It begins

**drk** · 10-09-2013, 07:26 AM

Trendy, kid friendly Otis & Piper™ Eyewear Collection coming soon
VSP® is introducing the VSP Elements Plan, a covered-in-full plan that meets the Affordable Care Act guidelines for pediatric vision as an Essential Health Benefit through Qualified Health Plans both in and outside of the Health Insurance Exchanges.
The Elements Plan offers children up to age 19 a selection of trendy, kid-friendly frames from the Otis & Piper Eyewear Collection in a variety of styles, sizes and fun colors, with no out-of-pocket costs.
Your frames are on their way
Your practice is in an area where enrollment in the Exchanges and the VSP Elements Plan is expected. To ensure your practice has Otis & Piper frames for patients to try on before ordering, we'll begin mailing frame kits in November, 2013. Practices carrying the Otis & Piper Eyewear Collection will be identified on the vsp.com Doctor Directory making it easy for patients to locate providers in their area. Likewise, if your practice doesn't carry the frames, it won't include the Otis & Piper indicator in the Doctor Directory.

**Chris Ryser** · 10-09-2013, 07:47 AM

......nice, you are being forced to carry other peoples choice or else .....................................

**Craig** · 10-09-2013, 08:26 AM

Originally Posted by drk

Trendy, kid friendly Otis & Piper™ Eyewear Collection coming soon
VSP® is introducing the VSP Elements Plan, a covered-in-full plan that meets the Affordable Care Act guidelines for pediatric vision as an Essential Health Benefit through Qualified Health Plans both in and outside of the Health Insurance Exchanges.
The Elements Plan offers children up to age 19 a selection of trendy, kid-friendly frames from the Otis & Piper Eyewear Collection in a variety of styles, sizes and fun colors, with no out-of-pocket costs.
Your frames are on their way
Your practice is in an area where enrollment in the Exchanges and the VSP Elements Plan is expected. To ensure your practice has Otis & Piper frames for patients to try on before ordering, we'll begin mailing frame kits in November, 2013. Practices carrying the Otis & Piper Eyewear Collection will be identified on the vsp.com Doctor Directory making it easy for patients to locate providers in their area. Likewise, if your practice doesn't carry the frames, it won't include the Otis & Piper indicator in the Doctor Directory.

Can you make a profit with a VSP plan that has no out of pocket or is this more like charity for under 19. It appears only VSP will make money on this program.

Craig

**vcom** · 10-09-2013, 08:36 AM

Here is what I found on the VSP website for the Elements plan reimbursements.

For eye exams, you'll be reimbursed your assigned exam fee depending on the qualified health plan's selected network, (Advantage, Choice, or Signature).
You'll receive a flat $** dispensing fee for glasses.
Members and their parents may also choose to purchase additional lens options.
You'll be paid 85% of U&C for contact lens fitting & evaluation, and 100% U&C for contact lens materials, subject to specified service limitations.
Refer to the VSP Elements Fee Schedule for full details

**Sledzinator** · 10-09-2013, 10:08 AM

There is a video on you tube about this. The dispensing fee is 25 dollars which is less than Medicaid. Also all orders have to go to vspone Columbus. The lab supplies all materials.

**drk** · 10-09-2013, 11:59 AM

Originally Posted by Sledzinator

There is a video on you tube about this. The dispensing fee is 25 dollars which is less than Medicaid. Also all orders have to go to vspone Columbus. The lab supplies all materials.

Oddly, that's what people are charging for p.d.s. The irony is going to make me cry.

Nobody loves a good optical service, I guess.

Great googly-moogley, that low a fee won't cover pupillometer bulbs, marking pens, and lens wipe-offs, let alone electric bulbs, cool air, music, soft chairs, and a gun-free environment.

An optician demands a little higher pay than $25 for all the work that goes into frame selection, lens design, measuring, ordering, quality control, dispensing, and aftercare. How much can we cut out?

**Johns** · 10-09-2013, 12:24 PM

Originally Posted by drk

Great googly-moogley, that low a fee won't cover pupillometer bulbs, marking pens, and lens wipe-offs, let alone electric bulbs, cool air, music, soft chairs, and a gun-free environment.

Wait one darn second!! Nobody said anything about a gun-free environment! (or gub-free as Woody would say).

This might be a deal breaker!

**Uilleann** · 10-09-2013, 11:22 AM

Originally Posted by drk

Trendy, kid friendly Otis & Piper™ Eyewear Collection coming soon
VSP® is introducing the VSP Elements Plan, a covered-in-full plan that meets the Affordable Care Act guidelines for pediatric vision as an Essential Health Benefit through Qualified Health Plans both in and outside of the Health Insurance Exchanges.

Hmmm...

In our research, the ONLY mandate of the ACA was that MEDICAL plans were required to provide vision SCREENINGS to kids - but NOT provide comprehensive eye exams OR hardware in any way, to anyone at any age. In fact, the Vision Council has confirmed that there is no mandate for Americans to have vision coverage. The Well-Baby program covers the previously mentioned screenings through age 22, and if a primary care doc or pediatrician finds something they feel warrants a more comprehensive examination by a specialist (OD or MD) they can make the referral to them. However, the secondary visit may or may not be covered depending on the patients insurance coverage (any third party vision for example) or diagnosis medical vs. routine vision.

