The optical manager of a local Costco store is friends, and told me that they billed over $17K to VSP last Friday the 30th, it was half of their business. $34K total in one day, $17K of it VSP. Both astounding numbers.
Does anyone still believe VSP is out the help the Private Practice?
There are very few, but not many. Most feel they are in an adversarial relationship, and why not?
Costco probably has online access for billing too.
So far I have submitted 3 claims to VSP. All of them ended up with the patient being sent the check. :angry: There always seems to be one more box that has to filled out. :hammer:
- Optician
- Frame Maker/Designer
- Teacher of the art of crafting handmade eyewear.
Overall VSP makes up about 60% of our business on average (a local group practice). I definitely wouldn't say we are adversarial just yet but quite a few of us are sensing that they don't have our best interests at heart moving forward. And we billed quite a lot of VSP out over the last few weeks of the year too, always do.
"Wise men don't need advice. Fools won't take it." - Benjamin Franklin.
so what! It doesn't matter what gets billed......it matters what you get paid. I wouldb't be suprised if that 17K billed ends up coming back at 10-20 cents on the dollar.
Costco should have a sophisticated enough system that 17K equals 17K. At the end of the day our system tells us retail, private pay and insurance to give us an accurate total.
As for VSP being for the private practice, they haven't been in years. A few years ago my former employer had to hire an attorney to "de-franchise" from a local chain due to VSP's rules. A year after that VSP invited the entire chain aboard.
[QUOTE=cocoisland58;
As for VSP being for the private practice, they haven't been in years. [/QUOTE]
I remember the cover of 20/20 (? - or Eyecare Business?) a few years ago.
An OD is blindfolded, gagged and bound to a chair. The caption; "Has VSP Taken Optometry Hostage?"
We knew the answer long ago.
I admit I'm naive but I find those sales figures hard to believe. My understanding is Costo's average sale is say $200, so that's well over 100+ sales/day Every Costo I have been in I never see anyone in their optical shop.
Originally Posted by cwinma
It's not hard to believe.
It's not hard to believe. I heard from some people from a large box in a mall. They had a day just before christmas and had over a 40,000.00 day. They also told me this box averages over 90,000.00 per week. :drop:
Notice the date, 12/30: It was FLEX money, I'd bet chaa!
B
My doc and I were wondering...Are doing straight Vsp or are they doing out of network??? We had a patient quote some of their pricing and seems nothing has changed??? Anybody know???
Christina
I think most are in network. Most plans I know of if your out of network it's a lower payback then in network. That's part of being in network you get a bigger payback plus your suppose to get more patients if you want to believe there bull!
They're out of network.
- Optician
- Frame Maker/Designer
- Teacher of the art of crafting handmade eyewear.
So the real question is why would so many patients totally $17k worth of business choose to go out of network and not just that but choose to go out of network via Costco vs elsewhere. IMO it doesn't sound like the problem is with VSP or Costco.
Most providers were probably closed that weekend (New Years Holiday) thus on Saturday the only possibility was costco for some money burning.
- Optician
- Frame Maker/Designer
- Teacher of the art of crafting handmade eyewear.
The 30th was a Thursday. Besides, what dispensary would be stupid enough to close over the busiest few days of the year? People went there on purpose, not because other providers were unavailable.
$34k sounds too high to me for a single day. Even $17k total is a stretch, considering the price point and how many people come through to buy a single box of contacts or some other low dollar amount transaction. If those were numbers for the week I'd buy it, but not for the day.
I believe it because I know the people in that box. At that box it's in one of the top ten in the country for retail sales. I was told by the manager of that box that there normal week is $90,000.00, it's one of the busiest boxes I know of.
Well I am familiar with that store and yes their 35,000 day is for real.. As far as them billing VSP for $17,000 I find that incredibly hard to believe. Before the first of this year Costco only accepted 2 VSP clients, Trader Joes and Tri Net Gevity. Those were the only two VSP companies we were authorized to do billing before the start of 2011. No way $17,000 dollars came from just those two companies.
Tri Net Gevity is an HR outsourcing companies, they claim to serve more than 130,000 people nationwide. I suppose if they have a LARGE client base in the area of this COSTCO store they might be able generate close to this volume. Keep in mind that VSP is just a big insurance company and no longer the friend of optometry (or the patient for that matter). Watch what happens to your 2011 reimbursements!
Only 2 VSP companies in 2010 were "In Network" for VSP/Costco. However, we need to stop thinking in terms of "In" or "Out" of Network because VSP has, its no longer black and white. VSP has created a "Non-Network Network" that both Costco and select Opticians are using where they direct bill VSP for reduced reimbursements directly through Eyefinity for any VSP member. This way VSP pays out less, and their "members" have more choice on where to go. By still calling it "Out of Network" they can deceive the OD's into thinking that VSP is still their "friend".
