With all of the negative comments I read about these third party giants, other than quality, low fees, excessive turn around, product/brand limitations, thickness screw ups, what are the real issues in dealing with these types of labs?
What could be done better that would make these a win/win experience for everyone?
A very similar new process in Canada may be starting shortly and old lessons learned can always be implemented in new business models.
I'd say the old leson of doing it once right with expensive well trained help cost less than redoing it six times with barely trained low wage monkeys.Originally Posted by eyemanflying
A lab can't carry all brands and do them well, it is better if the lab is more Essilor, Hoya, or Zeiss centric. Then they can provide the more compatible anti glare, have lens blanks in stock, and be more familiar with their particilar companies availabilities.
Nothing against the VSP labs, but phone staff cannot be expected to be knowlegeable about all brands and they can't do all compatible anti glares in house. And stocking what all VSP offices like is impossible.
I like Essilor product and have had better experiences with my VSP patients with the VSP approved essilor labs than with VSPs own lab.
Bottom line, is that you can't be everything to everybody. Car dealerships don't do it.
Harry
Good points...it is also impossible to please everybody. On another note, what would you say the average fee paid out is? I'm assuming there's an eye exam fee, lens dispensing and frame dispensing? Are the fees flat rate and fixed? Or, is profit per job shared?
The fees are based upon location and product. Davis had a flat dispensing fee that covers both frame and lens. VSP has individual dispensing fees based upon the type of lens (SV, BI, TRI, PAL, Lent) and a flat fee for a new frame. VSP also allows the patient to chose just about any frame and will reimburse you up to the maximum wholesale amount (But no more than frame facts) for a frame.. and Davis prefers you to use their own frames but will reimburse you varying amounts on provider supplied. The thing with Davis is that their payouts for provider supplied frames is not a straight formula. The amount I get paid for a $115 frame through FedEx is lower than by more than a few dollars than the reimbursement for a FEP $130.
You get more money by selling upgrades. Patient wants Alize? Great.. collect $61 from the patient as a copay, and then keep $20 for yourself. The rest is a charge back to cover additional costs for production. VSP in general has set rates across their major plan types (Signature, Choice, Value) compared to Davis where it seems to be negotiated on a per plan basis. It could be simliar to Eyemed's structure of Premier, Select, etc.. but w/o a name giving it away..
I have little trouble with our VSP approved lab. Using a VSP OWNED lab I had some delays and communication issues. It was a ton better to deal with than when I had to use a certain Choice approved lab in Texas before they opened the network to any lab..
Davis is getting better. I don't reject nearly as much as I used to from them. I still get about one order per month that I have to send back. Usually it is a cosmetic issue, though I have had a few off powers. NEVER send the product back to them w/o getting a NEW invoice number. The few times I have done that, they have ALWAYS lost the item in question. I try to cut them some slack cause if you are producing 1500 rx's a day, and have a 1% screw up rate.. you are still sending out 15 bad jobs. While theoretically we want 0 screw ups.. Most labs I know are not below 1/2 of 1%. Volume is what gets them.
I love being able to track my orders for the most part on the Davis website. Makes it easy to communicate with the patient about issues. They also fax us a list of any orders needing to be restarted. This is also helpful in keeping the lines of communication open with the patient.
VSP we make more money with :)
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
Are the add-ons calculated by the difference between their maximum allowance and your selling price? Do they dictate what the recommended upgrade cost should be to a patient for a particular item when it is not covered?
When the patient has to pay additional for something not included in their plan, what is their general reaction to the out of pocket expense? Are they of the mindset that it should be covered?
Both Davis and Signature plans from VSP have set upgrade costs. You charge the patient X, we take Y as a charge back, so you make Z off of the upgrade. VSP has basically anything goes. They do not have standardized coverage for a SV FF lens. So you have to go through their special lens pricing option. This allows you to factor in your usual and customary pricing into the equation but offers the patient a discount as well. So the patient can pay extra for non-standard options.
