Spectera is horrible.....

[gogetter]

Ok so i just got a clear pic of how this works......so my pt had spectera and came in and purchased a nice sillouhette with sv 1.60's, ar, and edge polish for readers.....so then i call to get help filing it and it turns out that all the surcharges the patient paid goes directly back to spectera.....DOES THAT SOUND RIGHT??...HECK...if thats the case cant just deduct the patients surcharge from our retail price (if they go above and beyond) what is covered and just have my lab make the lenses or do the complete job.....please feel free to correct me ...but thats what i got from talking to my "area rep" who resides in NY?

[cocoisland58]

I don't have any cash I recieve from the patient returning to Spectera. Whatever they are required to pay above and beyond the coverage for the frame, lenses and options is ours to keep. We know ahead of time what they pay so there is generally no discrepency and we do make the lenses. Can't say the provider payment recieved from Spectera is all that great but if you watch what you sell you do alright. Very slow payers though.

[gogetter]

coco: so in my case where the frame cost was 249-50(frame allowance) ; ar surcharge of 40; HI 1.60 surcharge 60.00; edge polish surcharge 13.00 ......do i charge them the surcharges and file a standard spectera frame and sv cr39??? or do i charge retail less the surcharges ....keep the difference and let my lab do the job???.....or would you do it differently all together??

[Uncle Fester]

We carried Spectera for a short while a few years ago. I don't know if they've since changed the display case, but ours was nicknamed "The Coffin". Wooden box with a hard to handle display.

After a few months we realized that like Davis Vision the profit margin was minimal and the patient base usually wanted "free glasses". Dropped them (and Davis btw) and never missed either.

P.T. Barnum's most famous saying IMHO is both their mantras.
The ECP being the sucker

[Johns]

In our area, there are very few spectera providers. When the pt. walks in they say "I'm just glad I found someone that take this plan!" They expect to pay a lot on extras, and most do without a problem. Usually, I don't mind the wait on the money from spectera, because the overages pay for the job plus profit. The check in the mail is just a bonus.

[gogetter]

John: What Overages? Please Explain.

[chip anderson]

Spectera is wonderfull. For Spectera. Invest in the company, don't put the company in your company and you will love it!

Chip:D

[DrNeyecare]

We have heard major nightmares about Spectera (and Davis also). So we have not enrolled as providers.

Just curious, Spectera was the major insurance for Walmart locations right? I think that was another reason why we didn't enroll.

[cocoisland58]

coco: so in my case where the frame cost was 249-50(frame allowance) ; ar surcharge of 40; HI 1.60 surcharge 60.00; edge polish surcharge 13.00 ......do i charge them the surcharges and file a standard spectera frame and sv cr39??? or do i charge retail less the surcharges ....keep the difference and let my lab do the job???.....or would you do it differently all together??

It's early, let me try to think. The surcharges (we call them extra charges) are on top of what Spec is going to pay on the claim. This is what we "ring in" as a total sale. I don't know about billing since this is one of a few that are sent to a third party to bill. I don't know why but that is how it has always been and was inherited when the store changed hands. We don't use their frames but I did come across the "coffin" that they rode around in a few years ago. We also use our regular lab for the jobs. We may just be grandfathered in somehow and are unique. I have made a list of what lenses and options are profitable and we try to steer away from those that are not. Sorry I could not be of more help. My specialty is VSP.

[gemstone]

I am soon to find out how well Spectera works from the patients perspective. I will let you know.

[Johns]

John: What Overages? Please Explain.

They only cover a certain amount for the frames.

Our average frame overage on Spectera is $148.


(This is for the "Patriot" plan.)

When the want an AR, we tell them about the premium ARs that are not part of their plan, but we give them 20% off on it.

We don't sell (allow the insurance to cover) premium products on most of the insurances we take. We've been called to the carpet by some of the companies, but I told them that it's the only way we do it. They back off..

[shellrob]

Patients have a frame allowance, which 99 times out of ten it's 50.00. You subtract the 50.00 from your frame wholesale and that is what the pateint pays. The patient of course pays all copays and surcharges. Any surcharges the patient pays are taken back from you. You don't get to keep that money. The only thing you get is the exam fee and a dispensing fee which is horrible anyhow. Contacts are fine. You get that money and your exam fee. Now, this is for offices that have to send their jobs to Crown(a whole other terrible place). There are offices that can do them on premises, but Spectera told us it's because you have to have at least 5 locations. We don't use Specteras frames either, I just canot bring myself to do it, they're horrible. We do supply most frames and send them to crown.

[drk]

I have heard that the Patriot Plan allows a higher reimbursement, but it's very difficult to get on (need a finishing lab, etc.).

Most Spectera, to my knowledge, essentially makes you essentially break even on eyewear, and pays a fair-to-middlin' routine exam fee.

Spectera...it's SPECTERRIBLE!

[shellrob]

Exactly!!!

