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Thread: VSP to discontinue special lens allowance

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    Master OptiBoarder OptiBoard Silver Supporter ak47's Avatar
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    VSP to discontinue special lens allowance

    This just in:

    Starting November 20, 2013, the VSP Special Lens Allowance procedure will no longer be available for lenses and coatings that aren't assigned a VSP option code. While nearly all lenses and coatings are approved today, a very small number require the use of the Special Lens Allowance procedure.

    Because we've received concerns and complaints from VSP members and clients who are dissatisfied with the high costs for these products and the loss of VSP benefits, we're discontinuing Special Lens Allowances. Refer to the updated Product Index in the VSP Manual on VSPOnline to check the lenses and coatings you dispense in your practice.


    Ok, so now if a patient wants something less than cookie cutter, they can't use their benefits at all?

    I'd love to hear what the folks at Maui Jim and Italee have to say about this.


    I'm sure no members or clients will complain when they are "not allowed" to get their Oakley Rx lenses !

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    Master OptiBoarder NCspecs's Avatar
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    Awesome. That just means the consumer will probably be able to order their Maui Jims through Eyeconic with measurements supplied by us. I'm sooooo sure they are "getting complaints from clients." I call BS.
    "Strictly speaking, there are no enlightened beings; only enlightened activity." -Shunryu Suzuki

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    Again, this is the new face of managed care. VSP/eyemed insurance, VSP/eyemed owned frames and lenses, and all work done thru VSP/eyemed owned labs, it is coming soon. If the public wants specialty product they can go on line or come to us.

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    Where was this information posted? I can't seem to find anything on VSP online...

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    On line, VSP Vision Care 31 Oct 2013

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    Yeah it's getting silly, and they wonder why people are turning to the online sites.......

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    Master OptiBoarder DanLiv's Avatar
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    In the Special Lenses section of the online provider manual:

    "Important! As of November 20, 2013, this is only available for genuine brand name RX lenses that must be sent to the frame company’s lab or a non-VSP contract lab."


    • "Enter the following in Box 19 on the CMS 1500 screen:


    • For a frame and lens mounting that is not available through a VSP contract lab: Type “Special Lens $xxx.xx – non VSP mounting + product name”. The cost of the lenses should be pulled from the lab’s private invoice and the product name should be the frame and lens product that was provided to the patient.
      For a Genuine brand Rx lenses that are not available through a VSP contract lab: Type “Special Lens $xxx.xx – Genuine Brand Rx + product name” The cost of the lenses should be pulled from the lab’s private invoice and the product name should be the frame and lens that was provided to the patient."



    Guess they are still allowing for Maui Jim, Ray Ban and Oakley authentic lenses. I'm not surprised they are nixing it, all it did was cost them money to provide a convenience and benefit to their members and providers. They are of course more in the business of profiting than providing conveniences.

    Gonna be a bit of a kick in the teeth for non-VSP custom labs like Digital Eye Lab and ICE-TECH, especially on the heels of Eyemed. I hope they have enough private business.

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    What's up? drk's Avatar
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    If I were that type of operation, what would it take to be "genuine name brand Rx lenses"? An act of congress? Does it require a frame to go with the lenses? Panoptixs/7Eye-IceTech potential merger comes to mind...Just for VSP jobs? Probably not worth it?

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    Master OptiBoarder DanLiv's Avatar
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    Quote Originally Posted by drk View Post
    If I were that type of operation, what would it take to be "genuine name brand Rx lenses"? An act of congress? Does it require a frame to go with the lenses? Panoptixs/7Eye-IceTech potential merger comes to mind...Just for VSP jobs? Probably not worth it?
    I'm sure VSP will have a strict list of "approved" genuine brands for the procedure.

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    That is terrible news as I use digital eye labs for most of my work.

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    Quote Originally Posted by DanLiv View Post
    I'm not surprised they are nixing it, all it did was cost them money to provide a convenience and benefit to their members and providers. They are of course more in the business of profiting than providing conveniences.
    add in many practices and groups including many of the big E reps touted SLA as a way around things and it ended up being abused. over time it wasn't so "special"

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    My Brain Hurts jpways's Avatar
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    I fail to see what the big deal is, it's not like they're eliminating the out of network benefits, yet it means more paperwork and probably higher costs for the patient since they're no longer using their full frame benefit. And yes the out of network and VSP as secondary payer benefits, when available, are a pain to do and for VSP to get right, but they're still there even if they eliminates the genuine manufacturer product exception, of which there are 7 companies that have exceptions that are listed in the VSP manual that will stay as a special lens procedure, of which Panoptx is one.

