VSP Out of Network claims

[optician2601]

Do you take VSP out of network? Have you noticed an extreme delay on getting claims processed and paid?
They have a new address now. We have not received for over 4 month.

Vision Service Plan
Attention: Claims Services
P.O. Box 495918
Cincinnati, OH 45249-5918

[Michael I. Davis]

We have not been paid in months but for a revolving number of reasons. Wrong tax number, wrong procedure code, wrong diagnosis codes. We had been paid out of network for years with no problem, but the last few months they are messing with us

[optician2601]

We have not been paid in months but for a revolving number of reasons. Wrong tax number, wrong procedure code, wrong diagnosis codes. We had been paid out of network for years with no problem, but the last few months they are messing with us

Have you tried to resubmit the claims? I tried to resend them all to the new address, but still have not received payments.

Is there a way to get a hold of someone? VSP representatives never wants to talk to out of network providers.

[Michael I. Davis]

Yes some have been resubmitted 3x with different rejection codes each time.

[kittyeyes]

The address I send my VSP out-of-network form is: PO Box 385018 Birmingham, AL 35238-5018
Is that the address you've been mailing the forms to as well? (I mail the form for my patients)

[Elvis Is Alive]

We use Anagram and have zero issues. Anagram lets you file for most out of network plans including VSP, EyeMed, Davis, Spectera, etc. There is a monthly fee to use it though.

[kittyeyes]

Wow-all those plans you listed have out of network forms that I mail in (Eyemed you can fax in) for patients. That service is something patients don't count on and are happy that they're getting some kind of reimbursement and don't have to process it themselves. Happy to share my OON forms and info so you're not paying Anagram- I cannot believe people pay Anagram to submit OON claims- What's Anagram charge??
Pay yourself!! (respectfully)

[Elvis Is Alive]

Well, we match the out of network on eyewear as an additional discount too. Anagram also verifies eligibility and we can file electronically and it takes all of 30 seconds to file a claim. Payment can be set to send to the patient as well, which is what we do.

To each his own, but it is worth it for us.

[Alex Camblor]

We have also not been getting paid for VSP OON claims ever since they switched mailing addresses. We used to be able to file electronically through our EDI clearinghouse but VSP kept making changes to block OON claims. It really feels like VSP is doing this intentionally to discourage OON claims from providers.

[Alex Camblor]

The address I send my VSP out-of-network form is: PO Box 385018 Birmingham, AL 35238-5018
Is that the address you've been mailing the forms to as well? (I mail the form for my patients)

Thats the old address, if you are still using it, your patients are not getting reimbursed.

[optician2601]

Do you file the claim on behalf of the patient, and receive payment from VSP?

[kittyeyes]

anybody have the correct address to mail the VSP claim to?

[Alex Camblor]

anybody have the correct address to mail the VSP claim to?

Per the website:

Vision Service Plan
Attention: Claims Services
P.O. Box 495918
Cincinnati, OH 45249-5918

We just resubmitted a bunch of claims from april and may that were sent to the old address and never paid. Have only received two back so far.

[optical24/7]

Well, we match the out of network on eyewear as an additional discount too. Anagram also verifies eligibility and we can file electronically and it takes all of 30 seconds to file a claim. Payment can be set to send to the patient as well, which is what we do.

To each his own, but it is worth it for us.

This^

We did something similar, 100 buck allowance on frames and 75 off lenses. But, we didn’t file for them or check eligibility or wait to be reimbursed buy an insurance company. If you’re gonna do all that extra leg work, you might as well be on the insurance panel of providers. We simply had the forms for OON on most insurers, filled out our part, price, location..gave them a stamped envelope to send it off, that was it.

Granted, most of our clients purchased from us because they wanted to, the discounts and reimbursement from their insurers were just bonuses to most.

[optician2601]

Just signed up for Anagram. Hope the service will help us keep track of claims.
Thank you!