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Good afternoon fellow optical friends.
I'm looking to find out a little bit about spectera. We are considering taking it once again in our practice and before we start the month long process I'd like to know if its even worth the effort.
Is there anyone who knows offhand what they pay for a routine exam? Also, I heard that they are similar to Davis where they have their own lab and selection or frames. Is that accurate? What is the average payout from spectera?
Thanks!!
Following.
In my area, exam pays $55. They do have their own lab and provide most of the frames as well. Consider yourself a showroom for materials. It is a step above Davis. Don't confuse that for an endorsement. Without itemizing everything (because I assume this falls into a gray area of what information is allowable on this forum), do NOT expect much over the exam for exam + glasses. You will likely have a negative balance from time to time after all the chargebacks. I'd rather not get too negative, but I wish my book was full enough to drop specterible.
What's the point?
They always offer a sop to the OD in the form of an offensive--but not too offensive--$55 or somesuch.
But it's the optical and the CL supply that screws you over.
Run--don't walk--away from Specterrible.
On contacts S will say they have 150 dollars worth of contacts but will only reimburse 120 dollars. You will get negative balances if they person gets more than basic add ons. They will give you cost for frames if you supply them. But that is the way everyone else is. You have to send the glasses to their lab. They also have covered contacts. you do better with them than non covered contacts. You get about 100 to 110 for glasses including the exam. The malls get a different plans than private practice. Like the previous person said RUN
Spectera is terrible, other than the exam reimbursement which is OK, ...the materials and the lab will for sure screw you over and the same can be said for Davis Vision as well. I remember when Spectera had the ugly frame box of horrors. At least that is gone.
If your state laws and/or their contract let you opt out of using their Specterible lab it's no different than EyeMed or VSP give or take $10-$15 on the eye exam reimbursements.
This sounds a lot like Eyemed!Quote:
Originally Posted by pbrownlee
I thought I heard that Spectera became United Healthcare??? I certainly could be wrong on this.
Spectera is associated with United Healthcare, however, some UNH members aslo have VSP.Quote:
Originally Posted by LadyDie
I have been for years trying to get my OD to stop taking Spectera, lab quality is not terrible more on the poor side. Payouts are very low. sometimes not worth the time it takes to service the patient.
You heard right... kind of. Some UHC plans have VSP. Some UHC plans have what they call "United Healthcare Vision." That is Spectera. So now we have the conversation, about five times a week, where we have to explain to a patient that yes, we accept their United Healthcare if they have a medical diagnosis, but no, we don't accept their United Healthcare Vision if they are a routine visit. It's infuriating.Quote:
Originally Posted by LadyDie
This same nonsense is why I won't "refer to this coverage as Cigna Vision" for Cigna VSP jobs.
We have been having the same discussions. Yesterday we had 5 patients ask if we took United Health Care and had to explain this. I was here looking to see if maybe there was something showing they had improved and UHC Vision was worth taking a look at again, but it seems like it's still terrible. It's really frustrating to not be able to give our local patients the service they deserve because of low reimbursements which wouldn't help keep the practice open and poor lab quality would give us a bad name and our patients bad vision.Quote:
Originally Posted by AngeHamm
If they give the patient 150 for contacts you will get reimbursed 120. If they have covered contacts you actually do better and get about 100+ from patient and Spectera but you do not get anything for the fit. You will get statements in the mail that you owe them money or pay you wth them. They do not take credit cards and you have to pay with a check. Transition warranty is only good for 90 days. We have to use their lab and it take at least 5 to 10 business day her in Oklahoma.
With all insurances, you can negotiate. That is the key. If they tell you they would pay this for a frame, offer something reasonable. If they won't play, don't play with them. Our worst problem is private companies taking over the state medicaid programs. One company, March Vision will reimburse you what you paid for the frame, up to $30 or so dollars. I told them no, and only do eye exams for them. Wal-Mart is giving free frames. They recently asked me to not refer any more patients to them, lol. Private businesses need to network better. This is the call to arms!
I think it's almost impossible to do well with the frames. There are two choices when it comes to frames: (1) you can sell them a frame that is supplied directly from Spectera itself (2) you can supply a frame that you have purchased. In the first case, whatever you get paid is basically a "dispensing" fee. This fee will vary a little depending on the retail price of the frame but averages to around $15. In the second case, where you provide the frame, there is a little more leeway here to make a profit. Once again it depends on the retail price of the frame and your particular cost. Spectera itself will send you an explanatory sheet where they've "done the math" for you. For example, a frame that retails for $300 will yield a "total frame reimbursement of $88". If you've purchased that frame for $100 you will actually LOSE money and it would have been better to go with option 1 where you don't buy the frame. Some other options may be for you to bypass Spectera entirely by offering their patients a frame for the same "over frame allowance" that they would have paid anyway. The reason why that may work is that the Spectera chargebacks sometimes wind up costing you money even on frames that you supplied yourself (doesnt' that sound crazy?) Bottom line is that even with a lot of fancy footwork, effort and concentration I think it is impossible to do well with the frames. My employee service costs are higher than what they reimburse. We only accept Spectera because there are some contractual issues that force us to do so. I would love to find out if there are other strategies here that I'm missing.