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Thread: VSP update?

  1. #1
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    VSP update?

    So, please don't kill me on here because I know this has been discussed before. But all the postings I can seem to find are a few years out, and I need some more up to date information: VSP. What's the deal?

    It seems they've tightened their stranglehold on controlling the market. I'm planning on opening a finish lab. I'm going to assume there's no way of be approved on their list of labs. So that means anyone using their insurance coverage can't use my services, correct? The provider can't go 'out of network' like the patient can. And between me being a lowly finish lab and there being a new VSP lab opening right next to me, there's no way I can become an approved lab....... Right?

    Z

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    OptiBoardaholic vcom's Avatar
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    It all depends- if you are a dispensary that wants to process VSP in-house, you have to sign up for the in-office finish program, which basically means you order the stock finish lenses from the VSP approved source, and then edge them in your own finish lab. I don't do this myself, but it is possible. Otherwise, you need to mail the frames in to a VSP lab and they have to be done complete by them.

    If you are trying to become a Lab that is processing outside jobs from other offices, I have no idea how you become a VSP approved lab.
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    Forgive my ignorance, I haven't dealt with this particular issue. If I were going to tackle that I might start by calling vsp and getting some information from them on the process, application, pros and cons being just finish as opposed to a full service lab and cost. I know we have to send all of our VSP jobs to a VSP approved lab in order to submit the claim or we get virtually nothing for dispensing fees. Im not going to say we can't edge our jobs in house if we wanted to. We certainly have that option, but theres no profit. This hurts in cases where we can pull a lens from stock to satisfy the customer (which we often do) but cannot submit for compensation because it was not through the original VSP approved lab. It looks like Eyemed is attempting to do the same thing and if you've read some of the posts from last month you'll see Davis in the same arena. The worst vice is advice, but you may want to get the information from the source and give them a call to see what must be done next. It may be worth the phone call =)

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    Its possible. We have a finish lab in our office and from time to time have to order uncuts for our VSP patients. When you are submitting your claim online there is no spot (I don't think) to select that you want uncuts. In these few cases I'll call the lab so they can make note to send it out as an uncut.

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    If I recall correctly, you are looking to open an independent finishing lab. Not a lab attached to a dispensary.

    While you can call VSP to get the details, I am 99.999% sure you will be told "we have no need for additional labs in your area." Especially if you would be competing with them.

    However VSP is not the only game in town.

    If you are insistent on wanting that work, I know some deals have occurred where labs will outsource some of their insurance work to relieve congestion in their own lab. Equipment down, staffing issues, etc.

    For us, the big cost savings on doing things "in house" comes from medicaid (low reimbursements mean gotta get it done as cheap as possible.) You can get uncuts, and charge a flat rate to finish, and be under what many of the big boy labs charge. Especially on Poly. Combine that with some Ideal optic frames/Capri/<inset low cost option here> and have a value pack option that allow your offices to be competitive with the popular internet retailer.
    Another huge cost savings though is on AR/Transitions. You can get Transitions/Cat D AR finished stock lenses for less cost than what the AR alone costs from many labs.

    Get a partner with digital processing capabilities. It is not unheard of for alliances to be made, so you can offer the Hawaii Digital PAL or Pal w/AR for XX. The partner will process the uncuts for you, and then you finish them in house. Partner is happy because they are processing more on the equipment they are trying to pay off, and you are able to expand your offerings to try and capture more private transactions. Provide a better turn time, and great quality/detail.. and it can work for you!

    Most of all.. be sure to promote you as the brand. Your attention to detail. Commitment to quality. Practice friendly policies.. why it is a better VALUE to utilize you..
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    I really don't like the "additional discounts" offered on Marchon / Altair frames. For example, the patient gets a frame allowance of $150 for frames, but an allowance of $170 for Marchon / Altair. The idea of saving an extra $20 is enough to steer people away from non-Marchon frames, not in every case, but often enough that is bugs me. In some cases the discount is an extra $40 or so. We're not getting much of that back btw.