Through Davis, if it isn't on the plan's option list, it is not available. So while Davis has the capability of producing Avance coated lenses and offers it on some plans, if a FedEx or Chrysler member wanted Avance, they could not get it through Davis. You want that SV FF lens? Too bad, they don't have it, and they won't be getting it. If the patient is willing to get out of network reimbursements and pay out of pocket.. then perhaps you have a chance. Or my understanding is if you have so many locations and are capable of inhouse lab work, you might get the ability to process inhouse and work something out that way.
VSP Signature Choice used to be a straight 80% of the U&C for "non-covered" options. However, they adjusted things to where some of the more common upgrades, such as Poly, Photochromic, PALS, and Tint now have a stipulation that it is 80% of U&C up to a maximum charge. Most of those maximums are higher than reg signature plans, and in some cases even with the chargebacks you can make more money on the upgrades than you can on the regular signature plan.
As far as patient reactions, we have only a few bad reactions. Most of our Davis/VSP patients are fairly happy with their insurance. They either have had it for a while and thus well versed with it, or at least sees the affect that the insurance has. Our Eyemed patients are the ones who seem to get upset due to the higher copays associated with them. Particularly for PAL's. If they had VSP before and used to paying a set fee, and then paying 2 times that under eyemed.. things get a bit harry sometimes!
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
The thing to note with Eyemed is that it is a retail based plan more so than wholesale the way VSP and Davis are set up. So part of the reason why we collect more money from the patient with Eyemed is because we are paying for the lab services out of pocket, where as Davis does everything inhouse, and VSP has their contracted network. For us, since we are not utilizing inhouse edging as of yet, our profit per patient is less with Eyemed factoring in our production costs. I may collect more for that PAL, but I am also paying more than the "chargeback" that I am assessed from VSP or Davis. Granted some labs will offer 20-30% discounts on Eyemed orders, and with the right controls in place (cheaper lab, inhouse edging for stock/uncut pricing, changes in fee schedule) we could end up making more.
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
I wish that the third-party vision insurance plans would re-imburse more for the eye examination. The amount they are willing to pay for the examination contradicts the image they try to portray to the patients about their concern for people's vision. We receive about 30-40% re-imbursement from the vision insurance companies versus the 80-100% re-imbursement from a medical insurance company.
What is an average cost for an eye exam in your region?
I'm reviviing an old thread because I got a PM about this subject.
Actually, everyone wishes managed care such as VSP would reimburse more, but the market won't allow them too. Where I'm located VSP pays $60, EyeMed $40 both rough figures. If you look at it through the company ( their clients ) eyes, EyeMed and VSP have a list of providers who are overlapped by 80% or better so why would they go VSP if you're willing to accpet less through EyeMed? In turn, why would VSP Pay you more for doing just that? So in one breath you're telling VSP to pay you more, yet you willingly accept less through their competor? Why? You're a service PROVIDER that while they support fully, you don't think doing so and paying you $90 would then in turn be used by EyeMed against VSP and You when they talk with clients? It sure as he11 would!
So now instead of the above company having to look at a list of doctors that not only overlaps and is willing to take less, EyeMed is going to further use any raise in fees against you and VSP by saying to the client their retails stores are an even better value and hers's way. It won't work man. Not to mention financially, companies and paitients won't pay more. Not in today's market.
VSP is however, doing all kinds of things to put money back into your pocket through a number of programs and products they offer that not even priviate or contract labs are offering. I'll be happy to give you examples as I do quite a bit of VSP and with more patients going from Signtaure to Choice, I needed to find ways to up my income per patient on managed care VSP jobs. I have found that and I can also apply the same benefits to my private pay jobs.
The market is changing and we have to change the way we dispense too if we want to stay profitable.
ok
Last edited by coupe; 02-03-2012 at 05:40 PM.
After you take:
Quality
Low Fees
Excessive Turn Times
Product Brand Limitations
Thickness Screw Ups
Out of the equations I have nothing bad to say about any of these labs, but that's like saying I eat crap sandwiches without crap in them.
I'm in the process of scrutinizing vision ins. I think EM pays a higher than that, but just getting to them. I've noticed you mentioniing the fourty figure a few times so thought I would bring this up. will report back when I get to it.
Exam fees vary by region so in your area EM may very well pay more than VSP for certain things, but then they leave the lab bill for you to pay. I have the information for Austin, TX but not handy.
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