VSP,,how are you making any money??

[brendajm]

We have been taking VSP for about 3 years.. We have been looking at some of our reimbursements and on a pair of SV glasses we are only getting a payback of 90$,, and then we have the frame fee that we paid,, so sometimes we are only netting 30$$$ WTH.. on progressives we make more,, but we are losing our shirts on SV jobs.. Am I missing something here? Do I need to really up the price of the frames??

[fjpod]

I'll start with a simple answer: it's hard. Vsp is one of the most controlling plans out there. Yes, they pay a little more for the exam. The only way it pays to take these plans is if they bring you patients that you would otherwise lose.

[Sphinxsmith]

The 'quarter-mile-guy' has many answers to questions regarding VSP. I would do a search and look for posts from racethe1320.

cs

[Tallboy]

Edge SV stock lenses in house. Don't mess them up. Get deals from your frame manufacturers where what you are paying for their frames are less than the listed "wholesale" of their frames.

Thats how you do it.

[cowboytelemark]

Edge SV stock lenses in house.

Do you actually file the lens claim or just take whatever their copay amount is?

[Paul Smith LDO]

Besides your scheduled service fees the only way to make money is through frames and 2nd pairs. I would not recommend VSP frames, that way you control the prices.

[peyes]

Out of network is perfect for me

[obxeyeguy]

I'll start with a simple answer: it's hard. Vsp is one of the most controlling plans out there. Yes, they pay a little more for the exam. The only way it pays to take these plans is if they bring you patients that you would otherwise lose.

Who cares? Market yourself to others, at full price, not half, all service and best choice, not what "my insurance covers", better.

Not sure why they say there is a shortage of OD's, as there seems to be plenty to work for half, or less, than usual fee. I am just a bottom of the pole optician, 41 years, and have done well at regular fees, based on my service. Ask Barry, Craig, or Robert how we survive. I don't worry about the ones I might not attrack, I work on the ones I can attrack after problems, lousy glasses, whatever, or on my personal service. I can't be all things to all people, and Walmart customers are typically not who I see.

Markets vary, I moved to get away, and succeed. Most won't, or can't, we all have our game plan, no real universal right or wrong. We do what we have to, I just choose to keep the "lady", on the other side of my door.

[Jubilee]

Well I thought I had this all worked out. Use frames that you can receive at a substantial discount compared to their "Frame Facts" price. Keep minimum amounts of "covered" product and try to get the items that are a few bucks or higher than your avg wholesale frame allowance. We charge above market mark ups, but make up for it with packages/multi pair discounts to help out the private pay patient. Sell lots of upgrades (AR, Transitions, Higher index) and then any and all SV edge in house to keep most of the chargebacks for ourselves, instead of having them sent to the lab..

However, I am not sure how many are aware of this latest blurb but...

News and Updates Update to frame reimbursement policy To better align frame reimbursements with frame industry pricing, VSP is updating its frame materials reimbursement policy, effective July 1, 2016. Practices meeting the Marchon/Altair minimum sales threshold of $6,000 during the last twelve months will continue to receive 100% wholesale reimbursement. Practices not meeting the minimum threshold will receive 80% on all non-Marchon/Altair frames. This policy change accounts for discounts and rebates practices typically receive from frame manufacturers. Since Marchon and Altair are VSP Global companies, VSP can pass the additional savings back to practices. The policy change applies to Signature and Choice plans.

And Marchon/Altair you wonder why I want NOTHING to do with your product.. Unless you want us to be franchise's.. afterall there are already 3 offices in 10 miles of us that carry almost the full line of Marchon/Altair crap. How dare I want us to differentiate ourselves..

[Dr. Bill Stacy]

My formula for success with VSP includes in-office-finishing, demanding significant discounts and other percs on frames that are "covered" or "close to covered", pricing my services and materials above most practices in my area, upselling where upselling is sensible, esp. 2nd 3rd and 4th pairs, making my office efficient, lean and mean, and fitting medically necessary contact lenses with complex lenses or daily disposables where possible.

