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Thread: How to qualify to accept Insurance in Optical Store?

  1. #1
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    How to qualify to accept Insurance in Optical Store?

    Hello All,
    I have been following OptiBoard and lot of my questions got answered with all the informative input you guys provide here. Thanks for being so supportive.
    My family opened up an Optical Goods Retail Store last year.We currently sell all designer Optical goods, specially designer Sunglasses and Frames at our store. Our plan when we opened up the store was to open a store like Sunglass Hut and sell designer Eyewear, but more than half of our customers ask for prescription glasses, and so we are planning to change our store to a proper optical store.
    The questions I have are,
    1. We currently don't accept any insurance, what will we have to do in order to qualify to accept Vision insurance from customers. (We have accounts opened with Luxotica and Safilo).
    2. We are planing to hire a licensed optician for providing service to customers looking for prescription glasses (for example to measurepupillary distance, and to assist customers in picking right frame), is this the right way to go?
    3. Do opticians also know how to make prescription glasses? like cutting the lens and fitting them in the frame? (obviously given the equipment is provided)

    Please try your best to provide me with the information for above mentioned questions. I know most of these questions are basic and some of them are dumb, but I am new to this field so please be nice.. thanks for your time :)

  2. #2
    Master OptiBoarder OptiBoard Silver Supporter Jubilee's Avatar
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    1) You need to get credentialed with the assorted insurance companies. Some, like VSP won't be interested without an OD partner/owner. Others, such as Eyemed might. Be sure to tread carefully, because you might be better off offering a special price and helping them file reimbursement. All of the major players will have a link for providers and a way to contact them for interest in joining their panel.

    2) Hiring a licensed optician is the way to go, given you are in a licensed state. Depending upon your store hours and the laws in GA, you might need a couple to provide adequate coverage.

    3) Not all opticians are handy in the lab. Depending upon your decision in regards to vision care plans (since some will make you use certain labs), and volume, you most likely would only be interested in someone with finishing/bench skills. Many edgers are very user friendly these days. For an experience optician, it might not be too difficult to train the right person..
    "Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland

  3. #3
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    Hello,
    Thanks for your reply. I would also like to know,
    1. In my case, Will I have to hire a LDO before calling insurance companies to get credentialed?
    2. Without LDO can I collect patients prescription, use pupilometere to measure distance, and have the glasses made by a third party optical labs?
    3. Do optical stores require to have an optician present in the store during store hours, or we can have part time opticians and part time sales person? Basically my question is what are the requirements for an optical store?
    4. If I am understanding this correctly, I won't be able to help customers with prescription needs unless I am an optician?
    5. What is the best way to hire part time full time LDO in South Atlanta area?
    6. My long term goal is to sublease my office space and couple other rooms in my optical store to an OD, in that case will the equipments used by OD will be provided by them?
    7. Incase if I sublease extra space to OD, do they pay a flat rent or a percent of there income? (I think this depends on the deal, but want to know usually what is the best practice)

  4. #4
    Master OptiBoarder rbaker's Avatar
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    You indicate that you are an eye care professional working in the optical retail business. If you are not aware of the current licensing laws in Georgia and are not willing to find out by contacting the appropriate authorities I suggest that you open a shoe store, bar room or a massage parlor. I realize that the retail optical business is a license to print money it is only open to those who have their optical ducks in a row. Only then can you approach the third party payees for information on their requirements to fleece you.

  5. #5
    Manuf. Lens Surface Treatments
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    Redhot Jumper optical ducks in a row ..............

    Quote Originally Posted by rbaker View Post

    I realize that the retail optical business is a license to print money it is only open to those who have their optical ducks in a row. Only then can you approach the third party payees for information on their requirements to fleece you.

    Get your ducks in a row



    Question:

    What does get your ducks in a row mean? Do people really have ducks, and why are they putting them in rows?


    Answer:

    These are entirely imaginary ducks. Getting your ducks in a row means organizing your tasks and schedule so that you are ready for the next step.
    There are a number of theories behind these ducks. Real ducklings, of course, walk in a line behind their parent, and the expression ducks in a row certainly brings that image to mind.
    Other theories involve the precise set-up of duckpins, which are a type of bowling pin, or the mechanical ducks you can shoot at in a carnival firing range. Some sources suggest the phrase comes from the game of pool, when a number of balls, called sitting ducks, line up neatly near pockets and can be tapped in one after another.
    Getting your ducks in a row has become a cliché, and some people object to its use. You should avoid it when you write. Simply say "get organized" or "prepare yourself."



    https://www.noslangues-ourlanguages....-dcks-eng.html

  6. #6
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    Quote Originally Posted by visioncare View Post
    Hello,
    Thanks for your reply. I would also like to know,
    1. In my case, Will I have to hire a LDO before calling insurance companies to get credentialed?
    2. Without LDO can I collect patients prescription, use pupilometere to measure distance, and have the glasses made by a third party optical labs?
    3. Do optical stores require to have an optician present in the store during store hours, or we can have part time opticians and part time sales person? Basically my question is what are the requirements for an optical store?
    4. If I am understanding this correctly, I won't be able to help customers with prescription needs unless I am an optician?
    5. What is the best way to hire part time full time LDO in South Atlanta area?
    6. My long term goal is to sublease my office space and couple other rooms in my optical store to an OD, in that case will the equipments used by OD will be provided by them?
    7. Incase if I sublease extra space to OD, do they pay a flat rent or a percent of there income? (I think this depends on the deal, but want to know usually what is the best practice)
    You are thinking way to far in to the future, right now. Your duty is to your customers (and later, your patients). Getting "approved" by an insurance company means that they are entrusting their good name to be represented by you, so you will need to know what you are doing.

    Your questions suggest you are more of an investor than a person interested in being an eye CARE professional. Consider hiring an optical manager who shares your visions but who will take the proper steps to provide quality eye care to patients at a profit for you. That way, you can step away from the business, let someone else run it, and reap some financial reward for your trouble.

    If you don't already, develop a panel of trusted business friends who can help guide you along this path. They don't need to be optical business people.

    By stepping in to the eyecare industry, you are opening up lots of new liabilities that you don't sound prepared to take on (which is why you think your questions are dumb).

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