I am wondering if someone can anyone please throw me a lifeline and tell me how I can make it work taking VSP. I just can't figure out what I need to do to maximize my profits participating with them. I figure you guys might be the ones that can help. Thanks
Ok, I'll nibble!
Very Simply, drink the koolaid on their products (Marchon and Altair Frames, and their Unity lens products). They will pay you (a little) more to fit these products. This is the very basic idea of profiting more.
If you are a Frame Manufacturer, why do you need to know how to profit more from VSP though, just curious. Good Luck, maybe Race will chime in and give you all the details how to profit with them. He is our expert on Optiboard.
Thanks Rich! Currently, I am managing an optical practice that participates with VSP. Not having worked with VSP in the past, I keep thinking, we must be doing something wrong as we are not making anything on these patients. I just don't understand how this is a sustainable model and how to survive till we can attract a private paying customer that is choosing to shop with us due to service/selection and not because a website told them to. Trying to maximize our profits now so that we can reinvest in attracting these new patients. Frustrating to say the least.
Use their products ... using the marchon frames doesn't help it just cuts into the money you get from the patient, BUT from what I understand the altair program works a little more to your advantage profits wise. we don't participate in that program but if you talk to your VSP rep they will tell you more about it.
Look for a PM from me.
"what i need is a strong drink and a peer group." ... Douglas Adams - Hitchikers Guide to the Galaxy
Here are the basics..
Frame purchasing:
There are many frame manufacturers who sell for below frame facts price. 20-50%, sometimes with bulk purchasing.. more. Also make sure you are pricing your frames so that you aren't selling frames that are at or below the Retail frame allowance, but above the wholesale frame allowance. Personally we took VSP's formula for pricing and adjusted it to where our mark up is above theirs.. so when a patient goes above the WFA we can make a bit more.
Lenses: 1st) If you take Choice plans, make sure you have an adequate price difference between flat tops and PALS. You want to be able to charge the limiting rate for those PALs.
2nd) Upgrades! Typically as you upgrade patients (digital, AR, Transitions, Hi-index..) you can make a few dollars more for each option.
3rd) IOF. In office finishing can help you get more profit from those upgraded lenses. When the additional cost of the lens blanks is only equal to one option upgrade, but the patient went with 2 or three, you can definitely reclaim some of those profits, especially with a talented lab tech.
4th) Multiple Pair sales.
Exam: Make sure you are charging for your fits/evals. The VSP fit or discounted rate it typically for the SV Spherical uncomplicated ones. Make sure if they are complex, you charge appropriately. Also make sure you charge for photos, ancillary testing.
Anymore, many practices are viewing these VCPs as stepping stones/marketing to get patients in the door. Once here you can also become their provider for medical services, and other possibly more profitable endeavors.
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
There are no secrets.
1. Enjoy extra volume and whatever positives that entails. Mostly incidental products and services.
2. Sell product. Lots of it.
3. They pay quickly, at least.
4. Make sure your frame markup is hefty. Yes, it squeezes your private pay, so you can't have it both ways.
If you don't dig the high volume/low reimbursment gig, get out.
I can feel the warm breathe of, RACE, on this thread. I will tread lightly on this one. Here's what we know, VSP dabbles the arts of Black Magic and Deception. Is the members frame benefit at 130.00 really 130.00, does the member really receive one free pair of glasses. Through the art of Black Magic, VSP alters the dollar amount payment and decreases it further with a material copay. Does the member truly receive a complete set of eyewear, a few may but most do not, especially if you consider UV and a Hard Coat to be a minimum lens. How does one counter VSP's practices, by selling their Marchon/Altair products and dispensing their Unity Lens products, so that you receive a VSP product spiff for selling VSP's product to VSP members. If that doesn't agree with you, stop taking it or get just as creative as VSP. Take a hard look at the actual dollar payments you receive from VSP for a frame along with the patients frame overages and make the appropriate adjustments. If you have to, implement a tier structure in your frame pricing, remember that your frame price should include the services that you provide to your patients who buy frames from you, are you recouping it.
I didn't attend the funeral, but I sent a nice letter saying I approved of it. Mark Twain
Sure they do! Even on the Ohio Medicaid program, they receive poly lenses.Originally Posted by Paul Smith LDO
Do they get a "set of eyewear"? Sure. Do they receive high fashion, luxury eyewear? Of course not.