We recently fit a keratoconus patient with scleral lenses and VSP reimbursement was 2.5K for the exam, fitting and materials. Med. nec. daily disposables can bring reimbursements around 1K. I hope all non-VSP providers will send anyone with KC, Rxs above 10 D in any meridian of either eye, aniso over 2.5 D, or any other corneal or refractive condition that qualifies for medical CL fitting to a VSP provider who fits complex cases and can maximize the patient (and doctor) benefit. If they don't tell the patient about this they are IMO willfully or unwittingly harming the patient.

I'm attending a vsp sponsored event this Saturday that promises to bring new information to some vsp-centric practices. I'll start a new thread on anything of significance I learn there, as the industry is certainly changing rapidly.

BTW the vsp/altair/marchon brands are not "crap". They have a wide range of quality and style from indexpensive Otis and Piper all the way to the higher end Skaga, Chloe', Calvin Klein, and Cole Haan to name a few, and they have been improving rapidly over the past couple of years. Yes, you can always get a higher net on some other lines, which is why I carry both vsp and non-vsp frames. I do not carry Luxottica frames. Their styling and quality seems to be heading the other way. The last wayfarer I saw was truly a piece of you know what.

[fjpod]

Who cares? Market yourself to others, at full price, not half, all service and best choice, not what "my insurance covers", better.

Not sure why they say there is a shortage of OD's, as there seems to be plenty to work for half, or less, than usual fee. I am just a bottom of the pole optician, 41 years, and have done well at regular fees, based on my service. Ask Barry, Craig, or Robert how we survive. I don't worry about the ones I might not attrack, I work on the ones I can attrack after problems, lousy glasses, whatever, or on my personal service. I can't be all things to all people, and Walmart customers are typically not who I see.

Markets vary, I moved to get away, and succeed. Most won't, or can't, we all have our game plan, no real universal right or wrong. We do what we have to, I just choose to keep the "lady", on the other side of my door.

Trust me. I do fine.

[obxeyeguy]

Trust me. I do fine.

I'm sure you do, and that wasn't meant directly at you. It was to say that I can't draw them all, so I stay in my market that I can. It's all what works for you.

[ak47]

"BTW the vsp/altair/marchon brands are not "crap". They have a wide range of quality and style from indexpensive Otis and Piper all the way to the higher end Skaga, Chloe', Calvin Klein, and Cole Haan to name a few, and they have been improving rapidly over the past couple of years."

It may taste like Coolaid to you, but to me it tastes like ****.

[brendajm]

I am confused on the frames.. I am under the impression that we "cannot" make them choose frames from a certain collection. I was told they can choose any frame on the board?? Some are choosing high end frames and we are only making about 14$ over the wholesale price!! That is just nuts.. When I run our report it shows that we average about 180$ PP but that does not include our product expenses.. The doctors are flipping.. And if this new pricing for the frames goes into effect in July does that mean we will lose money on frames now??

[newguyaroundhere]

I am confused on the frames.. I am under the impression that we "cannot" make them choose frames from a certain collection. I was told they can choose any frame on the board?? Some are choosing high end frames and we are only making about 14$ over the wholesale price!! That is just nuts.. When I run our report it shows that we average about 180$ PP but that does not include our product expenses.. The doctors are flipping.. And if this new pricing for the frames goes into effect in July does that mean we will lose money on frames now??

You could show them frames that might be covered or with small overage based on their plan but ultimately it is up to the patient. Or you could drop being a VSP provider altogether.

Yes, if you do not sell $6500 in a 12 month span of Marchon/Altair frames then your reimbursements on non-Marchon frames will be reduced by 20%

[Jubilee]

If your patients are choosing a non covered frame, and even after the overage you are only making $14, then you need to look at your pricing.

If your patients are choosing mostly covered frames, and you are only making $14 per frame, then you need to seriously look at your buying...

[Jubilee]

I was calling the Marchon/Altair product crap not based upon necessarily quality (though I do think some of it is overpriced wholesale wise and a fair amount of that is due to branding..) but because I am tired of them getting all up in our business...

