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Thread: Vision Insurance Questions? Doctor Insurance Questions?

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    OptiBoard Apprentice eyepeople's Avatar
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    Question Vision Insurance Questions? Doctor Insurance Questions?

    Hello,

    We have owned an eyewear dispensary for 2.5 years now selling only frames and lenses. We are now moving and hiring a doctor to perform eye exams. Since the beginning we have never taken insurance for many reasons which I am sure a lot of you already know those reasons.

    My question is if we were now interested in taking insurance what plans can we accept that do not require us to be "doctor owned" or 51% doctor owned, etc, etc. because that is not our situation.

    If we cannot accept any insurance as an "optician owned" dispensary, can the doctor we hire possibly be an independent company that we are sub-contracting and the OD accept insurance for just the eye exams? I hope that makes sense....

    Any advice about insurance for our situation, a doctor accepting insurance, etc etc would great be appreciated. People going on a rant about nothing related to my questions would not be appreciated :-). Thank you!
    Last edited by eyepeople; 05-17-2014 at 02:53 PM.

  2. #2
    Master OptiBoarder OptiBoard Silver Supporter Jubilee's Avatar
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    The majority of the major VCPs won't accept an optician owned dispensary anymore. That doesn't mean you can't work with some of the local unions and some of the riders on major medical plans like BCBS of IL. Part of this shift is the VCPs are aligning themselves with major medical to handle the vision care portion, citing the number of cases where an Optometrist was the first to diagnose diabetes, hypertension, and high cholesterol.

    The tide is also shifting with non dispensing doctors. The last few contracts I read in the latest round of credentialing had language to the affect of "we want our members to be able to receive all services in one location, if they so choose."

    Now if the doctor you bring on board is already credentialed with these plans, they might be able to just "add" their office (located in your building) as another location to receive services. Another option is for the doctor to be on many of the major medical plans so the exam is covered (and usually at a higher than VCP rate)
    "Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland

  3. #3
    Rising Star
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    Quote Originally Posted by eyepeople View Post
    Hello,

    We have owned an eyewear dispensary for 2.5 years now selling only frames and lenses. We are now moving and hiring a doctor to perform eye exams. Since the beginning we have never taken insurance for many reasons which I am sure a lot of you already know those reasons.

    My question is if we were now interested in taking insurance what plans can we accept that do not require us to be "doctor owned" or 51% doctor owned, etc, etc. because that is not our situation.

    If we cannot accept any insurance as an "optician owned" dispensary, can the doctor we hire possibly be an independent company that we are sub-contracting and the OD accept insurance for just the eye exams? I hope that makes sense....

    Any advice about insurance for our situation, a doctor accepting insurance, etc etc would great be appreciated. People going on a rant about nothing related to my questions would not be appreciated :-). Thank you!
    Yes, there are insurance companies that will contract with "Optician owned" opticals and allow you to be part of their network. I know of independent opticals that are contracted with VSP, Eyemed, Spectera, Davis Vision, Superior and others. I wouldn't count on getting VSP to accept you right off the bat unless you can prove that you have a good patient base that already has VSP or that you have the volume to warrant becoming part of their network. As far as the others, I suggest going to their websites and see if you can apply online to become a provider and find out what all is involved. Good luck!

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