Vsp

[jeffsoptical]

I think VSP is a terrible insurance company unless you work for them. VSP makes all the money, not the doctors. Why would anyone want to use VSP? I can't and don't want to take any insurance. Why don't more people drop VSP?

Thanks,

Jeff:cheers:

[Jubilee]

Yes and no..

We don't utilize a very high mark up in our office. Now that we are getting more upgrades, we are making more money. However, I have always made more money with VSP than Eyemed which is based upon retail. I don't have much profit at all selling a SV set of lenses for $39.50 (Patient discount plan price). Without us having an edger, by the the time we choose the lenses and pick out a frame, we have really aren't making any money at all on the materials. At least with VSP I get a set dispense fee and the playing field is evened out by wholesale values.

Yes if I was LensCrafters and charged a much higher markup while having much lower costs, then Eyemed would be a better plan.

Same goes for Davis. With them supplying the mats, I am guaranteed a certain amount of profit as well.

Cassandra

[ilanh]

Another factor (at least for our office) is that VSP has brought in a lot of patients to our office. About 30-40% have PPO or other acceptable insurance and will often remain as patients. It's true that the profits are somewhat limited by the requirements and limited reimbursement, but if you are seeing a steady stream of patients it can work out. VSP has brought thousands of patients to my practice that would otherwise not be there.

[MarcE]

Think of it this way, VSP already sold the CR-39 lenses and a basic frame. They will not pay you for those items. They will pay a dispensing fee to you. In order to make it work you have to sell upgrades. We offer poly as the basic lens to VSP patients. "Ma'am, your lenses including the scratch-resistant coating, UV protection, impact resistance and a thinner and lighter lens is only $25 (or $32 for PALS)" They almost NEVER balk. This AR is only $61, Transitions is only $72, etc.

If you don't sell upgrades, you don't make squat.

Unless you want to talk about frames . . .

[LENNY]

Yes and no..

Without us having an edger, by the the time we choose the lenses and pick out a frame, we have really aren't making any money at all on the materials. At least with VSP I get a set dispense fee and the playing field is evened out by wholesale values.

Yes if I was LensCrafters and charged a much higher markup while having much lower costs, then Eyemed would be a better plan.

Same goes for Davis. With them supplying the mats, I am guaranteed a certain amount of profit as well.

Cassandra

Why DONT you have an edger!?

[k12311997]

Why DONT you have an edger!?

because she has a sign?!:D

[Johns]

It's true that the profits are somewhat limited by the requirements and limited reimbursement, but if you are seeing a steady stream of patients it can work out.

Yes, but sometimes, that's all you're getting is a steady stream of limited profits.

VSP does not reimburse you for your staff, and it takes just as much, if not more staff time to wait on your lower profit "stream" than it does for your good profit clients.

Thousands of low profit patients do not translate into a good bottom line, and at the end of the day, the more of their patients you see, the less ownership you have in your own practice.

Not trying to discourage anyone, but don't confuse high traffic with high profits. The only guy that wins in that case is the guy that cleans you carpets.
;)


It's funny, last year when I went to Vegas, I interviewed every cabby that I rode with. To a man, each one had a similar story: "I came to Vegas and got a job driving cab until I could find something better. 20 years later, I'm still driving cab!"

VSP (and many insurances) is a lot like the cab. When you first open your practice, it's great as a supplement, and to attract some patients, but nobody expects that their practice could one day be 40, 50, or 60% third party. But one day, you wake up, you've got lease payments on new lanes and computers, a staff of 7 people, and all the bills a busy practice can generate. At that point, you have no choice but to keep catering to the insurance companies, that have continued to lower their fees, while you increase the amount of their clients you see.

You do have a choice, but you've got to make it early, and stick to it.

[Jubilee]

Exactly.. we all would be better off if we saw a bit fewer patients but made more money.

Since I am working for a doc who has been in business for over 30 years and has accepted many plans in the past and currently, we are very 3rd party dependent. I would say 80% of our base has some form of insurance. Be it exam only or exam and materials.