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    Quote Originally Posted by hawaiioptician View Post
    It seems they've tightened their stranglehold on controlling the market.
    I think it's a bit unfair to call what they are doing a stranglehold. From a business perspective they are simply shoring up the supply chain by building labs and servicing their own clients work vs paying others to do it. In the end that's a smart business move and given their model one that aggregates the cost savings which pay for the programs that ECP's have and helps them capture more clients.

    between me being a lowly finish lab and there being a new VSP lab opening right next to me, there's no way I can become an approved lab....... Right?
    Probably. Especially since the lab out there is a finishing lab.

    Quote Originally Posted by Blunder Woman View Post
    I really don't like the "additional discounts" offered on Marchon / Altair frames. For example, the patient gets a frame allowance of $150 for frames, but an allowance of $170 for Marchon / Altair. The idea of saving an extra $20 is enough to steer people away from non-Marchon frames, not in every case, but often enough that is bugs me. In some cases the discount is an extra $40 or so. We're not getting much of that back btw.
    Not sure how all that fits into this thread, but okay....here too though, it's VSP simply putting their product on their clients and members. Makes sense. Why would they continue to support putting other frames on their members? Key to navigating the program, especially on Federal Employees where it's not $40 but $50 more, is to insure you're upselling them. Again, if you have a patient walk in with an extra $50 you stand a way better chance of selling them a nicer frame than not. Depends on your market of course. In our locations, it's about 2/3 that will buy more, 1/3 fight it. In the end, it's been a win for us.

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    Eyes eastward... Uilleann's Avatar
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    And VSP laughs all the way to the bank.

    Again.

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    Quote Originally Posted by racethe1320 View Post
    Not sure how all that fits into this thread, but okay....here too though, it's VSP simply putting their product on their clients and members. Makes sense. Why would they continue to support putting other frames on their members?
    I agree with what you are saying, but it happens to be occurring when their frame selection and design innovation (from our office philosophy point of view) has gone downhill. In lieu of providing a better product to dispense, they offer better pay back. Is that really in the patients best interest?

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    Eyes eastward... Uilleann's Avatar
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    Nope. And why would it be? That's the great lie of all these managed care plans. They're in it for profit. Patient's best interests never the first priority.

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    Quote Originally Posted by AustinEyewear View Post
    I agree with what you are saying, but it happens to be occurring when their frame selection and design innovation (from our office philosophy point of view) has gone downhill. In lieu of providing a better product to dispense, they offer better pay back. Is that really in the patients best interest?
    Provide your patients with a better product that you control and leave the VSP products for those that what to sell it. I prefer working toward profits that benefit both the patient as well as the clinics profit margin. VSP is clearly looking to increase their on line presence as they continue to take your patients business out of your hands and sell to them.
    I didn't attend the funeral, but I sent a nice letter saying I approved of it. Mark Twain

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    Although I agree Uilleann, that they are in it for profit, isn't that the case for all of us. I don't necesarily like managed care, but I can't negate their goal of making money. That's what we call business isn't it.

    Race, I like your response, much more civil than in the past, welcome back.

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    Eyes eastward... Uilleann's Avatar
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    Quote Originally Posted by EyeCare Rich View Post
    Although I agree Uilleann, that they are in it for profit, isn't that the case for all of us. I don't necesarily like managed care, but I can't negate their goal of making money. That's what we call business isn't it.

    Race, I like your response, much more civil than in the past, welcome back.
    Certainly we are in business to remain in business. However, we are in the business of providing patient care, and in that vein, we are further in the business of providing the best patient care/service/products we can. Managed care is in the business of frightening doctors, and driving up the cost of everything by wedging themselves between the patient and their ECP. They serve no purpose that furthers the patients best visual or health interests - and that's the bottom line. But yes, they're making money hand over fist. Good for them I guess?

