VSP Update

[Uilleann]

Some of you have likely gotten this news before we did, but I thought I'd pass this on to any interested parties.

Let me state now - this is not intended to be a bash fest against VSP, Marchon, Essilor or any other optical entity. We know there are plenty here who would love to see all such entities gone. Please start a new thread if that is your motivation. This thread is only to offer information that other ECP's may find useful in helping their patients. :)

We just received word from our local Essilor rep that VSP will add a new catagory of AR lenses in Q1 2009. The new catagory "D" allows ECP's to offer the newer AR lenses such as Crizal Avancé with Scotchguard. They will be identified under code QV within Eyefinity.

Will be interesting to see what other changes may come with the new plan year. All the best!

[Happylady]

I am so glad. I really like Avance and I hate that I can't offer it to my VSP patients. I wonder what the cost will be.

[MarcE]

also included in this catagory is Kodak Clean and CleAR.


What is the patient's pricing? If someone would like to PM me;Thanks!

[Barry Santini]

I am so glad. I really like Avance and I hate that I can't offer it to my VSP patients. I wonder what the cost will be.

Happylady,

Just why, at present, couldn't/can't you offer Avance w/SGP to your present VSP cleints?

Inquiring minds want to know?

Barry

[Metronome]

Happylady,

Just why, at present, couldn't/can't you offer Avance w/SGP to your present VSP cleints?

Inquiring minds want to know?

Barry

Delete.

[Uncle Fester]

Happylady,

Just why, at present, couldn't/can't you offer Avance w/SGP to your present VSP cleints?

Inquiring minds want to know?

Barry

Right now Barry when you click the AR add-on on Eyefinity's order page it does not offer Avance. There is a way to special order but our bookkeeper has threatened a gruesome death if I ever try to offer anything that isn't listed in these drop downs. Billing appearently becomes very difficult and not worth it. By the way almost everything except Avance is available.

[Uilleann]

To be Essilor specific, neither Avancé (introduced earlier this year) nor the previous Alizé w/ Clearguard (now no longer available) were available directly through VSP using their online claims submission website. There are numerous other specialty lens products that due to some combination of treatments, materials or design were also unavailable. This is fairly common in my experience with several vision insurance providers.

There was (and remains) a means to submit for these lens options using a process VSP calls "SLO" or Special Lens Ordering proceedures. It requires use of a private lab and invoice, and special codes and descriptors to be entered in certain areas of the VSP claim form online. It can work if you don't miss all of the extra boxes and make sure everything is listed and coded exactly as VSP wants it to be. However, if you miss a step anywhere, or mis-code or omit a specific detail, you may be denied payment at all for the entire claim. That's when things get "fun".

In light of that, and coupled with the fact that the out of pocket cost to the patient is higher when using SLO's, most of the practices that I've worked with and in have opted to stick with the available lenses from the drop-downs as a general rule. At the least, it's minimized confusion and denied claims for the SLO submissions.

This is nice as it will allow a greater product offering directly from VSP. I hope (and expect) that this isn't the only change to come. With luck, we'll see the entire product line offered increase in some small way. Thanks for an informative 2008 all! Happy holidays!

Brian~

[obxeyeguy]

There is a way to special order but our bookkeeper has threatened a gruesome death if I ever try to offer anything that isn't listed in these drop downs.

most of the practices that I've worked with and in have opted to stick with the available lenses from the drop-downs as a general rule.

This pretty much sums it up, dispensing from the "drop downs". We have fallen too far, and I don't see any way to get back up....

JMHO

[Uilleann]

This pretty much sums it up, dispensing from the "drop downs". We have fallen too far, and I don't see any way to get back up....

JMHO

Perhaps it's true. But many practices accept a variety of insurance and discount plans. Many do so in order to be more competitive with other paneled practices in their area, to increase exposure to potential patients, or just to try and help maintain a viable business in their given environment. The insurance companies certainly make it *sound* like hoop jumping such as VSP's SLO process is the easiest thing since breathing, and that there's no possible way to mess it up. They'll also tell you how much more your practice will make vs their paltry remittances, and the absolute freedom you have in choosing any lab you like.

While there is some infinitesimally small shred of truth to claims like this from the company representatives, there are down sides that prohibit many (if not the majority) of practice settings to bill this type of special handling claim efficiently or effectively - for the patient or the practice. I'm not sure saying that the ECP has "fallen" as such is really fair or accurate across the board - though perhaps your statement hits closer to the mark than I or other ECP's wish to admit. There is certainly a heavy incenive not to use these types of programs due to the circuitous means required to achieve an end result...or at the least, it seems that historically, there has been.