Do you owe Eyemed $thousand$ in lab chargebacks?

[OldRoyBiv]

Rumor mill says that a Virginia provider trying to leave the Eyemed "family" was billed several thousand. Now if you check "payment history" on your own Eyemed account, you'll find confusion. Eyemed pays us out of at least 6 checking accounts: each one has a separate balance carried forward. So even though you may still receive payments on one check account, you may find a -$5000 deficit on another check account. What the hell? Has anyone called Eyemed on this? I already spend 50 hours a week selling glasses for Eyemed, but now I guess hour 51 will be spent on hold with a helpful Eyemed rep:(

[Chris Ryser]

Company Overview

EyeMed Vision Care, LLC provides vision benefits programs to Fortune 500 companies, state and local municipalities, unions, and employer groups across the United States. It offers vision wellness plans to improve the vision of its members and their dependents. The company offers its programs through sales and service representatives. EyeMed Vision Care, LLC was formerly known as LensCrafters Vision Care Management Systems. The company was founded in 1988 and is based in Mason, Ohio. EyeMed Vision Care, LLC operates as a subsidiary of Luxottica Group SpA.

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[Jubilee]

I am not sure why you felt the need to provide the handy link there Chris, since all participating offices should know how to contact the company and be familiar with the different plans.

As for the original poster:
While certainly our reimbursements from Eyemed has gone down the past year, I can not understand how an office is not aware of the chargeback situation.

While I am unaware of a negative EOB being sent to my office alone, the way that it happens with Davis union plans on a regular bases, I have seen them come with other checks/remittance advice.

Even if you did not receive anything from Eyemed, please tell me someone is routinely going through your insurance receivables to make sure you are accounting for every claim sent in. For accounting/tax/business purposes, you need to know how each and every claim has been adjudicated.

Lab charge backs mean you should have collected most of the fees upfront. If you are getting dinged 3 figures for providing a tier 4 PAL, Transitions and AR, you should be collecting a pretty penny or 2 from the patient upfront. All this means is that instead of the company a significant amount towards their eyewear, they are getting a glorified discount instead and we the provider, are forced to use the contracted labs.

Lab Chargebacks is a term to describe your lab bill for insurance work. It costs more period, be it insurance lab or non to add the premium options. They (the insurance company/lab) aren't doing it for free either.

Davis does the same thing with the multiple accounts/ledgers. My understanding is that is is set up depending upon the network/type of plan. For Eyemed this would be Blue View Vision, Access plans, Insight, etc. For the Davis union plans (DELTA, CHRYSLER) they will send me a bill asking to pay them once the negative balance has been on the account for 60 days and is over a certain amount. I am sure Eyemed would send such a statement as well.

If that provider legitimately owes 5K to Eyemed for chargebacks, then they should have made plenty of cash flow to pay it over the term. If not, they have bigger issues. Pricing or competence.