Spectera Vision Insurance?
Does anyone deal with this plan?, a pilot friend just called to tell me that American Airlines is just signed on with them; they pay 13/mo. cna get a complete pair of glasses(sv, bif, or trif.) each yr. for a $25 co-pay. pilot thought this was a really good deal; i'm thinking it must just cover some "very basic" eyewear. comments?
We turned them down because we had some patients who reported they were rude an very difficult to deal with.
Chip
My husband's health plan offers this to us as a deduction every year. Fat chance. Selection at covered benefit--forget it. You pay co-pays. Only good every 2 years. What can I get with the 180 a year times 2 and copays...alot more that looks good on my face and his..(not biased or anything):drop:
Thanks Chip and Bev, had hoped to get input from some providers to see how they dealt with them, claim filing and basic services. they say they've been around since '64, never heard of them; but for AA to go with them, makes me curious, but maybe AA is just downgrading employee benefits, they're always in disputes with all their unions, maybe this was a trade-off. only providers listed in my area are walmart and eyemasters, any input? Jo, Stephanie? Al.
spectera
:D Al. like any vision plan, i really dont like it, but it seems to be one of the better ones out there. I am in a situation where we do a lot of spectera.
.........Patient s need to know two things , one is they have to decide between eyeglasses or contacts, they cant have both. Also the contacts are only covered from an approved list of 50 types, mainly the disposables etc.. Expensive torics will not be covered.
.........Depending on the level there on depends what the copayment is, usually 0 to 20.00.
..........Very basic lenses that come with no extras and low cost frames, typically 29.00 to 79.00 are whats covered, for there copayment only.
.........Now, heres the good part, on average i have noticed that when the patient buys something that is not covered,IE expensive frames, poly transition,etc, they get about a 70 to 75 percent discount off the regular retail price. I had a woman in the other day whose bill came to 519.00, after spectera she paid 159.00. Thats what your patients will like about spectera, and BTW on all the plans i have seen so far it is one pair of glasses each year. On accuvue disposables ,4 boxes will be covered, the rest they will pay.
.........Al. if you have any more questions on Spectera, LMK or email me,Regards....harry
Hello Harry,
I have a question. "I had a woman in the other day whose bill came to 519.00, after spectera she paid 159.00." What do you get paid through Spectra? $360.00?
Curious,
Darris C
:shiner: Darris, i dont really remember as i just turn that nonsense into the manager and then it goes to corporate, but no you wont get that much, if i remember ill look it up tomorrow
If I can remember corectly the amount paid to the practioner is something based on cost of both lenses & frames similar to VSP with differences to patient as stated. Maybe a 1/3 to 1/2 of the 300+ you are stating.
Darris, looked that up today and spectera was billed 121 dollars. so your total from the two comes to 280.00. this was a calvin klien frame and outlook poly ar. hopre that answers your question and gives you an idea
Harry, I got some info on this; and I really hope you're not doing as much as you said. First, it works like a safety glass program, straight dispensing fee($25). They provide a "selection" of frames for the pt to choose from, and ALL lab work is done thru their lab. The lens options to the pt. are higher than my retail, of which the dispenser gets to keep 20%,i.e. if the pt. wants a Vailux Comfort, they pay an extra $110 to us, of which we get to keep $22, Spectera gets the $88 difference, Crizal is a $90 add on to the pt., the dispenser gets $18, combine the two(which we do frequently, the pt pays $200 extra, and we make an extra $40. So, my pt. that works for AA, that I regulary sell this lens to for $245, now pays $13/month (156/yr.), comes in with this plan, pays a $25 co-pay, and an extra $200 fot the Comfort Crizal lenses, So, the good news is that someone else does all the lab work, I make $65 for "order taking", processing the paperwork. I would have no frame cost or lab cost, so I guess it would just be pure profit, or course i'd have to deal with these folks and those glasses for longer than I'd care to. And God forbid if there was a doctor's error! So, Harry go back and re-evaluate the program. I think I'll pass. Al. This really makes Luxottica's program look really fine!