Ophthalmic Optician, Society to Advance Opticianry
No Sir, absolutely not. Polycarbonate is a material up charge on many VSP plans both Choice and Signature for adults.
I didn't attend the funeral, but I sent a nice letter saying I approved of it. Mark Twain
Jubilee nails it here. That is exactly how to "profit" on VSP orders. Well done Jubilee, you have done you're homework, thanks for sharing your hard work with all of us.
meh...not so much recently Paul. I have spent quite a bit of time offering up the facts and taken a fair share of criticism both via PM and posts for simply trying to point out details. In the end, there are a large number of very large lucrative VSP Practices and to deny that it's a profitable venture to take VSP is a dis-service to others trying to learn.
There's no black-magic in play. VCP's are discount plans plain and simple. They are there to benefit the client and members first and foremost and it's quite evident that patients realize a value in these types of plans. It's up to the ECP's to (what you call counter VSP's practices) work the VCP's plans and offerings no different than any employee works a compensation plan.
VSP is a business and they aren't in business to support their competition, thus why they are paying ECP's more to fit their products on their members. Pretty simple. Just as you don't want your patients walking with an Rx only to go elsewhere. The amount of earnings you can make with VSP today far exceed that of just 5 years ago. There's no need to gripe about professional fees, etc. as they are not going up anywhere in the Managed Care Space in our market or others. Work the material plans and continue to drive more patients through your office. If you max out or want to increase profits, open another location. Or if you're not business savvy, then scale back and try and maximize your per-patient revenue/profit. That doesn't appeal to me, thus I continue to expand. More patients, more offices, more profits and in the end, far less work for me as I just have to simply run a business with doctors and staff reporting to me. Your mileage may vary.
Jubilee did a good job of explaining things. Well done.
I appreciate your perspective and participation Race.
Thank you for standing tall and offering a different viewpoint and frankly........a breath of fresh air and reason in the managed care/VCP discussion.
Last edited by Fezz; 11-10-2014 at 09:57 AM.
+1
Drug companies are businesses too. Yet would YOU like them top pay doctors more to favor prescribing their drugs?
Ooops - I think legislation pealing back this very conflict of interest was just instituted.
Never mind.
B
Last edited by Barry Santini; 11-10-2014 at 02:11 PM.
Ok, here's my question: Am I losing out by not putting everything onto one authorization=Exam+materials? I also feel that I am missing out or doing something wrong. Maybe a code or something. I cannot bill for fitting and adjustment. The system wont let me enter it. Then it will calculate the Misc. code that never gets paid anyway so I am not sure what the point is in calculating it into the claim form.
Race has made plenty of valid points here.
However, there is one glaring miss: "The amount of earnings you can make with VSP today far exceed that of just 5 years ago. "
In my neck of the woods the balance of VSP Signature to Choice has tipped from roughly 10:1 5 years ago to nearly 50:50 now and reimbursement on Choice plans is less than half of Signature plans. And patients have much more out of pocket costs on Choice plans, so they are less happy as well.
Sadly the only way I see to truly be profitable, is to recommend and sell the high end product. When it comes to PAL's we do not offer anything below group F and the majority is group N sold. This is not only due to the technology and a way to separate ourselves from competition, but it pulls in the dollars and it just happens the patient will see much better. The VCP's reimburse poorly, so income has to come from somewhere and a well educated patient is usually ecstatic to pay the difference between a comfort and an auto 3. When it comes to frames, remember to hide the budget frames for the special cases that need them (some people truly need this section and I am more than happy to get a 30$ retail frame on them to allow them to see). Also, remember to include in the retail price the difference between patient allowance and what you see from the VCP. Remember you can still extend a discount to your private pays to make up for the difference between U/C and retail if you feel the need. Some VCP's limit this, i think VSP is 20%.
This is the same methodology that medical doc's utilize. Do you think that the Hospital or doc see that 250grand charge billed to a patients insurance. No, insurance forces medical providers to jack up the pricing for everything in order to get the correct reimbursement.
If it wasn't for VCP I would probably be charging half of what I actually do.
