Credentialing With VSP

[1424241]

First of all, I am not only new to Optiboard, but I am new to the industry.

I have been working in IT (which means I do everything including plumbing apparently) for a medical office for years. They decided they wanted to branch out and hire an OD. Naturally, I was asked to help our credentialing person figure out what to do about credentialing with vision plans.

It was then that I found out that vision plans appear to be nothing like medical insurance plans. VSP for example has sent us a laughably long list of requirements to credential with them. I suppose it would be laughable except I'm pretty sure they're not joking!

One of VSP's requirements in their laundry list is that the OD must own at least 51% of the dispensary. (I know you've all heard this question a million times. I tried to find a good thread to read and learn from but my situation is a little different than any thread I was able to find so I started this one. Any of the MODs are obviously welcome to direct me to a better location.)

First of all, what exactly does this mean? He must own 51% of the stock, or the company or the Optometry division? Do vision plans define what they consider a "dispensary"?
Secondly, our medical group currently includes 5 MDs. The practice is owned by a partnership of 3 MDs. Is this not sufficient for them? Do they require it be an OD only?

Again, I apologize for being a n00b. I suppose as time goes on, I will learn a lot more on this subject.

Thanks for your patience,
Aaron

[Jarhead Daddy]

You should also check your state optometry law. In some states, MDs cannot simply "hire" an OD. There might be a few hoops to jump through regarding "division of fees".

Would your MDs be able to meet the VSP credentialing requirements? That might be the simplest solution. Probably not unless they are Ophthalmologists.

Or, perhaps you could profitably lease the exam lane and dispensary to the OD. That way, the new OD practice would be 100% owned by the OD. The medical group would benefit by having more services in house (although as a separate business), and the new rent payments.

[RIMLESS]

Just wait till you get a load of the fee schedule . Lol

[1424241]

You should also check your state optometry law. In some states, MDs cannot simply "hire" an OD. There might be a few hoops to jump through regarding "division of fees".

Would your MDs be able to meet the VSP credentialing requirements? That might be the simplest solution. Probably not unless they are Ophthalmologists.

Or, perhaps you could profitably lease the exam lane and dispensary to the OD. That way, the new OD practice would be 100% owned by the OD. The medical group would benefit by having more services in house (although as a separate business), and the new rent payments.

Well, the PA state optometry code allows an OD to work for a corporation so we're safe there but I don't think (at least as far as I can tell) VSP credentials MDs.

The leasing idea seems like it could possibly work.