I like at least one of our Marchon reps, and I really admire her efforts to keep opticianry alive in Indiana.

However, business wise, Marchon is the ONE company that refused to help us navigate a sticky situation. An office that most of the staff, including the doctor had worked at, closed just before our new office opened. Many patients assumed it was simply her opening in a new spot.. not a whole new business. Since the patients could not have their warranties handled at the now closed location, and they recognized the doc and staff, they naturally expected us to take care of their warranty concerns. Every vendor, regardless if I had them in our new location agreed to help, but one. Marchon. They would not talk to me, only our patient, then directed our patient to receive their care elsewhere.

If docs are all worried that there is a provider on every corner, and every independent doc should partner with VSP, and in order to maximize your return on VSP, you should be premier.. and carry Marchon/Altair and sell Unity branded products.. what will differentiate you from the other VSP franchises in your area? Service, maybe.. but I am not foolish enough to think that I am the only one that provides exceptional service in our area. Warranty policies? Our technology?, Pricing?

When your frame and lens selection becomes uniform, and the same through out the area, it will become more difficult to differentiate. Many of the practices that have gone Premier in my area don't have room for any other lines but Altair/Marchon. There simply isn't any other monies for frames left..Pricing becomes a bigger draw, along with availability.

I do not want to become a slave to an insurance company, vendor, lab, or whatever you want to call them. In the areas they passed legislation to limit the insurance company's influence, the insurance companies are striking back by either having to be All in or None for lab work (which I can kind of understand) but they also are making those reimbursement rates so low for the groups that decide to opt out of the lab network that they are having trouble finding a way to make it work..

I have been fairly supportive to VSP in the past. However the cost of frames will end up going up, as every company then is going to be pressed to give a discount to compensate for the VSP play. Not every vendor I currently work with gives me a 20% off frame facts discount. While it isn't common to see this with designer brands, many smaller independents don't offer that kind of discount either. Simply because they aren't trying to inflate prices to decrease them with "special pricing" be it through buying groups, negotiating terms, etc..

[dv]

I am actually getting paid more on my SV than I am on my PALS?! I swear I also feel I am in the dark regarding how to get above water with VSP. It feels as if the services in the end are all for free. I still need to service the patient and their frames as if they were any other. I pride myself in taking my time with patients throughout the process from choosing the best frame for their style and proposed function to making sure all new PALS are trained properly to use them successfully. Frames are adjusted to full patient and my satisfaction. I don't want them having to return for anything other than an additional purchase or for their next exam. Not looking for complaints or half-*** customer service here. They see and notice the difference and I want to keep it that way. But spending the same amount of time and effort on orders that will get me next to nothing if not (-) payments is ridiculous. What good does it do me to get these "new patients" that I wouldn't normally get if we don't get paid?!

[brendajm]

I have been fairly supportive to VSP in the past. However the cost of frames will end up going up, as every company then is going to be pressed to give a discount to compensate for the VSP play. Not every vendor I currently work with gives me a 20% off frame facts discount. While it isn't common to see this with designer brands, many smaller independents don't offer that kind of discount either. Simply because they aren't trying to inflate prices to decrease them with "special pricing" be it through buying groups, negotiating terms, etc..

We are a small practice in the woods..Most of our patients don't even want add any extras.. Some will only go with flat tops since that is what is covered.. I get some that I can upsell but not many. We too do not have the room to add lots of Marchon and Altair frames.. I have about 100 Marchon,, no Altair.. I would have to let go some of my board space from my other frame vendors to make room.. We did raise the prices on our frames and give discounts to our self pay patients.. We do not do enough unity lenses to get into premier status or sell enough marchon frames.. We do sell enough I found out that we will still get our 100% of wholesale.. This is all just so confusing. I guess I got to start using Unity lenses! I don't even know what to price them out at.. Headache time.

[Johns]

26 seconds in my head:

The crows are coming home to roost.

