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VSP Out of Network (OON) Discontinued?

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    VSP Out of Network (OON) Discontinued?

    It is my understanding that effective 7/1 VSP will no longer provide out of network benefit verification. For the OON suppliers how do plan to overcome this?

    #2
    Originally posted by peyes View Post
    It is my understanding that effective 7/1 VSP will no longer provide out of network benefit verification. For the OON suppliers how do plan to overcome this?
    Is this really true?? Have you confirmed with VSP Out of network provider services??

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      #3
      Same trouble here. No way to verify eligibility since 7/1. Would love to find a work around to be able to explain what coverage members have available.

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        #4
        Oh yeah! It is confirmed. The last time we called they said that phone number was going to be "turned off". I wonder if that was because we called so many times?

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          #5
          How do we obtain authorization, to bill and submit claim to VSP OON? We used to do all the billing for the member.

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            #6
            As an out of network provider we just do a straight percentage discount. Same for any plan we aren't in network with. Specifically with VSP, we will also provide the form for reimbursement. Not sure if what you guys are doing is discounting more or less but it has worked fine for us for years. No one asking us to get them any special discounting through VSP directly.

            Are you getting something back from them?
            Have I told you today how much I hate poly?

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              #7
              We received 21 checks from VSP yesterday. Don't know why they have to write a check for each one instead of 1 check. Out of network.

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                #8
                Originally posted by peyes View Post
                We received 21 checks from VSP yesterday. Don't know why they have to write a check for each one instead of 1 check. Out of network.
                We have been billing and submitting claims to VSP OON, and also receive individual payment checks. But now that the OON of telephone line is discontinued, how can we continue to do the billing for the patients??

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                  #9
                  Originally posted by optician2601 View Post
                  We have been billing and submitting claims to VSP OON, and also receive individual payment checks. But now that the OON of telephone line is discontinued, how can we continue to do the billing for the patients??
                  I got through the OON line (800)877-7195.
                  I asked if OON providers can still submit a CMS1500 form to bill for frame and lenses, and if we need an authorization number. She said NO, we no longer need to obtain an authorization. As long as the claim is submitted correctly. We can still hold on the line to speak to a representative. They will let provider know if frame and lenses are eligible, but they will NOT provide the reimbursement amount or breakdown.

                  I hope this helps. If you know more information, or how we can overcome this new change, please let us know!

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                    #10
                    Originally posted by optician2601 View Post
                    I got through the OON line (800)877-7195.
                    I asked if OON providers can still submit a CMS1500 form to bill for frame and lenses, and if we need an authorization number. She said NO, we no longer need to obtain an authorization. As long as the claim is submitted correctly. We can still hold on the line to speak to a representative. They will let provider know if frame and lenses are eligible, but they will NOT provide the reimbursement amount or breakdown.

                    I hope this helps. If you know more information, or how we can overcome this new change, please let us know!
                    Thanks.

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                      #11
                      Originally posted by peyes View Post
                      We received 21 checks from VSP yesterday. Don't know why they have to write a check for each one instead of 1 check. Out of network.
                      Good to know. Not sure if it would be worth handling more flaming insurance hoops to jump through but worth looking into. Thanks!
                      Have I told you today how much I hate poly?

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                        #12
                        When I call that number I get disconnected and I'm told to have the member call

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                          #13
                          Originally posted by colleen26 View Post
                          When I call that number I get disconnected and I'm told to have the member call
                          Just stay on the line. Enter the members information.

                          Please 0 (zero). you might have to wait for awhile. The representative said this is all very new. Im sure they are on the phone explaining to OON providers.

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                            #14
                            So I guess there are no more authorizations

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                              #15
                              Originally posted by optician2601 View Post
                              Just stay on the line. Enter the members information.

                              Please 0 (zero). you might have to wait for awhile. The representative said this is all very new. Im sure they are on the phone explaining to OON providers.
                              Are you still able to get through to determine eligibility? We just tried and they will not provide any info, although the representative said there "is a 3rd party software that will determine eligibility for OON providers but she did not know where or what." Anyone heard of this?

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