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Thread: Can you tell me what my vision plan is?

  1. #1
    looking up the answers smallworld's Avatar
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    Can you tell me what my vision plan is?

    I was wondering how other offices are handling the growing amount of people who have no idea what if any routine vision coverage they have?
    What is reality but a concept unique to each of us? Can anything be classed as real when our perceptions differ greatly on so many things? Just because we see something a particular way does not make it so.

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    OptiBoard Moron newguyaroundhere's Avatar
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    Quote Originally Posted by smallworld View Post
    I was wondering how other offices are handling the growing amount of people who have no idea what if any routine vision coverage they have?
    I ask them to see their medical card & ask where the primary member works at. Usually I can figure out what their plan is based off of that information. Worse case scenario I inform them to contact either Human Relations through their employer or contact Member services
    Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity

  3. #3
    looking up the answers smallworld's Avatar
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    And what do you do when they want you to call their medical policy or Human Relations person?
    What is reality but a concept unique to each of us? Can anything be classed as real when our perceptions differ greatly on so many things? Just because we see something a particular way does not make it so.

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    Master OptiBoarder
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    Quote Originally Posted by smallworld View Post
    And what do you do when they want you to call their medical policy or Human Relations person?
    As a courtesy to our patients and clients we will bill the insurance's we can. For others we will be more than happy to provide you with an itemized statement for you to submit to your insurance company. On the back of your medical card, there should be a number for customer service, they should be able to assist you with who your vision is through. Once that information has been ascertained we can assist you with your vision benefit. We are unable to contact your H/R department as that is a personal conversation that takes place strictly between you and them.
    Hope this helps
    I didn't attend the funeral, but I sent a nice letter saying I approved of it. Mark Twain

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    Master OptiBoarder
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    I will try take the time to do a full search through all of the insurances to see what their benefits are. It makes people feel good when you take the time to do that, and they don't mind waiting. If I can't find anything through the usual channels then i'll ask them to check with HR to see if they have any hardware or routine benefits. Typically, when you make the effort to save people money they will reward you with thanks in return, or a cantakerous, ill-mannered sarcastic thanks for nothing. No good deed goes unpunished.

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    OptiBoard Moron newguyaroundhere's Avatar
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    Quote Originally Posted by smallworld View Post
    And what do you do when they want you to call their medical policy or Human Relations person?
    If I am free I will do what I can to help them. If that means making the call myself, then so be it. (I know there will be some of you who will say I am doing too much for the patient). I try to go above and beyond for every patient I work with, regardless if I get the sale or not.
    Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity

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    Master OptiBoarder rbaker's Avatar
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    Quote Originally Posted by smallworld View Post
    And what do you do when they want you to call their medical policy or Human Relations person?
    It would be very unusual for a human relations department to give out any employee information to an outside caller. It is clearly the employees obligation to provide you with the appropriate authorization before you render any services. Of course, you can demand payment and give them a receipt for your services which they can submit to their plan provider for reimbursement.

    When you allow a third party to come between your customers wallet and your cash registers you are indeed on slippery ground.

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    O.D. Almost Retired
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    We ask for their health insurance card first, and we check to see if it's an HMO or PPO. Then we ask if they have vision coverage. If they are not sure, we ask where the primary member works. More often than not this leads us to the vision plan. If no luck, we will "fish" at vsp and eyemed for coverage. Still no luck? We tell them they need to research what plan they have and let us know. If they do, we update our database to link their employer or group with the plan so we might not have to repeat this exercise next year.

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    looking up the answers smallworld's Avatar
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    I work in a large city, with ever changing vision plans. Plus my retirees and medicare patients are being sold vision plans by brokers. I am the only person that handles routine vision in my medical center. I absolutely can't be on the phone with patients medical insurance or HR because I have constant phone calls and foot traffic. I obviously try to "fish", but it seems many patients are telling me "you do it" when it comes to finding or keeping on top of their vision plans. And when there is confusion..like a 25 year old child not listed on vsp..I try explaining I can't change their policy. Today I had a patient who wanted me to verify if they have a medicaid glasses benefit..and I'm not a medicaid provider. I guess I understand patients frustration in understanding what their vision plan is, but when I'm being yelled at, I'm confused what other businesses are doing? Do you have a person or department that calls medical plans or HR for the patients?
    What is reality but a concept unique to each of us? Can anything be classed as real when our perceptions differ greatly on so many things? Just because we see something a particular way does not make it so.

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    Master OptiBoarder OptiBoard Silver Supporter Jubilee's Avatar
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    We try to get all the insurance information upfront, while scheduling the appointment. I let the patient know that while we are a provider for many plans, we aren't participating with all the plans. So we like to verify everything first so if there is an issue, we can know up front and not worry about surprises. We use Trizetto/Gateway to do most of of insurance verification for medical plans (there is also a way to verify if they have optometry benefits through the medical plan) or the portals for the major VCPs.