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    I don't begrudge anybody making money. But doing it with the aggressive manipulation and expense of independent doctors, pursuing new corners of the market and picking favorites at every level of the industry, I don't think it's a force that helps competition for the consumer or better care for the patient. When an insurance company leans as heavily into the patient's choices as VSP continually strives to do, when they do their very best to coerce providers and patients into a closed shop of limited choices, that's just a brother bigger than any of us needs. Since that's they way they want to make money, I hope their story ends as a cautionary tale of overreach rather than a portend of things to come.

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    yeah, i cant even wrap my mind around how this crap is legal. luxottica is doing the same thing with its 'hidden' monopoly. vsp is seeming to make inroads as well. I have now contacted them 3 times about getting more info on becoming a contract or partner lab, and they're ignoring me.

    I have no problem with a company making money, thats what were all here to do. but subverting and controlling the market, using tactics that i had thought were reserved for thugs and mafiosos, all the while portraying a public front that they give a damn about helping people..... its very disheartening.

    when a patient pays X amount of money for the coverage to begin with, they should have a choice as to where they go to recieve services, just like the person providing the service should have a choice on who performs the labor, or where they source the parts from. I can propbably think of other industries where the company reserves the right to approve the charges and the PRIVATE vendors, and I may be uninformed, but im not aware of many other industries where a private company gets to control all aspects of services performed for one of their clients.

    So VSP, (just like LUX) can continue to keep a handful of token private labs around (whos numbers are apparently dwindling) all the while pushing more agressively their own labels, now having been extended to lenses and frames. how this is not a conflict of interest, i havent the slightest idea. but as is usual with our industry, nobody but us really seems to care.

    so give it around 15 years, and between vsp, eyemed, and maybe spectera and davis vision, ALL of our dispensaries will be 'convenience centers' where patients can sit in, enter their insurance information, and select from their respective companies privately held frame selections. sit down, take a digital measurement image, which prints a ticket at one of their respective companies closest district processing hub, and then can pick up the glasses a week or two later, or have them mailed direct to their home.

    Last time i checked, opticians are needed to take measurements and fabricate the glasses. I dont see either being done here, in a market controlled by luxottica, vsp, and whatever other giant insurance company comes along to get their piece of the pie.

    just think of when vsp starts agressivley going after the retail side... maybe then them and lux can make it so theirs are the only retail locations that can offer their members 1 hour service, and everyone else can just kick rocks. seems just as legal as all the other underhanded tactics they do. OR they can make their biggest opthalmic brands exclusive to their own retail locations? what are we going to do when all the big name brands are exclusive to lenscrafters and whatever the VSP equivalent is called?

    I dont think their story will end any worse than luxotticas, until people are willing to do something about it, and it doesnt seem like that will happen any time soon.

    PS. in a less abstract (and certainly less pessimistic manner) if anybody has the phone number of their local (friendly) VSP rep, can they forward it to me? I'm not going to give up until i get a hard NO from these guys, and thus far, all the cowards have done is ignore my requests.

    thanks as always

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    Quote Originally Posted by hawaiioptician View Post
    yeah, i cant even wrap my mind around how this crap is legal. luxottica is doing the same thing with its 'hidden' monopoly. vsp is seeming to make inroads as well. I have now contacted them 3 times about getting more info on becoming a contract or partner lab, and they're ignoring me.

    I have no problem with a company making money, thats what were all here to do. but subverting and controlling the market, using tactics that i had thought were reserved for thugs and mafiosos, all the while portraying a public front that they give a damn about helping people..... its very disheartening.

    when a patient pays X amount of money for the coverage to begin with, they should have a choice as to where they go to recieve services, just like the person providing the service should have a choice on who performs the labor, or where they source the parts from. I can propbably think of other industries where the company reserves the right to approve the charges and the PRIVATE vendors, and I may be uninformed, but im not aware of many other industries where a private company gets to control all aspects of services performed for one of their clients.

