This might fall under the classification of an "ethics question. IF we just bill Eyemed for the frame, and do the lenses in-house (charging only Eyemed suggested co-pays). What do you think about charging the customer 25.00 for "expediting" the glasses?
I know offices that charge a "use your own frame fee", so why not?
If your profit can only be achieved by adding on "creative" fees, don't you think you should consider dropping Eyemed,VSP, Spectera, etc?
Are we allowed to bill for frame only on Eyemed?
yes, but the frame cannot have plano sun lenses in them.
Smart idea
I like the idea of going outside the box and not just necessarily just blindly sending the order to the EM contract lab, but I think if you are going to take the plan you should probably stick with the co-pays dictated by the plan and no more.Originally Posted by opticianjoe
EM used to be a profitable plan. In my store it accounts for approx. 20% of the patient base. So I don't think dropping it with out exploring "creative" and legit ways to make it work is particularly good business. Every post I see about increasing profitability with EM or VSP someone says "just drop it" but I don't see any recent post about businesses dropping EM after the new contract and having a increase in sales or accepting VSP for years then dropping it and having a increase in sales. If there is somebody I would love to hear from you. I think its easy to say "drop it" when you never took it but I think people are looking for legit help not the same tired line of "drop it".
Now I thought about billing EM for the frame only and cash paying on lenses. But I wonder if we'll get in trouble for that. I am also squeezing the lab for better pricing on private pay jobs to help make up the difference and using my Shamir rewards to help.
Consult with your patient about the restrictions of the Eyemed lab. If it takes longer, if the warranties aren't as good as what you provide through your private lab, if they have to give up their own frames, if they can't get Chemistrie, if certain products you recommend aren't available, tell your patient. If your patient agrees and prefers to forgo their benefits and let you do the work privately, then all fees are between you and patient. Some will decline and prefer to go with the cheapest option, and you really have little choice then as you are contractually obligated to send and bill to the lab at patient request, but if the patient agrees with you it is their choice, they are not required to use their benefits to purchase eyewear.
Additionally, patients may be able to purchase privately from you and subsequently submit their receipts for out-of-network reimbursement from Eyemed. The net result could end up being the same cost to the patient, at the expense of a bit more billing hassle. I had a family of four long-time patients with whom I had the discussion, and they were all uninterested in having the insurance lab make their glasses since I have made them myseld for years. I advised them about submitting for out of network. I haven't heard back, but if I do I'll let you know how that goes.
But if your private work *isn't* any better or faster or more convenient than through the Eyemed lab, you have little to offer.
It seems as though you have a good approach; however, one must remember to tread carefully because your agreement with EyeMed forbids you from trying to persuade your clients to cancel their EyeMed plan.
Don't confuse an increase in sales with an increase in profits. Sometimes you have to decrease your sales to increase your profit.
True, but I definitely don't want them to cancel their plan! I still use their exam and frame benefits, and that alone is enough to make the plan (and me) valuable to them, and as long as I keep them happy and take those benefits they keep coming to me and that makes me happy. I'm just helping my patients avoid Eyemed's hassles.
I just inquired with EM about using our own lab and not theirs as their lab is significantly more costly. I was told that if I use my own lab that I would be reimbursed on a lesser fee schedule. 60% less!!! I know it's not ethical, but is it legal?
We don't get reimbursed anything anyway. Right
Our optical is not a provider for EM or VSP or any other for that matter. We refuse to have these big corporate companies to dictate how we will run our business. We have our own in-store surfacing lab, quick service and very reasonable prices. If all doctors and business owners could do the same, eye care would not be like it is today.
It would seem it is not legal in Georgia, at least: http://www.visionmonday.com/latest-n...-their-labs-1/
I think how the contract works out is.... if its the customer's own frame you do not charge for patients own frame. The lab doesn't care where the frame originated.
quick, what is 60% of zero ?
Zero!
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