So we are in bed with the devil already. The question becomes which plans allow us to make some money. As far as that is concerned, I do better with VSP and Davis cause they do provide their own mats. Now if I had an edger (which if I had my way we would!) I then would be happier with Eyemed and a few others that would allow me to see the higher profit margins.

Cassandra

[cocoisland58]

In a perfect scenario we would be filling our books with cash patients. The reality is that we can't. We are in an the Detroit area and almost everyone has some form of insurance. The straight pay no discount plans are great. NVA sucks but is ok if you don't sell up. VSP on the other hand is a great money maker. I have been dealing with them for well over 20 years so have figured out what works. The trick to VSP is to sell up on frames and options. Almost all of our VSP patients buy up so the sale is very good. If the patient asks you what they pay on a frame you simply tell them that VSP covers $$$ on any frame in the store and you get 20% off the difference. That plus options make the sale profitable. If you want to take this to the professional forum I will show you how to make this work. But it shouldn't be to hard to figure out on your own.

[drk]

Think of it this way, VSP already sold the CR-39 lenses and a basic frame. They will not pay you for those items. They will pay a dispensing fee to you. In order to make it work you have to sell upgrades. We offer poly as the basic lens to VSP patients. "Ma'am, your lenses including the scratch-resistant coating, UV protection, impact resistance and a thinner and lighter lens is only $25 (or $32 for PALS)" They almost NEVER balk. This AR is only $61, Transitions is only $72, etc.

If you don't sell upgrades, you don't make squat.

Unless you want to talk about frames . . .

This Marc guy is absolutely brilliant. Listen to him.

[Happylady]

I find it very easy to upgrade VSP patients. Sure, I get a few that want nothing extra, and I don't push them to get more. But most patients have no problem upgrading to a premuim AR, more expensive frame, polished edges, progressives, and high index lenses. They are still getting a heck of a lot of eyewear for a bargain price.

[segcutter]

Quick, look at the doctor charge back sheet to see how much you actually made on the up sale. I bet it is alot less than you think. If you up sale anything, VSP charges the doctor back by reducing base reinbursments to cover their lab bill. Not to mention, if there are specific "plans" the VSP site will choose which lab you can use to fill the rx.

[jeffsoptical]

I find it very easy to upgrade VSP patients. Sure, I get a few that want nothing extra, and I don't push them to get more. But most patients have no problem upgrading to a premuim AR, more expensive frame, polished edges, progressives, and high index lenses. They are still getting a heck of a lot of eyewear for a bargain price.

That's my point. This business is going to the corporate giants. Before long we'll all be working for second rate pay. There are still plenty of people who don't have insurance and several of the OD's here don't accept VSP. Thanks for the responses.

Jeff:cheers:

[Jubilee]

Quick, look at the doctor charge back sheet to see how much you actually made on the up sale. I bet it is alot less than you think. If you up sale anything, VSP charges the doctor back by reducing base reinbursments to cover their lab bill. Not to mention, if there are specific "plans" the VSP site will choose which lab you can use to fill the rx.

Well for one, my two main labs are VSP labs to begin with. So having the work done by one on the list isn't an issue for me.

Yes, If I sell an ar for $61, I won't see all that money comeback. I still only make roughly a 1/3rd of that. Does it suck.. yes. But that is still better than selling ar for $45 via Eyemed and paying all of the copay to the lab for the coating to begin with, and in many cases more...

With my current pricing, if I gave the 20%-30% disc that most plans offer even if they don't cover materials, I still would only get either the same amount or maybe $5-10 more. While I realize that if you multiply that $5 by hundreds or thousands of patients depending upon your volume it may add up to a significant amount. However for my office considering that prior to my tenure they sold AR only 3% compared to my 30% (would be higher if I had the support of my doc) That $20 does add up to the overall profitably of the practice. I know many patients initially in my area anyway, wouldn't have purchased the coating if it was not discounted.

Do I make as much as a cash pay patient. No. No 3rd party plan will ever payout better than cash basis. However in certain markets, you play the insurance game, or you simply don't play.