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    I believe this may be step one in a directional move by VSP. They are going to build out lab capacity and it does not take a fortune teller to see that eventually all VSP work will go exclusively to a VSP lab. Correct that. They will give you $4 to edge one of their unity lenses so you can earn "a return" on the edger you bought at Vision Expo. You won't miss Essilor as the VSP labs will have a full suite of Unity like lens products that will work great with the Marchon frames that will be covered. The SLA type of program will gradually be reduced. After all, who will need a "special lens"? All you will need will be offered as a VSP product.

    Put yourself in VSP's shoes. They are at a disadvantage to Lux and Davis as they do not own their own retail outlets. But what they do have is market domination in many areas of the country. If you live in an area dominated by VSP, they might as well give you a VSP sign as they will basically own your business.

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    Quote Originally Posted by Stan Tabor View Post
    They will give you $4 to edge one of their unity lenses so you can earn "a return" on the edger you bought at Vision Expo.
    I know there's sarcasm there but the reality is if you're doing in office work for VSP Patients, the minimum payout is $10 and if you're not properly selecting the right jobs to edge in house so that you're averaging nearly double that then you're doing it wrong.

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    Quote Originally Posted by racethe1320 View Post
    I know there's sarcasm there but the reality is if you're doing in office work for VSP Patients, the minimum payout is $10 and if you're not properly selecting the right jobs to edge in house so that you're averaging nearly double that then you're doing it wrong.
    I know you are a big fan of VSP and I have no issue with that. They have been good to you. You apparently know how to work the system.

    The issue I have with VSP is they have drifted so far away from their original mission, they no longer represent the principles upon which they were founded.

    For years VSP chiseled away at its providers as reimbursements did not keep pace with inflation. VSP made tons of money and chose to invest this money into buying frame companies, labs, and experiment with retailing; both online and bricks and mortar. Talk to independent lab owners who have been pounded into the ground by VSP and now VSP is opening labs to crush them. The smart labs sold to Essilor. The Essilor partner labs that sold out but who had big VSP business are getting hurt. They made a deal with a devil and now they live by the results. Your devil is VSP and you will live with your results.

    VSP has become more about the ego of its leadership then it is about creating a vision plan that produces quality vision care for its subscribers while fairly compensating the providers. Their ego is focused on dominating visioncare from end to end. When this happens, they may not technically own you. Instead, they will control you which is even better for them as ownership creates risk that you will bear. All they have is upside.

    Today, you are able to work the system. I would wager that eventually they will get around to changing the system to take your profits as well so they can buy another frame company.

    Finally, there are thousands of not-for profits in the US. How many are so profitable that they actually lost their tax exempt status and had to start paying taxes! Basically, if you read between the lines of the governments attack on VSP, essentially VSP was a sham with respect to its claims to be a non-profit.

    I have no issue with an entity making the moves that VSP has made as long as it does not adopt a holier than though attitude and claim to be a non-profit. I am a simple guy and to me, a non-profit provides a benefit to the community it serves and does not use its not-for profit status to corner an industry.
    Last edited by Stan Tabor; 11-03-2013 at 10:26 AM.

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    VSP to discontinue special lens allowance

    This just in:

    Starting November 20, 2013, the VSP Special Lens Allowance procedure will no longer be available for lenses and coatings that aren't assigned a VSP option code. While nearly all lenses and coatings are approved today, a very small number require the use of the Special Lens Allowance procedure.

    Because we've received concerns and complaints from VSP members and clients who are dissatisfied with the high costs for these products and the loss of VSP
    PROFITS, we're discontinuing Special Lens Allowances. Refer to the updated Product Index in the VSP Manual on VSPOnline to check the lenses and coatings you dispense in your practice.

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    Quote Originally Posted by NCspecs View Post
    Awesome. That just means the consumer will probably be able to order their Maui Jims through Eyeconic with measurements supplied by us. I'm sooooo sure they are "getting complaints from clients." I call BS.
    Yes, this is AWESOME:

    "Sorry, your insurance plan is not allowing you to use your benefits for premium products, that is, what you really want, but we're can still get it for you, and at a discount. You may want to mention this to your HR person at work when it's time to re-sign for your benefits.