Has something changed we're not aware of?

**drk** · 10-09-2013, 11:57 AM

Has something changed we're not aware of?

Yes.

In our research, the ONLY mandate of the ACA was that MEDICAL plans were required to provide vision SCREENINGS to kids - but NOT provide comprehensive eye exams OR hardware in any way, to anyone at any age.

It's a "comprehensive exam" benefit. Materials are based on state-by-state decisions.

In fact, the Vision Council has confirmed that there is no mandate for Americans to have vision coverage.

True.

The Well-Baby program covers the previously mentioned screenings through age 22, and if a primary care doc or pediatrician finds something they feel warrants a more comprehensive examination by a specialist (OD or MD) they can make the referral to them.

Unlikely true, but pediatricians are probably welcome to get into the comprehensive eye exam game, if they wish.

**drk** · 10-09-2013, 12:32 PM

Who wants a piece of this action? C'mon, guys! Step up! Don't push each other down lining up to provide the pediatric benefit!

**racethe1320** · 10-30-2013, 07:24 AM

Originally Posted by drk

Who wants a piece of this action? C'mon, guys! Step up! Don't push each other down lining up to provide the pediatric benefit!

Why do you still accept VSP at all? Why is it you haven't dropped them completely?

Originally Posted by Johns

Actually, this might be pretty funny to watch. Say for instance, there are 4 providers in a neighborhood, and three of them decide not to be on the coveted Otis & Piper (OP), list. That one guy that is will be slammed by non-paying patients like flypaper in the outhouse. That will free the others up to concentrate on those pts. they can profit from.

This could be good..

My guess is if there aren't enough providers on the private practice side, they would likely push them to their retail affiliate partners or local clinics. That would not be good. Careful what you wish for.

**drk** · 10-30-2013, 12:20 PM

Why do you still accept VSP at all? Why is it you haven't dropped them completely?

Because about 40% of my community has purchased VSP? I have a job to do.

**drk** · 10-30-2013, 12:21 PM

My guess is if there aren't enough providers on the private practice side, they would likely push them to their retail affiliate partners or local clinics. That would not be good. Careful what you wish for.

Oooh, scary. It is Halloween.

**Johns** · 10-09-2013, 01:02 PM

Ironically, back in the day, when our docs wouldn't take VSP, the rep's mantra was always, "But think of the traffic it will bring!".

Well, you'll be getting the traffic now, but not much of anything else.

**Johns** · 10-09-2013, 01:06 PM

Originally Posted by drk

Practices carrying the Otis & Piper Eyewear Collection will be identified on the vsp.com Doctor Directory making it easy for patients to locate providers in their area. Likewise, if your practice doesn't carry the frames, it won't include the Otis & Piper indicator in the Doctor Directory.

Actually, this might be pretty funny to watch. Say for instance, there are 4 providers in a neighborhood, and three of them decide not to be on the coveted Otis & Piper (OP), list. That one guy that is will be slammed by non-paying patients like flypaper in the outhouse. That will free the others up to concentrate on those pts. they can profit from.

This could be good..

**drk** · 10-09-2013, 02:31 PM

The good news is that I'm sure the frames are going to be top quality. Plus, kids don't need much in the way of repeat adjustments and warranty work.

**drk** · 10-09-2013, 02:30 PM

The inevitable sorting into two tiers can begin.

**sharpstick777** · 10-31-2013, 02:23 PM

Originally Posted by drk

The inevitable sorting into two tiers can begin.

I think I predicted here 5 years ago that VSP would one day match Spectera, I just never imagined that they would actually beat them to the bottom.

**Stan Tabor** · 10-09-2013, 02:53 PM

This is the design team for the Otis & Piper frame line:

**jefe** · 10-11-2013, 10:16 AM

Originally Posted by Stan Tabor

This is the design team for the Otis & Piper frame line:

Otis does his best work in the morning. Piper is simply too rowdy to be very productive.

**CCGREEN** · 10-11-2013, 10:54 AM

Just ewwwwwwwwwwww

**Golfnorth** · 10-11-2013, 12:50 PM

Originally Posted by jefe

otis does his best work in the morning. Piper is simply too rowdy to be very productive.

lmao!

**David_Garza** · 10-28-2013, 11:05 AM

Originally Posted by stan tabor

this is the design team for the otis & piper frame line:

that's quite offensive to both of these men.....

**Uncle Fester** · 10-28-2013, 12:49 PM

Will this further a fee for service's provided future?

Would you be allowed to charge $10 to realign juniors bent glasses (every time!)?

"Plan covered glasses are discounted and require a small charge for any future services like new nose pads or adjustments post dispensing."

**drk** · 10-28-2013, 03:01 PM

Originally Posted by Uncle Fester

Will this further a fee for service's provided future?

Would you be allowed to charge $10 to realign juniors bent glasses (every time!)?

"Plan covered glasses are discounted and require a small charge for any future services like new nose pads or adjustments post dispensing."

This is an important point.

If you use your own frame lines, and the "allowance" isn't obnoxious, you can provide included frame adjustments with the purchase of the frame.

If the frame line is "supplied" for an obscenely-low dispensing fee, then, yeah, you adjust it at dispensing, and charge a la carte for adjustments. We're considering instituting a $5/adjustment fee for this.