The "new" VSP??

[Jana Lewis]

Okay...giggle, giggle....my first "real" post!!! Heh, heh, heh!

What is your opinion on the "new" VSP? After reviewing the materials sent to me by VSP, I realize that we must now offer an additional 20% off of frames. How will I ever make some sort of profit off of these patients?? They have now set the standard "cost" fee for the frame, with the additional 20% taken off it!Just seems like they are just nickel and dimeing us to death!

What can I do to atleast make the VSP glasses worth my while?

Your input is well appreciated!! :angry: (my first smilie!!!)

[Robert Wagner]

:o
I agree with you, what can we do?
I don't know what your mark-up is, but VSP has advised us to mark up 2.6x if you want to make the same "profit" as last year.
Also to get an extra 5% discount if you are to order your frame from eyefinity with VSP chosen venders you can also order frames only through eyefinity with that same 5%discount for your own inventory.

Good luck for we all will need it!
Robert:)

[paw]

Whatever else you decide to do, the first thing you should do is complain to VSP. They take note of the response of the VSP members. If there is little to no response to this hit, you can bet there will be more hits to come. All insurances squeeze until the victim hollers. We must all holler now.

[Johns]

We had a VSP rep walk us through a claim using the new system, and for some reason, it looks like we're coming out w/ more (??).
They said that we can now use the retail pricing or the wholesale frame allowance.

Example 45 / 130

The 45 would be the frame allowance, and the 130 would be the maximum retail.

Did we misunderstand it. We came up w/ the same # that they did. We worked another one out, called them up to double check, and it was the same story. What am I missing ?

(Please note that I don't handle the insurance, but when I saw the pkg come in, I had the ins. person review and check it against the old system. Since I don't handle the VSP, I'm not very well versed on how it works)

[paw]

Johns,

This is the way it works:

Take the price of the frame the patient chose:

Compare that price to the patient's retail frame allowance ($130, in your example).

Then compare wholesale price of the chosen frame to the patient's wholesale frame allowance ($45, in your example).

If the chosen frame's retail price is higher than the retail allowance, AND it's wholesale price is higher than the wholesale allowance, the patient pays an overage.
(The overage is: frame retail price minus retail frame allowance. Then, you must take 20% off the overage. That is what the patient will owe.)

If the chosen frame is lower than the allowance on either the wholesale or retail, the patient has no overage.

Hope this helps.

[Johns]

Paw:

Doesn't this mean that there will be different payouts for different offices, deciding on what their retail prices are?

[Jana Lewis]

Johns,

Yes, there are different payouts for different price structures. You will also notice that there are different payouts for different plans! It gets so darn confusing!!

I guess my big gripe is that how does VSP expect me to stay competitive if they are squeezing me dry? I guess the only way is to raise my percentage over frame cost to help offset that 20%.

I was just curious if any of you had a new game plan for the "new" regs.

[Johns]

I explained my game plan to the Charmant rep when he stopped in all smug with his new "partnership"manual from VSP.

He said, "If you buy a frame from us for $XX you'll get an added savings of $ for using the VSP network." I said "Show me all your frames that are priced for $YY (read:china)" He said he doesn't selll any in that price range, and I said, "The I don't PLAN on buying any of your frames for use w/ vsp."

VSP just wants more control over the true price we are paying for our products, so they can have more control over the profits we can make. The only way to survive is to "go underground"on how much we pay. Of course, they will try to squeeze the non-traditional frames out of the picture as well, but I don't think theý'll be able to completely.

Note: I just heard that one of the larger OD practices on the Ohio/Pa border just stopped taking VSP altogether. Good for them! Someday, I hope I'll have the guts to do the same.

[Steve Machol]

It occurs to me that VSP could help themselves immensely by sponsoring their own forum on OptiBoard to answer questions like this and to provide support. :)

[Jana Lewis]

Johns,

I have refused for the longest time to carry the Altair line, I know that it is supposed to help our "bottom line" but....I just can't carry that crud. I find it cheap and very ugly.