    So VSP, (just like LUX) can continue to keep a handful of token private labs around (whos numbers are apparently dwindling) all the while pushing more agressively their own labels, now having been extended to lenses and frames. how this is not a conflict of interest, i havent the slightest idea. but as is usual with our industry, nobody but us really seems to care.

    so give it around 15 years, and between vsp, eyemed, and maybe spectera and davis vision, ALL of our dispensaries will be 'convenience centers' where patients can sit in, enter their insurance information, and select from their respective companies privately held frame selections. sit down, take a digital measurement image, which prints a ticket at one of their respective companies closest district processing hub, and then can pick up the glasses a week or two later, or have them mailed direct to their home.

    Last time i checked, opticians are needed to take measurements and fabricate the glasses. I dont see either being done here, in a market controlled by luxottica, vsp, and whatever other giant insurance company comes along to get their piece of the pie.

    just think of when vsp starts agressivley going after the retail side... maybe then them and lux can make it so theirs are the only retail locations that can offer their members 1 hour service, and everyone else can just kick rocks. seems just as legal as all the other underhanded tactics they do. OR they can make their biggest opthalmic brands exclusive to their own retail locations? what are we going to do when all the big name brands are exclusive to lenscrafters and whatever the VSP equivalent is called?

    I dont think their story will end any worse than luxotticas, until people are willing to do something about it, and it doesnt seem like that will happen any time soon.

    PS. in a less abstract (and certainly less pessimistic manner) if anybody has the phone number of their local (friendly) VSP rep, can they forward it to me? I'm not going to give up until i get a hard NO from these guys, and thus far, all the cowards have done is ignore my requests.

    thanks as always
    All this stuff could be proven in court through a judicial system. Question is, has anyone in the U.S. ever challenged Lux or VSP in court?

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    Quick note, sorry hawaiioptician , I didn't mean to hijack the thread or take focus away from lab related questions.

    As some others have agreed, I still believe that the frame incentives are relevant to the topic as they show a pattern of behavior from this company. Is it a savvy decision on their part? Sure is. Do I consider it a conflict of interest on their part? Sure do.

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    There it is! Is VSP still considered a not-for-profit entity? How is that?

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    Quote Originally Posted by scottster View Post
    There it is! Is VSP still considered a not-for-profit entity? How is that?
    In lies the conundrum. They have compartmentalized; VSPONE/Labs, Marchon Frames Division, Unity Lens Division, VSP Insurance, etc, etc etc.
    I didn't attend the funeral, but I sent a nice letter saying I approved of it. Mark Twain

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    Quote Originally Posted by AustinEyewear View Post
    I agree with what you are saying, but it happens to be occurring when their frame selection and design innovation (from our office philosophy point of view) has gone downhill. In lieu of providing a better product to dispense, they offer better pay back. Is that really in the patients best interest?
    Yes it is in the patients best interest. THEY get to decide if they use the additional frame allowance and whether they want to choose the lenses being covered. The ECP can still suggest whatever they wish. There are no restrictions to anyone. In the end, VSP is working to meet the clients needs of how to best maximize the patients/members benefits. That happens to be by leveraging VSP Products. None of the other brands are doing that.

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    Quote Originally Posted by scottster View Post
    There it is! Is VSP still considered a not-for-profit entity? How is that?
    Quote Originally Posted by Paul Smith LDO View Post
    In lies the conundrum. They have compartmentalized; VSPONE/Labs, Marchon Frames Division, Unity Lens Division, VSP Insurance, etc, etc etc.
    No conundrum at all. The gov't changed that status because VSP bought out other lines of business outside that of insurance where the NFP entity originated, but the company still operates as a not for profit; nothing has changed there. In the end, Uncle Sam wants his millions in taxes and is getting it.