[volente]

we have see spectera patients often because we have a lot of older folks nearby and secure horizons has recently dropped eyemed to go w/ spectera. 75-90% of our spectera patients are unhappy when they realize what high copays and surcharges they have. 100% of our workers are unhappy with spectera.

most cl's are actually ok (although we have to order directly through crown), which takes longer... so that sucks.

the reimbursements are usually horrible. not only that, sometimes what is listed on the website in terms of the surcharges does NOT reflect what we get reimbursed, so if something looks fishy call in and they will actually read you the real benefits. e.g., we had ones that said that poly was covered in full, when in fact, there was a $20 copay (or something like that). in addition, even some frame from "the box" are discontinued w/o them letting us know. sometimes, they might not even have the frames from "the box" in stock so that causes a lot of wait time as well.

also, there are no real big benefits for staying inside "the box..." the frame copays are the same inside and outside "the box." usually the copay is really high... like exam $30, material $30. the main benefit for staying inside "the box" is that there's no overage besides the frame copay and there MIGHT be a chance the lab has it in stock..

if you want a frame outside "the box," they have to order the frames themselves, which take extra long. if we send in our own frame, they will reimburse us $0 for that frame. if we order through them a frame they cannot order (i recently tried to order a hugo boss), then we have to let the patient know that have to choose another frame because it's not covered by spectera. i know they can order older safilo frames but not anything "newer" like j.lo or hugo boss.

the turnaround time for an order is between 1 week and 6 weeks. the bottleneck is crown processing the order and ordering the frame from the lab.

for some reason, we do not receive the frame's case 85% of the time. other times we do. e.g., i ordered a fendi frame and they sent it to us w/o the case. however, i ordered a flexon and then they sent us the case. it seems to be random to me. one of our patients who ordered a coach frame had to purchase a coach case separately because they didn't send us one. when i got mad i specify on the order "please include coach case." i don't know if that gets them mad because i have never received a case w/ that specification. i stopped putting that and now i receive a case 15% of the time.

IN ADDITION, we have to go through one of their labs. we've tried over a dozen of their "essilor" labs, and the jobs come back subpar. lenses missing AR when it was clearly specified... lenses being cut eye-for-eye... lenses coming back scratched up... etc.

IN ADDITION, (we have found out a lot because we have to use them often), if they want any type of warranty on their lenses, they have to PAY and additional amount. i called one of the labs we talk to and they said "oh don't worry that's OUR policy on warranties (such as AR, scratch coat) so we'll replace it." sorry, not that simple. i sent something directly to that same lab and as soon as it arrived i received a call from crown saying that we must send it through them first. so yes, you DO need to purchase the warranty because you'll be submitting it to crown.

everyday one of my coworkers mutters "stupid spectera..." (no one argues)...

[shellrob]

[quote=volente;194603]
if you want a frame outside "the box," they have to order the frames themselves, which take extra long. if we send in our own frame, they will reimburse us $0 for that frame. if we order through them a frame they cannot order (i recently tried to order a hugo boss), then we have to let the patient know that have to choose another frame because it's not covered by spectera. i know they can order older safilo frames but not anything "newer" like j.lo or hugo boss.

.

quote]


We send every single frame to the lab and get reimbursed our wholesale cost plus dispensing fee everytime. So, if someones telling you that you cannot send frames, they're wrong. You can.

[drk]

we have see spectera patients often because we have a lot of older folks nearby and secure horizons has recently dropped eyemed to go w/ spectera. 75-90% of our spectera patients are unhappy when they realize what high copays and surcharges they have. 100% of our workers are unhappy with spectera.

most cl's are actually ok (although we have to order directly through crown), which takes longer... so that sucks.

the reimbursements are usually horrible. not only that, sometimes what is listed on the website in terms of the surcharges does NOT reflect what we get reimbursed, so if something looks fishy call in and they will actually read you the real benefits. e.g., we had ones that said that poly was covered in full, when in fact, there was a $20 copay (or something like that). in addition, even some frame from "the box" are discontinued w/o them letting us know. sometimes, they might not even have the frames from "the box" in stock so that causes a lot of wait time as well.

also, there are no real big benefits for staying inside "the box..." the frame copays are the same inside and outside "the box." usually the copay is really high... like exam $30, material $30. the main benefit for staying inside "the box" is that there's no overage besides the frame copay and there MIGHT be a chance the lab has it in stock..

if you want a frame outside "the box," they have to order the frames themselves, which take extra long. if we send in our own frame, they will reimburse us $0 for that frame. if we order through them a frame they cannot order (i recently tried to order a hugo boss), then we have to let the patient know that have to choose another frame because it's not covered by spectera. i know they can order older safilo frames but not anything "newer" like j.lo or hugo boss.

the turnaround time for an order is between 1 week and 6 weeks. the bottleneck is crown processing the order and ordering the frame from the lab.

for some reason, we do not receive the frame's case 85% of the time. other times we do. e.g., i ordered a fendi frame and they sent it to us w/o the case. however, i ordered a flexon and then they sent us the case. it seems to be random to me. one of our patients who ordered a coach frame had to purchase a coach case separately because they didn't send us one. when i got mad i specify on the order "please include coach case." i don't know if that gets them mad because i have never received a case w/ that specification. i stopped putting that and now i receive a case 15% of the time.

