I'm a benefits administrator for a large regional employer (+25,000 employees) and I'm researching the difference in provider reimbursements between EyeMed & VSP. Specifically, we're interested in determining which carrier has more favorable reimbursement terms for providers (both lens and frame allowances) and offers the greatest flexibility to participants. Any info or feedback would be very appreciated.
1. For frame purchases that exceed the network frame allowance, does the network agreement allow you to balance bill the ppt up to U&C? Does the network limit the out of pocket cost or require a discount to the ppt and if so, what is the limit/discount?
2. Which carrier has better provider discounts for the carrier's proprietary brand frames? (Marchon / Luxxotica)
3. What is the review/approval process for medically necessary contacts?
Thanks in advance for your help!
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