Fezz and I predicted this (although the stealing of your patients and directing them online took a bit longer) back in 2004. They've got the ODs cornered, and they are closing in by lowering reimbursements, and not even a little bit at a time - a lot! They refer your contact lens patients online. Opticians try took peek through the keyhole to see what is going on, and grab a few bucks - don't bother.

Hey, at least VSP doesn't have all of your patients' contact and demographics information, so they can direct market to them. Oh wait! That's right, they have all that too! And they are direct marketing already!

I can remember when the mantra was, "At least we'll make it up on volume!" I've recently been in offices where they are saying, "Good we ONLY have 3 VSP patients today..."

Well...at least you can make millions on taking PDs for all the online purchasers.

Maybe the question should be, what is "any money"?

[drk]

VSP's ultimate goal is to have retail. They're acquiring bits and pieces, starting up here-and-there, and trying to make outlets of practices.

They may succeed, they may not. I don't care if there's another vertical goof in the marketplace.

As to this new "stick" (which used to be a "carrot"):
1. You stand to lose only a few bucks on this new rule (for now). Don't post it, here, but consider what 20% of a wholesale frame allowance is. (Yes, we are being nickeled and dimed, but it's not a financial game-changer.)

2. Due to VSP-created self-pimping frame retail allowances, VSP frames are slightly more attractive at the retail level to the patient by $20-30. But we have been making more from non-VSP frames, to date, despite this, by formula (lower allowance for patient is good for you). This new arrangement makes it about even on your end regarding VSP and non-VSP frames, so that's bad, but still leaves VSP frames slighly more attractive to patients due to higher allowances. So that's bad.

3. If you don't have enough Marchon sales to hit 2 frames/week (6K), just drop Marchon and tell them they don't seem to appreciate your $5,999/yr account. You have nothing to lose, and maybe if all the smaller accounts dropped VSP frames for this fiasco, it'd send a message. (If it weren't for me carrying Flexon--which is replaceable, of course--I'd not hit the 6K, but I think I do.)

4. With a few exceptions, Marchon frames are 15-20% overpriced, anyway. Not a good deal for anyone. When a patient gets a "special deal" on Marchon frames, in reality they're not getting anything special at all. They're over-inflated at wholesale then over-discounted at retail. It comes out even.

5. Die, VSP, die. I will dance on your grave. I think.

[Jubilee]

I don't have any Marchon/Altair product.. and I don't want to.

However, our doc magically is worth just under 10% less on her own compared with another practice.. that closed before we even opened. So she still is the only provider in this town.. that she opened a mile away from the old location.

Ahh, but when I inquired about this, I was told it was due to their new formula of allocating fees, that they weren't paying as much because they were pushing premier status, and thus why we were worth roughly 10% less. We weren't carry their product.

Not all Non-VSP frames are the same. WFA is WFA. While some vendors do offer "extreme" discounting, many of those same vendors are selling product that wasn't worth the original frame facts anyway. I like some of that product for value packaging, etc.. but don't want it necessary to be my main insurance line...Eyes of Faith is a line that has several frames that fall under the most common WFA's but offers less than 20% off. I don't want to quit buying from them because now VSP is forcing me to take a loss. So that will mean I have to be even more careful about buying and telling vendors than unless I can get at least 20% off, I don't want to see a single frame under X dollars..

I didn't have a problem with the "reward" of selling our product, you will get these kickbacks.. I have seen it done so many times over, with Lux/Eyemed, Davis/Viva, and any and every chance Essilor has...

But to take away so that I don't recover COGS... that is a huge problem. Not sure how much time they think I have, or what it is worth.. but they either think we all work cheap or do the churn and burn.

[drk]

If you're the only provider in the area, I'd be really tempted to be out of network. Why are you dealing with VSP if you don't have to?

[Jubilee]

The hospital network, Federal employees, and Medicaid/HIP plans..

We had about a 10 mile buffer, but the old practice is being reopened soon, so we'll have competition..

On a bright note.. now at least we might be able to get patient records!

[Johns]

I just interviewed someone for a receptionist position, and she currently works at America's Best. She said that they started taking VSP in January. Nice to know they've got the "brand integrity" holding strong...