IN ADDITION, we have to go through one of their labs. we've tried over a dozen of their "essilor" labs, and the jobs come back subpar. lenses missing AR when it was clearly specified... lenses being cut eye-for-eye... lenses coming back scratched up... etc.

IN ADDITION, (we have found out a lot because we have to use them often), if they want any type of warranty on their lenses, they have to PAY and additional amount. i called one of the labs we talk to and they said "oh don't worry that's OUR policy on warranties (such as AR, scratch coat) so we'll replace it." sorry, not that simple. i sent something directly to that same lab and as soon as it arrived i received a call from crown saying that we must send it through them first. so yes, you DO need to purchase the warranty because you'll be submitting it to crown.

everyday one of my coworkers mutters "stupid spectera..." (no one argues)...

Good heavens, man...Why do you flagellate yourself so?

[Happylady]

We stopped taking Spectra for eyeglasses. The service was horrible. Crown Lab would take their sweet time and when we got jobs back, often there was a problem with them.

We still take it for exams and contacts. We give patients a 20% discount on eyeglasses. I would say at least half buy their glasses from us rather then take it to an another Spectra place. I think if you can do your own edging they are better, but we are a single location.

[Fezz]

If I had to deal with this nightmare...I would go spin pizzas, cut grass, exotic dancing, or escort service.

Life is too short.

[volente]

we HAVE sent frames in, and we have NOT gotten reimbursed. that's just the bottom line. so we don't do that anymore...

anyways, i guess i spoke too soon because another weird case today... it was just a regular order, but the lab sent us lens blanks. i called crown and they said that they had already sent the lab the frame and that the lab has our frame as well.

[DrNeyecare]

We stopped taking Spectra for eyeglasses. The service was horrible. Crown Lab would take their sweet time and when we got jobs back, often there was a problem with them.

We still take it for exams and contacts. We give patients a 20% discount on eyeglasses. I would say at least half buy their glasses from us rather then take it to an another Spectra place. I think if you can do your own edging they are better, but we are a single location.

Are you allowed to do that? i assume under the contract you signed, that you would have to see all Spectera patients and provide them with terms under the contract. If you do not give them their frame benefits, but give them 20% discount instead, is that not a breach of contract... susceptible to prosecution and possible jail time? j/k :cheers: If this was totally within the contract agreement, I would sign up as a provider ASAP!

[cocoisland58]

Are you allowed to do that? i assume under the contract you signed, that you would have to see all Spectera patients and provide them with terms under the contract. If you do not give them their frame benefits, but give them 20% discount instead, is that not a breach of contract... susceptible to prosecution and possible jail time? j/k :cheers: If this was totally within the contract agreement, I would sign up as a provider ASAP!

If the patient chooses not to use his insurance benefits how is that a breach of contract?

[DrNeyecare]

If the patient chooses not to use his insurance benefits how is that a breach of contract?

Happylady wrote that she provides Spectera patients with their exam and contact lens benefits. However, she provides them with a office courtesy discount of 20% off frames.

From this statement, I assume she does not provide them with their frame benefits. Therefore, the issue is not if the patient choose to use their benefits or not... the issue is they are not given their frame benefit at all. They are given a courtesy office discount of 20% off frames. Even if a Spectera patient decides to not purchase a Spectera consignment frame (but chose one of the doctor's frames instead), they must be given the Spectera frame benefit regardless. They cannot be given a 20% discount.

From what I understand, if you take a certain insurance, you have to provide the patient with all the terms of the contract. You cannnot pick and chose and substitue the terms as you like.

If there's a loophole I don't know about, please let me know. :)

[Happylady]

Are you allowed to do that? i assume under the contract you signed, that you would have to see all Spectera patients and provide them with terms under the contract. If you do not give them their frame benefits, but give them 20% discount instead, is that not a breach of contract... susceptible to prosecution and possible jail time? j/k :cheers: If this was totally within the contract agreement, I would sign up as a provider ASAP!

We were signed up as a regular provider. We were very unhappy with the Spectra lab and called to be removed as a provider. They offered to allow us to stay as a provider for only exams and contacts. It is not a breach of contract.

[DrNeyecare]

We were signed up as a regular provider. We were very unhappy with the Spectra lab and called to be removed as a provider. They offered to allow us to stay as a provider for only exams and contacts. It is not a breach of contract.

Then I totally agree. That's not a breach, and actually a good deal!
I'm send you a PM.