So...what to do next? I wish we could drop VSP too...It drives me insane!!!

And yes Steve...it would be nice if there was a Q & A forum for VSP, maybe then they could try to understand just how frustrated the providers really are!! :o

[paw]

Johns said:

"Paw:
Doesn't this mean that there will be different payouts for different offices, deciding on what their retail prices are?"

Jana said:

"Yes, there are different payouts for different price structures. You will also notice that there are different payouts for different plans! It gets so darn confusing!!"

Jana is right, there are different payouts for different offices, depending on what their retail prices are.
And, as Jana said, it can be confusing because different VSP groups have different allowances and co-pays.

It is imperative that you obtain the patient's authorization (easiest done over the internet) and print out the authorization sheet which tells you what the allowances and co-pays are for that patient. Once you have that info, it's not too difficult to figure overages.

Jana also said:

"I guess my big gripe is that how does VSP expect me to stay competitive if they are squeezing me dry? I guess the only way is to raise my percentage over frame cost to help offset that 20%."

That's exactly our gripe, too. We've already made our feelings known to VSP. I hope you do too.

[paw]

Jana,

I was reviewing our VSP Explanation of Benefits and discovered something that has made me livid.

Before the change to the new way, between the VSP reimbursement and the patient's frame overage, we were always reimbursed the cost of the frame, and even made a profit if the frame price was high enough.

Well, today I discovered an instance where the VSP reimbursement plus the patient's frame overage came to $38 and the wholesale frame cost was $40. We actually lost $2 on the frame.

I was so upset I called VSP immediately. The rep verified yes, it looks like we lost $2. I asked him if VSP knew that this change would cause doctors to lose money. He said they found that in very few instances some would lose money. He countered that the average doctor sees an increase from this new way. I asked him to explain how anyone can see an increase when the frame allowances have increased (making it harder to sell a frame with an overage), and having to take 20% off any overage that does occur. He could only repeat that the average doctor makes more money. What BS. I can't believe they would even implement a plan that would cause a doctor to lose money off his cost. I am so upset !!!!!!!!

Anyone who takes VSP must complain to them !!!

[Jackie L]

It is my understanding that...

I spoke with a VSP rep the other day and they can not dictate the mark up we use. Who is to say that we can't mark up frames more than 2.6? We can. If the frame retails for $150 and the plan allows for $145, we charge the P the difference less 20% ($4) and VSP pays us back for the predetermined wholesale price.

[Robert Wagner]

It seems to me that if a frame mark-up is anything less than 2.6% there is a "chance" that you may not get reimbursed the VSP pre-determined wholesale price (I believe that is according to the listed wholesale price in the FRAMES DATA INC. book)

It is too bad for all of the "cash" paying patients, for if you had to raise your mark-up on all frames to what VSP is "suggesting" your loyal cash paying patients are paying more for an insurance's plan for it's self:shiner:

:cry:

Robert

[Texas Ranger]

It is such refreshing conversations as these that make me so very thankful that as an independent optician, VSP prevents me from all those great profession/business opportunities. I do see many vsp pts who have reimbursible plans, that I can say a great deal of money, since I don';t have to mark up 2.6 times. they are all likely to get glasses that cost their limit or more. and many of the plans are similar. lady was in the other day, a Cole vision deal, my $92 Nine West frame was $229 at Pearle, they discounted it $52. so her "benefit" was goint to cost her an $177, or $85 more than coming to us, and that didn't count the lens savings. So, what about all those regular folks who come in, that don't have the gift of a vision care benefit? they get to pay the regular, inflated for vsp prices, don't they, and that helps you in what way? and all that paper work, we don't have to do it at all, amazing....I am sure that if you were dealing with intelligent patients, they'd figure out that their glasses cost them more, not less, if you add the premium fees that they pay for this benefit?