My area of town is very industrial. We have lots of manufacturing and transportation companies that utilize vision insurance as a employee benefit. If I turned my back on them all at this point in time, with 80% of this practice being insurance based.. I would probably lose 80% of those patients. I get phone calls every week saying "I am so glad my company switched to VSP so I can see Dr. XYZ again." I also get "I really like Dr. XYZ, unfortunately my insurance has changed and I can't afford to not go in network. Can you try to get on this plan or foward my records to a new doc?" So what is an office to do?

Cassandra

[cocoisland58]

VSP is not at all low profit. Consider that you are only supplying the frame and the exam. You do not pay for the lenses. If you add up all the options, exam fee, dispensing fee, service fees,frame overages, etc. what you end up with is the full retail price of the frame, the exam fee, and more. Yes it takes time, yes the exam slots should ideally be filled by cash patients, yes you have to use a VSP lab. Our VSP lab is excellent, the work is quality and the turn around is good. What is wrong with that?

[obxeyeguy]

VSP is not at all low profit. Consider that you are only supplying the frame and the exam. You do not pay for the lenses. If you add up all the options, exam fee, dispensing fee, service fees,frame overages, etc. what you end up with is the full retail price of the frame, the exam fee, and more.

If I did frame only's and exams to 80% of my customers, as a previous post said is their % of vsp, I would not last long.
I don't take it, so I don't know the paybacks but, two people(vsp and you) are splitting the $$$$$ made from all extras. I would rather not work on 3 times the people for no more money.

[HarryChiling]

Our office tells all patients that we can match thier plan with a larger selection and better service. We also ask them to bring in their benefits.

If VSP exmas go for a copay of $10.00 and they only reimburse a patient $45.00 out of network. We charge the patient $55.00 and give them a $5.00 discount. If they have a frame allowance of $120.00 and VSP only reimburses them $60.00 we have them pick a frame that's $120.00 and we charge them $60.00 for it. Same with lenses and everything else and so far it has been very close to what we would charge minus our best promotions + we have it to them in less than two weeks which we are thinking of adding an upgrade charge for to VSP patients, we keep all of that upgrade. ;)

[cocoisland58]

If I did frame only's and exams to 80% of my customers, as a previous post said is their % of vsp, I would not last long.
I don't take it, so I don't know the paybacks but, two people(vsp and you) are splitting the $$$$$ made from all extras. I would rather not work on 3 times the people for no more money.

If someone is doing 80% VSP that isn't going to work out very well. I think of VSP as a nice fill in.

[MarcE]

This Marc guy is absolutely brilliant. Listen to him.

Now if they only believed that at my office, we would all be rich!

Thanks. Lying gets you greenies.

[Jubilee]

I was the one who said our office is 80% insurance based. Now that insurance is a mix of VSP, Eyemed, Davis, and a few union/Great west type (allowance based) plans.

We did axe Specterra some time ago..

And by the way.. as I said the doc has been in business for 30 years, has had the best couple of years ever since I have been on board, and while we might not be making him rich, he also works only 4 days a week.. 2 different offices, and takes off for 7-10days every quarter for vacations..So he isn't hurting either..

Of course it helps when you own the building and have two people leasing from you as well..

Cassandra

[snowmonster]

Yes, If I sell an ar for $61, I won't see all that money comeback. I still only make roughly a 1/3rd of that. Does it suck.. yes. But that is still better than selling ar for $45 via Eyemed and paying all of the copay to the lab for the coating to begin with, and in many cases more...

Cassandra - you're not charging the patients correctly with Eyemed. That $45 copay for AR and $15 copay SRC only applies to crappy in house coatings, and does not apply to Crizal, Alize, Teflon, etc. I've called Eyemed about this before. Those people get a 20% discount off your U&C. In my case, they pay $80 after discount for Teflon. Similarly, the $15 copay on SRC does not apply to TD2, it just applies to basic SRC's. These patients would also get 20% off our U&C = $32 after discount. We just explain to the patient that these ridiculous copays only apply to substandard coatings that we don't even offer to patients because they are simply inferior.