And yes, the numbers are real... Optical is Costco's single largest revenue point, and by a long ways its their highest profits per square foot.
[QUOTE=sharpstick777;376375]Only 2 VSP companies in 2010 were "In Network" for VSP/Costco. However, we need to stop thinking in terms of "In" or "Out" of Network because VSP has, its no longer black and white. VSP has created a "Non-Network Network" that both Costco and select Opticians are using where they direct bill VSP for reduced reimbursements directly through Eyefinity for any VSP member. This way VSP pays out less, and their "members" have more choice on where to go. By still calling it "Out of Network" they can deceive the OD's into thinking that VSP is still their "friend".
QUOTE]
You have hit the nail square on the head.
Pez:D
So who are these two companies you speak of? Why not just share the names?
This "non-network network" you speak of; are the insured paying in network or out of network rates?
Ultimately it's the patients choice where to go, why blame VSP? Why do you care if you don't like VSP?
Would OD's be better off if the end users choosing to use Costco were with EyeMed instead?
Racethe1320 I think the 2 companies were already mentioned :
Ok I know I have addressed the "non-network network" before in another VSP thread but I'll try to explain it again. In VSP eyes "we" can't advertise that "we" are in-network however if a patient comes in and asks, do you take VSP?" "we" can say, "yes we are a VSP provider". (word of mouth). The way it is supposed to work is the independant Optician uses usual and customary prices then calls VSP (yes the real VSP, the SAME one the docs call when they have questions) and give the customer service rep the members info. They give us their out of network reimbrsments(these are paid to us by VSP after we bill them on-line) then "we" deduct these amounts from the pts bill and they pay the remainder. But then again if someone has previously worked say in a Dr's office and knows about the "special price lists" whats stopping an independant from matching the prices to keep business...I'm just sayin. I agree with you that it is the patients choice and blame VSP because what they are doing in my opinion is restriction of trade (another topic). Anyway I hope this has explained a little more into the secrets VSP is trying to keep from Optometrists ;) (ok that last bit was a little harsh..sorry)
Last edited by pezfaerie; 01-11-2011 at 11:51 PM. Reason: Because I can't spell
Pez:D
Okay...didn't see them. Nothing new, I just thought they were being kept hidden for some reason.
That’s sounds normal and right. You’re not an in network provider, so you shouldn’t be allowed to advertise that you are in network. You’re an out of network provider. If that means saying that you are a VSP Provider, that’s fine. It’s just language.Ok I know I have addressed the "non-network network" before in another VSP thread but I'll try to explain it again. In VSP eyes "we" can't advertise that "we" are in-network however if a patient comes in and asks, do you take VSP?" "we" can say, "yes we are a VSP provider". (word of mouth).
Again, normal. I don’t see why you’re calling out the “REAL VSP” as apposed to what…a fake VSP ? or that you’re highlighting the SAME VSP. Why would customer service at VSP for in and out of network provides not be the same group?The way it is supposed to work is the independant Optician uses usual and customary prices then calls VSP (yes the real VSP, the SAME one the docs call when they have questions) and give the customer service rep the members info. They give us their out of network reimbrsments(these are paid to us by VSP after we bill them on-line) then "we" deduct these amounts from the pts bill and they pay the remainder.
I don’t see there being a “Special” price list. There’s simply one for in network providers and one for out of network providers. Nothing special. Matching the prices isn’t the issue. VSP has no control, nor would they care. They are still only paying out so much money to cover the patient, which is their customer. The In Network Practice that you would then be “matching” in terms of pricing, is simply a provider for VSP and VSP Clients employees.But then again if someone has previously worked say in a Dr's office and knows about the "special price lists" whats stopping an independant from matching the prices to keep business...I'm just sayin.
Another topic for sure, however, not one I agree with. If a practice doesn’t meet VSP requirements to qualify as an In Network Provider, they act as an out of network provider and make less. I see no restrictions on trade there.I agree with you that it is the patients choice and blame VSP because what they are doing in my opinion is restriction of trade (another topic)
What makes you think VSP is trying to keep this “secret” from OD’s ? They have been pretty open about the whole thing and not keeping anything a secret. The whole Costco thing is nothing more than a rebranded marketing talk-track for Out of Network. So they allow them to file electronically on the patients behalf….big deal. They are doing so to compete with EyeMed. Private OD’s are gaining access to these patients by what VSP has done. If they did nothing and the companies stayed with EyeMed, statistics show a large percentage of the patients would go big-box retail. I too have covered that in a past VSP Thread.Anyway I hope this has explained a little more into the secrets VSP is trying to keep from Optometrists ;) (ok that last bit was a little harsh..sorry)
Regards,
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