Al, spectera has a lot of different plans, and thats the way mine works. I have no choice as its a signed deal through our corporate
Spectera tells you how much you're allowed to make, just like Eyemed does, but they don't make you buy a dispensary full of frames. You can make money at it Spectera, but not if you play by the rules. They will reimburse the O.D.s higher than the local rates, but who cares if you get $15 more per exam, but you make on average $144 lesss on the glasses ? We got off the plan but still offer a "Spectera Discount" of 25%.
Dr. Johns, First, You do have to buy frames for Eyemed, but they are current styles and frames that are saleable to non-Eyemed clients. You can do your own lab work, allowing Eyemed members the same quality of service as your other customers. So, there are a couple questions, on Spectera, what happens if a client wants a frame style from your other inventory? What happens if your eye doctor decides that maybe they should of had that extra 0.25 on the add? What recourse do you have if the glasses order comes back from the lab after an unreasonable fabrication time and they don't meet your standards?
Al.
What I meant to say was that Eyemed makes you buy frames, Spectera does not. Even though we advertise that we off an Eyemed discount, we are not providers. We were providers for Spectera, but dropped them and now also give a Spectera discount. On any plan that we are on that requires that we use their lab, we send only 10% of the jobs to them, and do the rest in-house. We eat Dr.'s changes and other remakes, but the manufacturers usually back us up under warranty. We are on one plan that supplies frames to us, but the pt. can choose off-plan frames as well. In this case, we have a nice display in the closet, next to the vacuum, the Lysol, and the feather duster. The plan rep knows that we don't display his program frames, but he doesn't care because he's happy to have someone to service his plans customers in anyway they can. We refuse to turn our profits and control of our offices over to third party plans, and frame companies masquerading as insurance companies.
I sound like John Kerry here, but I agree with both sides of this discussion. As a private practice optometrist, I was a Spectera provider. I learned quickly that it was not worth the trouble. The most you can hope is that because of the expanding popularity of this plan, the patient draw will bring non-spectera referrals to your practice. I learned to only use spectera frames and allowed Crown labs to make the lenses. I collected co-pays and exam fees only. I didn't encourage add-ons b/c spectera will only bill you later for those.
With that said, since losing my private practice to Hurricane Katrina, I have been forced into the world of Corporate optometry. As an Independent Doc in a commercial setting, I bill directly to spectera for exams only. I don't have the hassel of processing lens orders, and I have enjoyed a steady increase in my patient base. I get a hefty check every 2 weeks from the insurance. I'm seeing about 60 spectera patients each month. Eligibility and claims processing are made very simple by internet. Although not great, the reimbursement rate for exams and Contact Lens fitting is reasonable. For difficult to fit contacts, I typically will add a surcharge beyond the reimbursement rate of 30 dollar fitting fee.
We recently signed up with EyeMed and we didn't buy any frames.
We have stopped using Spectra for eyeglasses, we do exams and contacts only. We were being forced to use their lab and we had nothing but problems from it. Also we were sent a box with some of the ugliest frames I have ever seen. Almost no one wanted them. But if they wanted one of our own frames the Spectra lab had to provide it, unlike Davis where we can send our own frame.
Jobs were taking way too long and quaility was poor.
Speaking of Eyemed.. anyone have trouble with their "provider relations" dept? I called them up to ask if they had an ETA on when we were going to be on the provider panel.
They said we receive the application on March 16th.
Yes, I know that... can you tell me when you will have us on the provider panel.
It takes 60-75 days to process.
I know that, I want to be able to put these patients on my schedule. Will it be taken care of by June 1st?
Ma'am, it take 60-75 days.. you do the math.
So you have no idea if it will be the 60 or the 75?
NO
Can I get benefit information for a patient so she can know what she is eligible for and have everything ready to go for her, Since she needs to get an exam and glasses as soon as she can, once we are on the program?
No, we can only give out that information once you are on the provider panel. I can verify she will be able to get benefits through you, but I can't tell you what those are yet.
AaaarRRRGGGGGGGgg!
Makes me really concerned about what it will be like dealing with them once we are on the damn panel.
Cassandra
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
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