I have to agree with some of the opinions on here that it stinks to take discounts, but are we really as bad off as we think if we get a patient with VSP? Sure, we make less than we would if they had no insurance, but I looked at a VSP EOB today, and we only took a 25% discount off a Silhouette after all the patient payments, insurance reimbursements, etc. And yes, we can make more if we could use our own labs for such jobs, but it's still income. A lot of it simply depends on how your frames are priced, so you can offset the discounting.

And HappyLady is right, it's easy to upsell these people because the stuff is less expensive for the patient.

Fire away...

-Steve

[Jubilee]

I realize that the premium coatings do come with only a 20% disc.

Without giving away our prices/costs.. I would still net more money from VSP for the standard (OLD) stuff..

Eyemed on the premium would net me about $7 more.. which is better than Davis where I only make $7 on AR...

Cassandra

[Johns]

VSP is not at all low profit. Consider that you are only supplying the frame and the exam. You do not pay for the lenses. If you add up all the options, exam fee, dispensing fee, service fees,frame overages, etc. what you end up with is the full retail price of the frame, the exam fee, and more. Yes it takes time, yes the exam slots should ideally be filled by cash patients, yes you have to use a VSP lab. Our VSP lab is excellent, the work is quality and the turn around is good. What is wrong with that?

What's wrong with that is this company has you convinced that because your not buying the lenses up front, they're doing you a favor. What used to be a good profit, you are now settling for what some insurance company 1,000 miles away is telling you you're allowed to make. What favor have they done for you ? They've taken a patient you would have probably had anyway, and had them pay premiums to them , which in the past, would have been the lenses you could have sold and profited on.

I think this industry has a complex where they believe that if they don't sign up for every insurance company there is, that they're going to miss some scrap of a customer. Ironically, by being on all these plans, you'r allowing the insurance companies to solicit even more of your cash paying patients into their ranks.

No, third parties are here to stay, but there is a lot wrong with it.:angry:

[cocoisland58]

What's wrong with that is this company has you convinced that because your not buying the lenses up front, they're doing you a favor. What used to be a good profit, you are now settling for what some insurance company 1,000 miles away is telling you you're allowed to make. What favor have they done for you ? They've taken a patient you would have probably had anyway, and had them pay premiums to them , which in the past, would have been the lenses you could have sold and profited on.

I think this industry has a complex where they believe that if they don't sign up for every insurance company there is, that they're going to miss some scrap of a customer. Ironically, by being on all these plans, you'r allowing the insurance companies to solicit even more of your cash paying patients into their ranks.

No, third parties are here to stay, but there is a lot wrong with it.:angry:

Early morning reply to late night rant. I have discovered that in the last few years only 20% of our VSP patients are local. The rest have traveled to us simply because we accept their insurance. Therefore they would not have been our patients. Many of these are dual contact lens and eyeglass wearers and purchase one or the other out of pocket. What favor has VSP done for us? They have steered a larger patient base our way. Would we rather have cash patients instead, use our own lab and finish in store? Of course, but in the economy we in Michigan are trying to survive in it would not pay to turn our noses up at VSP. We have turned our little noses up at a few others lately. But like it or not VSP is a money maker for us. There is a lot wrong with third party insurance but each individual practice has to decide what works best for them and if you are savvy you can use most of them to your advantage.

[ilanh]

I don't think that the exam and dispensing fees with VSP are insignificant. You get paid about $50-72 for exam (depending on the plan, region etc). And you can get a $110 dispensing fee for progressives. If you sell a few upgrades eg: poly, transition you get dispensing fees of $25 on each of those as well (these figures are very approximate). If you upsell your frames you can eke out some profit there also. This means that a typical progressive sale will bring $200 in exam and dispensing fees, along with whatever else you make on the frame. If they get a second pair, that's pure gravy. Furthermore, once they have this great experience at your office they'll come in for their other problems as well. On top of all that they have a system that's fairly seamless, very highly computerized and easy to deal with. They are instantly accessible by phone at all times and seem to have a knowledgeable support staff.

I can tell you that from the perspective of a clinician I often have non-vsp patients with serious problems who take up more of my time that will a vsp patient; and I will often get reimbursed less for those.