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    Quote Originally Posted by hawaiioptician View Post
    yeah, i cant even wrap my mind around how this crap is legal. luxottica is doing the same thing with its 'hidden' monopoly. vsp is seeming to make inroads as well. I have now contacted them 3 times about getting more info on becoming a contract or partner lab, and they're ignoring me.
    what's the monopoly? They aren't required to sign up more contract labs. That don't need to. VSP and even EyeMed are not in business to support contract labs. Contract labs like the ECP's are just servicing centers for the manage care needs. Supply and demand. Both are shoring up their own materials and services thus less need for others. Again, purely a business move to maximize their end of the industry.
    I have no problem with a company making money, thats what were all here to do. but subverting and controlling the market, using tactics that i had thought were reserved for thugs and mafiosos, all the while portraying a public front that they give a damn about helping people..... its very disheartening.
    I fail to see how generating a client/patient base, which is what managed care does, then signing up nearly 40k ECP's as providers who all opt-in to service said patients is wrong. The patients are clients of VSP first and like any business, they can sub-contract providers to do work for them to service those patients. If you are questioning what they are doing to support the patients, that's an entirely different topic. You don't have to even ask VSP, go ask their members and clients. Why do you're own employees and many here have insurance/discount plans such as vision and dental? The answers are all the same.

    when a patient pays X amount of money for the coverage to begin with, they should have a choice as to where they go to recieve services, just like the person providing the service should have a choice on who performs the labor, or where they source the parts from.
    yes/no. Said patients opt-in to the plans they choose. They go in knowing that they are being serviced by ECP's and have no limitations. VSP members can go to anyone they like. They can go in or out of network. The patient isn't involved in the selection of what lab does the work. That's up to the ECP. There too, the ECP can go where ever they want within the guise of the plan they also opt-into taking.

    If VSP or EyeMed wanted to direct all their lab work to where ever they wanted, they can do that in most states. The client chooses the plan, managed care doesn't dictate that. In states where the lobbyists are fighting that even, will ultimately just cost themselves money.

    If I were VSP, I'd select those states to be where I'd set up a retail shop of my own or perhaps open the channels to other provider networks. Or they could just chop reimbursements. Over at EyeMed they will just direct patients via plans to their own retail stores through greater discounts. That's my guess what will happen if the ECP's and lobby folks don't be careful.

    I hear rumblings at regional meetings all the time about how my peers want to stop taking managed care and "hurt" these companies. That's not going to happen. If EyeMed signs a client in BFE Vermont and there aren't any providers, they will just build a retail store. VSP will just sign up one of their retail affiliate partners or heck, perhaps they will enlist opticians who always seem to be clamoring to get on the panel. Point is, there are options still un-tapped.

    I can propbably think of other industries where the company reserves the right to approve the charges and the PRIVATE vendors, and I may be uninformed, but im not aware of many other industries where a private company gets to control all aspects of services performed for one of their clients.
    Pretty much all managed care works that way. The gov't is now the biggest offender.

    So VSP, (just like LUX) can continue to keep a handful of token private labs around (whos numbers are apparently dwindling) all the while pushing more agressively their own labels, now having been extended to lenses and frames. how this is not a conflict of interest, i haven't the slightest idea. but as is usual with our industry, nobody but us really seems to care.
    There's no conflict because there are no restrictions. The patient chooses to maximize their discounts if they wish by selecting specific products and plans based on what their employer, the client sets up. The ECP can aggregate their earnings or not too. The choices exist on both sides. What's also ironic is how many non VSP or Essilor/EyeMed labs push their own products in the form of digital progressives. To me that's an even bigger conflict of interest as the main reason docs and labs offer their own is purely because of profitability! How about the opticians and doctors that take kickbacks from vendors? That's not a conflict?
    so give it around 15 years, and between vsp, eyemed, and maybe spectera and davis vision, ALL of our dispensaries will be 'convenience centers' where patients can sit in, enter their insurance information, and select from their respective companies privately held frame selections. sit down, take a digital measurement image, which prints a ticket at one of their respective companies closest district processing hub, and then can pick up the glasses a week or two later, or have them mailed direct to their home.
    Likely. It's happening in other countries right now. Think Australia. Heck, again, if I were VSP or EyeMed, just set up a franchise program. Capture the kids right out of school, let them take over a practice and offer them a buy-in once they and if they choose. If they don't (which many new docs are not choosing) they can simply continue to be a doctor/employee of VSP or EyeMed. EyeMed really already has this in their retail arm, but the difference is most of their locations are not franchised.

