VSP Modern eclaim...Observations

[Uncle Fester]

So I'm using VSP Modern eclaim pretty much exclusively and over the last couple of weeks I've got some observations those of us stuck with it may find helpful (or not!).

I always print a Service Report (I think most posters here do not) and note the 2 letter code at the bottom of the page to verify my charges are correct in what I'm charging. This most always gave me the accurate amount reflected on the Savings Statement.

If it wasn't I would usually investigate and if in doubt always charge the higher number.

However--- Lately Modern eclaim is forcing me to change frames overages from $0.00 (!!!) to the correct amount instead of automatically calculating it. Is it happening to you too?

This requires me to manually adjust the Savings Statement. I give this to patients because I find when patients go home and decide we are cheating them because the free glasses are not free, and our itemized receipt is too much to decipher I can just tell them to call VSP and resolve it themselves with VSP and that's the end of that.

I find frustrating that a progressive now always requires a V2200 and/or V2300 lined bifocal code as well. I hope they can fix this to always auto fill.

Finally- It's bugging me that I'm finding the need to put in patient home addresses much more often.

And BROTHER does it feel like I am doing ALL the work for them but- that's been building since I was doing paper forms in the 1990's.


Any observations from others in the trenches?

[EyeTrek]

We've had the same problems. I especially hate that the frame overage is showing up incorrectly. Probably just a matter of time before a patient complains about that. We have also been getting a "Not signed in" error when we try to display patient reports. Usually closing that screen and clicking "View reports" again will fix it.

[NAICITPO]

Yeah been having the same issue with frame overages. I noticed it on both the modern eclaim and using the old eclaim so I think its a problem with their system?

I just wish they would fix being being able to bill glasses and CL fit on the same freaking claim. It's just ridiculous that you cannot do that. That would be a nice change they could have done instead of completely reimagining the process. Talk to people who use the system every day, I know that is weird. But I guarantee the people who used the old eclaim weren't frustrated at having to navigate two screens to bill glasses. That really wasn't that difficult.

[KrystleClear]

I always print the service report too. What I have noticed is for ARs w/ UV included, it is forcing us to bill for AR and UV (like Crizal Esay UV), so I take our normal price and separate what we would charge for UV and break it down that way. On the service report it says UV backside. I have tried to just delete the UV from the claim but it FORCES you to that. If you select the basic Tech Shield, it doesn't do that.

Also, now, you HAVE to hit the calculate button and let it generate the billable items and codes and it's a pain in the **** if it generates something it shouldn't have.

Also, when you first create an authorization and go to print the report it will say login expired half the time, even if you literally just logged in minutes ago. I just close the pop-up and click view reports again and it usually works.

[juno]

I always print the service report too. What I have noticed is for ARs w/ UV included, it is forcing us to bill for AR and UV (like Crizal Esay UV), so I take our normal price and separate what we would charge for UV and break it down that way. On the service report it says UV backside. I have tried to just delete the UV from the claim but it FORCES you to that. If you select the basic Tech Shield, it doesn't do that.

Also, now, you HAVE to hit the calculate button and let it generate the billable items and codes and it's a pain in the **** if it generates something it shouldn't have.

Also, when you first create an authorization and go to print the report it will say login expired half the time, even if you literally just logged in minutes ago. I just close the pop-up and click view reports again and it usually works.

Yeah, all the Crizal ARs have that backside UV add-on charge (eyemed does this as well, but they just have the one UV charge). I've just taken to adding it to the order, whatever. The real deuced odd thing is that I frequently get 2799 charges that I can't figure out. The lenses are going into zyl or metal frames, no edge treatment, but I get that misc charge for SOMETHING. I used to be able to delete it, but alas, no longer. Now I have to enter 0s in that field or I have to re-calculate and it gets re-added anyway. Super annoying

[Uilleann]

As always, these UX "improvements" look like they were designed by a drunken kindergartner with a fat crayon. Loss of functionality, loss of any sense of brevity whatsoever. So many of these idiot companies love to make thinsgs LESS useable, LESS efficient, and of course LESS functional at every possibility. We're not using the abomination of a redesign untill/unless we HAVE to.

[Uncle Fester]

The real deuced odd thing is that I frequently get 2799 charges that I can't figure out. The lenses are going into zyl or metal frames, no edge treatment, but I get that misc charge for SOMETHING. I used to be able to delete it, but alas, no longer. Now I have to enter 0s in that field or I have to re-calculate and it gets re-added anyway. Super annoying

I would never enter $0.00 for a V2799 without knowing why the code is there.