    As for walkin traffic, we get little in regards to exam. We do our best to pull it up on the fly.. but let the patient know it might be a few minutes as we get all the information for their visit.
    "Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland

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    Master OptiBoarder Mizikal's Avatar
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    I will usually say that since we are not providers their insurance company wont talk to me or tell me information. That is mostly true. Most of time you need to enter a provider ID to get any information. If the back of the card has a number for vision I will call it but only because they answer with thank you for calling acme vision. I can then tell them who their vision is through. I kind of have to draw the line at that. I simply do not have the time or the patients to sit on hold foe with their insurance company. They should also be able to go online and get the information they need. I have never been asked to call human resources before. I just think knowing this information is the patients responsibility.

    How do you sign up for benefits and pay for a service but have no idea who you are paying? That is like to knowing the name of your electric company.

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    Master OptiBoarder Mizikal's Avatar
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    I point out that i am not a provider and they will need to call the vision number on the back of the card. " I am sorry sir but since I am not a provider for this insurance they will not be able to tell me what your benefits are'. They really wont. Point out the number on the back of the card. When they get mad I simply repeat myself " I am sorry but they wont give me that information because I am not a provider". Above all be polite.

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    ABOM Wes's Avatar
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    I wonder how an MD's office would handle a prospective patient who said they didn't know who their plan was through, or if they even had one, and were told to "figure it out."
    People become more ignorant every day. As the number of ignorant people like this increases, I am less inclined to hold their hands. I just don't have the time for them all. This behavior is by no means exclusive to optical patients.
    Wesley S. Scott, MBA, MIS, ABOM, NCLE-AC, LDO - SC & GA

    “As our circle of knowledge expands, so does the circumference of darkness surrounding it.” -Albert Einstein

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    Master OptiBoarder rbaker's Avatar
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    Sometimes you just have to get real !

    https://www.youtube.com/watch?v=97TW1Zm1uMI

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    Master OptiBoarder RIMLESS's Avatar
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    Quote Originally Posted by Wes View Post
    I wonder how an MD's office would handle a prospective patient who said they didn't know who their plan was through, or if they even had one, and were told to "figure it out."
    People become more ignorant every day. As the number of ignorant people like this increases, I am less inclined to hold their hands. I just don't have the time for them all. This behavior is by no means exclusive to optical patients.

    Well stated. We deal with this on a day to day basis. The public now expects us to deliver Eyecare and function as omnipotent H/R department. We tell them it's their responsibility to contact their H/R department at work. That pisses off about 70% of them.
    90% of everything is crap...except for crap, because crap is 100% crap

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    What's up? drk's Avatar
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    Quote Originally Posted by Wes View Post
    I wonder how an MD's office would handle a prospective patient who said they didn't know who their plan was through, or if they even had one, and were told to "figure it out."
    People become more ignorant every day. As the number of ignorant people like this increases, I am less inclined to hold their hands. I just don't have the time for them all. This behavior is by no means exclusive to optical patients.
    Wes, since when have you been a stud? You are these days.

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    Master OptiBoarder CCGREEN's Avatar
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    Quote Originally Posted by Wes View Post
    I wonder how an MD's office would handle a prospective patient who said they didn't know who their plan was through, or if they even had one, and were told to "figure it out."
    People become more ignorant every day. As the number of ignorant people like this increases, I am less inclined to hold their hands. I just don't have the time for them all. This behavior is by no means exclusive to optical patients.
    Well speaking for this MD's office, the only time we do insurance for specs is after Cat Sx. Medicare allows X amount of $ towards a frame and X amount toward lenses and X amount for UV. And will probably only pay 80% of that X amount. The other 20% we submit to their secondary, collect what we can from there and send them a statement for the rest. BUT when they come in to pick up their glasses they have to pay for any and everything above what medicare does not cover. So they can have whatever they want. Medicare and most insurances just don't pay for extras.

    And then we work with Cigna Health Spring. That's a simple one. Depending on plan they get $100 or $200 towards glasses once a year.

    Other then that I tell them we do nothing with insurance and eyeglasses. Thank Goodness!

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    Quote Originally Posted by Wes View Post
    I wonder how an MD's office would handle a prospective patient who said they didn't know who their plan was through, or if they even had one, and were told to "figure it out." People become more ignorant every day. As the number of ignorant people like this increases, I am less inclined to hold their hands. I just don't have the time for them all. This behavior is by no means exclusive to optical patients.
    Here here!

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