods, compared to collecting a straight dispensing fee for the pal. We support VSP because we make more with VSP. They are also a lot easier to deal with on things too. If I were truly independent.. I would probably feel a lot different about it :)
    Last edited by Jubilee; 09-29-2010 at 06:44 AM. Reason: For some reason thought this was on pros forum and had pricing on it. So took figures out. bah
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