With the new provider agreement are we able to use our own lab or do we have to continue to use the Spectera lab.
Jeramy
With the new provider agreement are we able to use our own lab or do we have to continue to use the Spectera lab.
Jeramy
We have always used our in house lab where I work.
We received the new provider agreement on Monday. There was provider training by conference calls dated in August and in September. Is someone in the federal government running Optum Vision/Spectera?
The Optum Vison folder the agreement came in shows the new flashy Optum Vision logo, everything inside says Optum Vision but on the page to sign the agreement
it has a heading above the signature that says Spectera, Inc. IS IT SPECTERA OR OPTUM VISION?
The big question is why are you guys even looking at a provider agreement? Seriously?
I want to make more money.Originally Posted by IndianaOD
Was that sarcasm? Seriously why do providers sign up for such terrible plans? You realize that squeezes out the better plans.
I currently only take Spectera for the exam and contacts. But if I can start doing the glasses and make money at it I will. Spectera as its currently set up is the worst.
Like the ones opticians aren't allowed to take? I believe this quote was in reference to your VSP rep:
I think that's reason enough to sign on for them. I've been taking Spectera, using my own lab, and actually making a pretty good profit (it's how you buy, not sell:bbg:). Plus, to add icing to the cake, in 2007, I approached 2 local companies (700 employees total) and talked them out of VSP and on to Spectera.
Guess who the only provider is for 30 miles?
Squeeze out BETTER plans? Now that's funny!:bbg:
Ophthalmic Optician, Society to Advance Opticianry
I was told by Spectera that I had to have 5 stores to do my own lab work. So huh.
You can always band together w/other opticians. (You've got to be creative, but it can be done...) The nicest thing about the plan is that there are very few providers, so you it's like having your very own 3rd party plan.
I've had families drive 45 minutes to come to our office because, "We had a heck of a time finding anyone that takes this!"
Ophthalmic Optician, Society to Advance Opticianry
Boy this is not an ideal world,.. but you can often make the most money from the suckiest plans. But in the end, you've got to do justice to the patient or they will see through you.
:cheers::cheers::cheers:
Does Spectera pay within a half year of submission of the claim?
Yes they actually do because it's only like a nickle.
No they dont!
You always end up owing them money!
VSP is no saint but good lord its amazing compared to Specterrible.
If the only way you can attract patients is by taking terrible plans and low cost you suck at the business to begin with.
From the plans I have seen VSP will pay you better out of network than Specterrible will pay you in network.
:cheers:
I couldn't agree more! And yes, I've heard that many ODs say that about their colleagues that take VSP. I guess the true professionals don't have to take insurances.
What category do you fall under? (After all, "terrible plans" are all relative.)
:cheers:
Ophthalmic Optician, Society to Advance Opticianry
If you have a software setup that autocalculates the discounts, Optum can be an easy plan to bill. If you have to do it by hand..good luck
The only way to make money off of Specterrible is to do the job yourself and collect the copays, or sell a frame that Specterrible can't provide on its own. And you have to do quantity, as you can't provide quality at their paltry reimbursements and horrible "lab".
As it is, Specterrible and Davis are fighting it out to claim the award for $hittiest vision plan. They seem to keep one-upping each other lately.
You guys do realize that Spectera with the new contract is going to start taking a percentage of overages. This will be on frames above the 130 allowance and on premium lens upgrades. I can't take this considering it is my lowest payer. I just feel if we allow this to happen, it will start here and move to other plans.
Maybe I am missing something and you guys know how to make something from Spectera (hope so!), but what I see is that any Spectera scheduled fees you collect from the patient are charged right back to you from Spectera, minus an insulting dispensing fee. This means every pair, no matter what type of lens or features you sell, gains you only the same dispensing fee. E.g if the pt gets covered only and just pays copays of say $60, Spectera charges me back $60 minus the dispensing fee which I get. If they upgrade with every option in the book and pay $300, Spectera still charges me back $300 minus the dispensing fee. I don't know anything about using other labs, Spectera flat out tells me we have to use Crown for all Spectera materials patients.
Other than convincing a patient to go out of plan and get privately from you, how can you even make anything but the dispensing fee?
We do hate Spectera, but it's an old pactice with a lot of entrenched elderly patients with Spectera, so we hate to drop it an put those long-time patients in a hard spot. Were it not for that we would have dropped right along with Davis years ago.
Spectera will stop using the wooden box of frames in jan. so going forward will i have to mail my frame to crown to cut or are they completely changing to plans similar to eyemed where we can use any lab.
We use our OWN lab with Optum/Spectera. We do not charge "dispensing fees" to the patient, nor do they charge dispensing fees to us. Every order, though, has a sizable write-off amount, though. They do not "back-charge" us for any fees above the scheduled amounts, like DanLiv says. Of course, maybe there's a special contract going on with Optum and us as we're a pretty large client overall.
That being said, DavisVison (FEP! GAAAAH), Optum/Spectera, and NBN are some of the worst vision insurances around.
Financially, how do you even do the job with your own lab? Some Spectera plans have a $0 copay, how do you pay for lab work since Spectera doesn't pay anything? Even if they throw in a dispensing fee, that would not even cover my lab cost. There is some room on the upgraded lenses, but very little, and that doesn't make up for a loss on the low-end materials.
The net profit on Spectera glasses to our practice is zero, the dispensing fee merely offsets optician time.
I did a Spectera job on Monday. The patient was 19 years old. We showed her the 8 frames that we show for Spectera. She was horrified, disgusted, revolted, and repulsed. Not to mention she didn't like the way it looked. She "upgraded" to a disco. Columbia (thanks FezzJohns!) that retails for $179, but we made it available to her, w/her Spectera of course, for $89. She wanted poly(stock), so she paid the $40 upgrade charge, paid w/a CC, and walked out with her glasses. Not sure what Spectera pays us on that, and although we billed it, I don't really care. We did alright.
She was THRILLED at what she could get with her insurance for under $150. I was more than happy with the sale, plus we'll get another check in the mail in a few weeks. Heck, who cares what Spectera pays? Even if Ihad do use their lab, I wouldn't. Before we could use our own, we did it anyway, and didn't submit to Spectera.
We often do the same with Medicaid when they want a progressive. Charge them for the lenses, give them a free frame, and do it in house. Easy...
s
Ophthalmic Optician, Society to Advance Opticianry
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