Next time this happens look at or print the service report and look at the bottom of the page.

You will see a 2 letter code and an explanation next to it. Now look for those 2 letters on the Signature or Choice charge list. Each of those 2 letter codes should match an add on. Not every charge will have a 2 letter code. Often V2799 codes (SP, SQ, SR, SV, BV, TA, SW) are found with "Miscellaneous" on the charges pages.

And unless next to the 2 letters it says "covered in full" those charges should apply so be sure you are charging it- because VSP is sure as heck taking the labs cut by assuming you have!

So say you don't charge the $10.00 V2799 "CM" Customized Measurement on a digital progressive where you specified Wrap, Panto and Vertex- your office loses not only the $2 charge back but the $8 lab click fee as well. So the office lost a total of $12 on this Unity Via Elite! (You are always using Unity Elite Sunsync Elite and TechSheild Elite UVR as the first choice right?)

If in doubt with a total charge- charge the higher number, as a refund for an overcharge is much easier than clawing back money from a patient or VSP imo.

I'm fortunate that the back office checks this- though I sometimes think it's more effort than it's worth to them when the VSP paid statement comes in. But god forbid I missed the $10 charge!!!

[Uncle Fester]

V2799 "Gltch in e modern program"...

So I too just had, for the first time, an unknown V2799 code appear after trying to calculate and called VSP.

They said there is a glitch causing this and that they are working on it.

I'll update in a couple of weeks after our next statement comes in to be sure there is no charge associated with this code.

For now you do have to enter $0.00 before you can successfully submit an order.

[iD]

I HAVE TO FILL OUT 99.99% OF ADDRESSES AND ITS ANNOYING!!!!

and getting this message as well "Alert message 1 of 1: OFFHDR2016 Lens materials not covered under PIA" good thing I can override it.

[Uncle Fester]

"Glitches" that cost your office money...

I HAVE TO FILL OUT 99.99% OF ADDRESSES AND ITS ANNOYING!!!!

and getting this message as well "Alert message 1 of 1: OFFHDR2016 Lens materials not covered under PIA" good thing I can override it.

Anything "not covered" needs a follow up when the VSP paid statement arrives to be sure you are not paying lab fees for something that is covered. Or worse- paying full price.

We're finding, as I've been suspecting, a failure to reimburse frames wholesale costs fully. They are only paying the lower wholesale cost for frames from Altair and Marchon. This "glitch" has been going on for a while now.

Why are OD's not uniting and insisting these issues be addressed? Is it being discussed on OD web sites???

[drk]

Nope.

[Sledzinator]

Last I saw they are only forcing practices in California to implement the new system in q1. I think everyone else will be later this year. I wont switch over until they force us to.

[Uncle Fester]

Last I saw they are only forcing practices in California to implement the new system in q1. I think everyone else will be later this year. I wont switch over until they force us to.

If the savings statement is not available (quite frequent these days) or you find the savings statement is showing no frame balance due- even under the old e claim and when you know frame overage charges do apply- double check you are getting paid properly.

You may be in for a surprise that adds up over a month of VSP's.

Also- trying some Modern e claim now (start with simple orders) will be valuable practice for when the switch is forced on you as there are changes that take some time to figure out.

When the change happens, I predict, the wait time for live help is going to be extra long and extra frustrating.

[iD]

Anything "not covered" needs a follow up when the VSP paid statement arrives to be sure you are not paying lab fees for something that is covered. Or worse- paying full price.

We're finding, as I've been suspecting, a failure to reimburse frames wholesale costs fully. They are only paying the lower wholesale cost for frames from Altair and Marchon. This "glitch" has been going on for a while now.

Why are OD's not uniting and insisting these issues be addressed? Is it being discussed on OD web sites???

I'm not in charge of the EOB when VSP sends it. I hope it's right. The only issue I have with it is when I bill for Medi-Cal.

[Sledzinator]

If the savings statement is not available (quite frequent these days) or you find the savings statement is showing no frame balance due- even under the old e claim and when you know frame overage charges do apply- double check you are getting paid properly.

You may be in for a surprise that adds up over a month of VSP's.

Also- trying some Modern e claim now (start with simple orders) will be valuable practice for when the switch is forced on you as there are changes that take some time to figure out.

When the change happens, I predict, the wait time for live help is going to be extra long and extra frustrating.

Thanks for the heads up, we will definitely be checking to make sure we get paid properly. As for switching over I used it for about a week and really didn't have any problems switching. Its different but pretty straight forward. It was annoying to have to manually enter so many addresses and the fact that most of the frames weren't showing when we searched for them was extra annoying too.