Oops, perhaps my tongue and cheek usage of,"Black Magic" was too much for some, call it what you want but when a printed dollar amount is not just that, what is it. I had a patient petition me to buy a frame(line I don't carry) from another shop, at full retail and that I could bill it to their VSP so they could use their full 130.00 frame allowance. Both the Optical and a VSP customer service rep said that I could do this for them. Now I don't blame the Optical as they don't take insurance but for the VSP service rep to get involved; well that got my dander up. So I informed the patient that they needed to see their frame benefit as, VSP $ and they do not carry the same exchange rate. Oh and by the way their plan covered UV and Hard Coat with a 16.00 and 17.00 copay. The eruption that followed was epic. In conclusion, as many before me along with myself have stated, sell their product if that is what you chose to do. If I list a baked potato as part of the meal I had better damn well explain what that potato comes with and that there may be additional charges for salt/pepper and a tab of butter. Deception or just plain folksy cracker barrel vernacular of Managed Vision Care.
I didn't attend the funeral, but I sent a nice letter saying I approved of it. Mark Twain
The truly amazing thing about VSP is their ability to completely snow both patients AND optometry nationwide. Imagine they were in the food services industry, their story would look an awful lot like this:
Person: "I'm hungry"
Person's employer: "Come work for me, and as a bonus I'll throw in a free* Thanksgiving dinner every year! (for a premium you'll pay on every month of course.)" *"free" is what VSP said the restaurant would offer so it must be true...and why would I actually bother to check?!
Person: "Great!"
...come dinner time:
Person (at VSP contracted restaurant): "I'm here for my free VSP Thanksgiving dinner.
Restaurant owner: "That's great. However, it isn't actually free sadly. Your dinner plan requires copayments, and the complete deluxe meal you thought you were getting for free actually will cost you several hundred additional dollars out of pocket."
Person: "But I pay money every month for this dinner, and they promised me it was free! Why are you lying to me?"
Restaurant: "I'm very sorry for the misunderstanding. Unfortunately we can only offer food that is allowed by your plan, and what you need to actually be full will cost several hundred dollars."
Person: "But the said it was all free! Why can't you give me what is free?!"
Restaurant: *holding out a single small dinner roll* "Here you are. This is what is actually 'fully covered' under your plan."
Person: "But that is NOT a Thanksgiving dinner! That is not turkey with all the fixing, mashed potatoes, cranberry sauce, fresh veggies and spiced cider!"
Restaurant: "No. I'm sorry your plan/employer made it appear that way. Sadly, we spend more time explaining this glaring discrepancy to our dinner clients than we do actually feeding them. And unfortunately you aren't the first hungry client to discover this the hard way."
Person: "Well what am I supposed to do? That is the dinner I want, but I will not pay that much money."
Restaurant: "I understand your frustration. I would feel the same way if I was misled in such a way. We would be happy to offer you an even higher quality dinner that is not supplied by VSP, for just a little more than your co-pays would be. Would that interest you?"
Person: "No. I am paying for this free dinner, and I want this free dinner."
Restaurant: "Ok. I'm sorry you weren't aware of the details of your dinner plan. Here's your roll. Have a nice day."
Person: "This restaurant sucks, I don't think I'm coming back next year."
and so on and so forth....
Just remember kiddies, playing the VSP game is FUN!
I'll split the wish bone with you if no one wants to.
I didn't attend the funeral, but I sent a nice letter saying I approved of it. Mark Twain
Wishbone...for an additional $160 co pay of course. Plus $115 for the true bone material, plus another $85 for genuine turkey flavor, plus another $76 to ensure the proper cracking sound...
Jump !!
We'll put out a trampoline if you rent our sky diving kit for $120.
Uilleann.
With all due respect to the VCP bashers, are you really seeing a high percentage of patients who don't know how their plan works? I ask because I don't. I. just. don't. At least 80% of my patients whether returning or new, know/expect co-pays for exams and materials. They expect to pay out of pocket for "thin lenses" "no lines" etc. I don't get the whole "poor patient" story.
I do understand the soapbox principle of the thing sticking in the craw of the provider. Sure I wish they paid more, offered more, and shined my shoes as well. But it is what it is, play the ball or get out of the game.
I will state that VSP is the easiest VCP to work with.
dv,
The fits were in regards to the contact lens fitting. They do not cover anything towards the fit/adjustment of the eyewear since this is covered in their dispensing fee.
We typically pull an authorization for all services, however if they are contacts and have not completed the fit, we will file for exam only, and pull a new authorization for the materials when they come in for their contact lens check.
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
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