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    I'm not surprised their cutting out the SLA provision it was a loser from the get go. This is just one more opportunity for your office to reinvent it's pitch on vision plans. Mrs. smith wants the non covered product? no problem lets do it as a second pair!
    "If you don't build your dream, someone will hire you to help build theirs..."-Tony Gaskins

    So I built Prentice Optical Lab.

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    Quote Originally Posted by Johns View Post

    Because we've received concerns and complaints from VSP members and clients who are dissatisfied with the high costs for these products and the loss of VSP
    PROFITS, we're discontinuing Special Lens Allowances. Refer to the updated Product Index in the VSP Manual on VSPOnline to check the lenses and coatings you dispense in your practice.
    I assume this is a direct quote from a VSP pronouncement? I thought VSP still claims to be a non-profit???

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    Quote Originally Posted by Stan Tabor View Post
    The issue I have with VSP is they have drifted so far away from their original mission, they no longer represent the principles upon which they were founded.
    What principles do you believe they were founded upon? Their core mission has always been about providing affordable vision care so that millions of people can see better. It's always been about the patient. The market has since misconstrued and perhaps they played along with the phrase, by OD's for OD's. That's still true as well but they have had to evolve over time just as everyone here has.

    For years VSP chiseled away at its providers as reimbursements did not keep pace with inflation.
    I would argue they can't continue to focus on exam reimbursements. They are already getting their clock cleaned by clients when EyeMed goes in touting the same doctors for far less for exam fees. If VSP raises them any further EyeMed Sales reps will only use it against them even more. In terms of reimbursements, they have greatly raised the money back to practices but now it's on Materials vs exams. It has to be in order to compete while at the same time offering more to their panel providers.


    VSP made tons of money and chose to invest this money into buying frame companies, labs, and experiment with retailing; both online and bricks and mortar. Talk to independent lab owners who have been pounded into the ground by VSP and now VSP is opening labs to crush them.
    Again, VSP has had to invest in these areas. Materials such as frames and labs, lenses, etc. all make up part of the industry that just a few years back they didn't leverage and the competition at Lux/EyeMed did. It was a smart business move for them to do so. Investing it back into exam fees wouldn't strengthen their position in the marketplace. Materials and labs do. Independent lab owners haven't been "pounded into the ground by VSP? Quite the contrary, many have built fine businesses by being a SERVICE PROVIDER to VSP. VSP was never in business to support independent labs. For those businesses to now feel VSP isn't supporting them is selfish and out of line. It's up to the INDEPENDENT Labs to support THEIR OWN business not up to VSP to do so. Stop the Crazy Talk. VSP isn't opening labs to Crush Them. It's part of VSP's business model and it's quite clear why. They are pushing their own products and if the Indy's won't then VSP Will. They also are clearly trying to rely less on Essilor who owns the majority of their contract labs. Why give the Big E profits to do what they themselves can now do? Last I checked, VSP is offering their own products to ALL contract labs too, thus they aren't cutting them out or crushing them.


    The smart labs sold to Essilor. The Essilor partner labs that sold out but who had big VSP business are getting hurt. They made a deal with a devil and now they live by the results. Your devil is VSP and you will live with your results.
    The smart ones sold yes but perhaps because they didn't or couldn't run a business. Perhaps the market evolved and they were no longer needed or seen as bringing value to the ECP's of the world. If they were, they would still be thriving. I don't fault Indy's for selling. Part of forming a business is succession planning which often means cashing in and selling.


    VSP has become more about the ego of its leadership then it is about creating a vision plan that produces quality vision care for its subscribers while fairly compensating the providers. Their ego is focused on dominating visioncare from end to end. When this happens, they may not technically own you. Instead, they will control you which is even better for them as ownership creates risk that you will bear. All they have is upside.
    I don't see it that way. Share more details on your thoughts of what their EGO looks like? What I see is a COMPANY not a charity. A company that compensates their providers better than any other MC Company out there. Show me where others are doing more for private practice? Their mission has not changed and they are simply evolving to insure the market and competition doesn't dominate them. No different than any other business.

    Today, you are able to work the system. I would wager that eventually they will get around to changing the system to take your profits as well so they can buy another frame company.
    How has VSP Taken any profits? Last I checked, providers offer up a share in return for VSP Patients and the opportunity to earn rewards in many different ways. I do hope they continue to expand and take a bit more out of the market that Lux and the Big E dominate. By doing so they continue to support me and my practices.