    just think of when vsp starts agressivley going after the retail side... maybe then them and lux can make it so theirs are the only retail locations that can offer their members 1 hour service, and everyone else can just kick rocks. seems just as legal as all the other underhanded tactics they do. OR they can make their biggest opthalmic brands exclusive to their own retail locations? what are we going to do when all the big name brands are exclusive to lenscrafters and whatever the VSP equivalent is called?
    Exactly. Think about it. VSP is already segregating their providers. Why wouldn't they? They will likely continue to do so too. Again, why wouldn't they? Pay the ECP's that partner with them more and let the rest starve. Makes sense really. WHy would they push their clients members into locations that don't support their products? WHy would they reimburse the same for non VSP products vs their own? That's dumb. That's like any ECP here servicing a patient that brings their own frames and lenses into their location. Would you tolerate that? Doubtful. Then why would you expect managed care companies to?

    PS. in a less abstract (and certainly less pessimistic manner) if anybody has the phone number of their local (friendly) VSP rep, can they forward it to me? I'm not going to give up until i get a hard NO from these guys, and thus far, all the cowards have done is ignore my requests.
    I wouldn't call them cowards, they likely just have no need to discuss anything with you. We've already covered why and yourself already know the answer as to why.
    Last edited by racethe1320; 10-25-2014 at 08:13 PM.

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    VSP is not insurance it is a buyers/discount membership club. If you look at routine vision insurance that way, you can see that what they do is perfectly legal, and makes good business sense. Promoting their own products, with the dangling dollar carrot in front of the patient? Not all that different than Costco brand items costing less at Costco than national brands they sell.

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    So we are to believe that the VCPs, including VSP are health based plans. They not only go direct to employer/patients, but to the health insurance plans as well to tout the benefits of having an vision plan.

    Yes, routine vision exams do help save lives and money. However, the main goal of the plans aren't altruistic. They are to shore up the vertical monopolies that they have built.

    I understand the business sense. I get it. VSP, et al can reduce their operating costs, and increase their profitability by promoting their own products and services. Unity AR is free, or only get $20 towards the other brands. Get extra allowances by purchasing our frames. Get the patients to DEMAND the company's goods and they make even more $$$. You end up having to submit the orders to VSP technology centers anyway. Not to mention some accounts can only be processed by VSP labs, like Federal Employees.

    The problem is that they are selling themselves to the general public as if they are genuinely concerned about patient health. They are fighting to be on the exchange, like the health care plans demanding an equal stake. Do you see any health plan demanding of their doctors to use drugs made by the health company's pharmaceutical company? Use durable medical goods manufactured by their partner companies who provide similar goods to their company owned medical offices? Drop support for claim processing because they use an EHR not sold by the same health care plan?

    Many providers feel like they are not an individual small business anymore. It is more like a franchise to be the face of one or multiple of these plans. As the plans get more and more tighter controls, it all is getting homogenized. As practices try to break free by expanding their care to medical, these VCPs are grabbing hold to, reducing yet another revenue stream for the office.

    I know many offices that are successful in being able to compete without taking these plans. They simply match the copays/coinsurance these plans dictate. However when they can get their goods cheaper than what the insurance company charges, they actually make more. VCPs are driving up the costs to both patients and providers simply because everyone has to take into consideration the average 40-50% discount these VCPs make us take.
    "Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland

  25. #25
    Master OptiBoarder opty4062's Avatar
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    Is it really all that different than your medical insurance telling you which drugs they cover, which hospital is "in network", etc? I don't see medical insurance companies as altruistic either and I don't know many people who do. It's all business, not misrepresented in any way that would be legally wrong, but not all that apparent to your average joe either.

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