    Finally, there are thousands of not-for profits in the US. How many are so profitable that they actually lost their tax exempt status and had to start paying taxes! Basically, if you read between the lines of the governments attack on VSP, essentially VSP was a sham with respect to its claims to be a non-profit.
    Just because the Gov't is now taking a portion of their income as taxes doesn't mean anything within the way VSP Operates as a not for profit has changed. Tell me how it has? The company is managed and run just as they were years ago. How is it a sham? Is there a secret stock market or shareholders group you know about? The reading between the lines is now that they took over some Non-managed care companies, the rules of the gov't dictate Uncle Sam wants a piece of that action. Hey, that's gov't in the US of A. No surprise. However, again, please share with me how VSP isn't still operating to support their panel providers just as they always have. There's nothing wrong with a not for profit using those profits to expand and grow. Again, along with that growth, they've also began reimbursing far more than in the past.


    I have no issue with an entity making the moves that VSP has made as long as it does not adopt a holier than though attitude and claim to be a non-profit. I am a simple guy and to me, a non-profit provides a benefit to the community it serves and does not use its not-for profit status to corner an industry.
    Show me how VSP isn't benefiting the community it serves? Please, let's have that discussion. I'll be happy to show you how the panel providers are able to earn far more today than even just 5 yrs ago. VSP IS absolutely in fact supporting the community of OD's it serves. The difference is today they are supporting those that support them better than those that don't. I for one agree with that move. I carry Marchon, Use OfficeMate, UNITY, etc...and their labs for a large portion of the work we service. I for one DO NOT support others who do NONE OF THAT being paid the same reimbursements as me. I support VSP More and thus I should rightfully EARN more. That's thankfully part of what many don't like.

    When I started here on this board it was my first real intro to such a network and it shocked me and still does that so many are willing to see VSP Patients, cash their checks and then talk bad about them. VSP should just cut them and let them close up shop and dry up suffering. However, I've yet to see that. They are seemingly leaning towards just not supporting such practices as much as in the past and again, that's a good thing for those of us that do support them.

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    Quote Originally Posted by Johns View Post
    and the loss of VSP PROFITS, we're discontinuing Special Lens Allowances.
    So you're upset that VSP is finally tired of allowing their potential PROFITS to go elsewhere? Like I said, Visionsource, Essilor and many of my colleagues abused the SLA program long enough to benefit themselves FIRST, not the Patients. Cut the crap already people and quit pretending the world revolves solely around your wallet first.

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    Quote Originally Posted by Johns View Post
    "Sorry, your insurance plan is not allowing you to use your benefits for premium products, that is, what you really want, but we're can still get it for you, and at a discount. You may want to mention this to your HR person at work when it's time to re-sign for your benefits."
    in reality, it's "sorry that your insurance plans providers are no longer able to sell you the products THEY want to in order to Maximize their own profits while snowing you about your insurance coverage and the loop-hole they have exploited." Please go see your HR Person about finding another VSP Provider in your area.

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    Quote Originally Posted by Stan Tabor View Post
    I thought VSP still claims to be a non-profit???
    VSP Is a not-for-profit and all that means is there's no public group of investors that benefit from taking a share of their profits. Instead they pay their people and invest profits back into the machine that brings you patients and more products and higher reimbursements. It's up to you to work their system and programs in order to benefit more yourself. It's not difficult.

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    Quote Originally Posted by racethe1320 View Post
    VSP Is a not-for-profit and all that means is there's no public group of investors that benefit from taking a share of their profits. Instead they pay their people and invest profits back into the machine that brings you patients and more products and higher reimbursements. It's up to you to work their system and programs in order to benefit more yourself. It's not difficult.
    I can't recall meeting anyone as gung ho on VSP as you are and I admire your enthusiasm. If you are in, go all in.

    However, I think you should read the briefs filed by the venerable Kenneth Starr with the Supreme Court a few years back when VSP was fighting to overturn the ruling the revoked its tax exempt status. You will see that the claims made by VSP in these briefs portray something different from what you describe. Maybe this was just a bunch of BS in an effort to avoid paying the IRS. What we do know is the Supreme Court rejected their arguments and VSP is paying taxes on its profits.

    I wish you the best. I just hope you are not on a journey with VSP in a race to the bottom with Eyemed and Davis.

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    Quote Originally Posted by Stan Tabor View Post
    I assume this is a direct quote from a VSP pronouncement? I thought VSP still claims to be a non-profit???
    No, sorry Stan! The bold part was my word, interpreting what VSP is afraid to say. I apologize, for not putting it into parenthesis.

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