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Thread: Opticare Vision Insurance

  1. #1
    OptiBoard Novice
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    Opticare Vision Insurance

    At our office, we consider to take another vision insurance to increase our patient base. Does anybody know anything good or bad about Opticare? Do we have to use their lab? Is it worth to take this insurance? The only this we know that they just have changed their name to Evolve.

  2. #2
    Master OptiBoarder rbaker's Avatar
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    Taking on another vision care plan will probably increase your patient base. If the plan is popular in your area it can generate a significant increase in the number of people who cross your threshold. However, increasing your patient base should not be your prime directive. Your goal should be increasing the profitability of your office. Insurance plans may, or may not, help in achieving this goal. This can only be determined by careful financial analysis of you financial records, a task best left to a CPA.

    One thing does seems to be the rule with these plans, policies, schemes or whatever name they go by these days is that is they collect a lot of money in premiums and only pay out chump change after forcing you to jump through all sorts of hoops. In many cases bottom line is that you have to spend $100.00 in order to make $90.00. You have to "run the numbers" and look at the big picture.

    It's not just about "patient base" and "market share" for if that were the case you could quickly rise to the top by offering $1.00 exams and $2.00 glasses. Of course you would soon find yourself living under an overpass on the I-75 toasting a squirrel in a stick for supper. But, hey . . . you did have a really really big patient base.

  3. #3
    Manuf. Lens Surface Treatments
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    Redhot Jumper you would soon find yourself living under an overpass ............................

    Quote Originally Posted by rbaker View Post

    It's not just about "patient base" and "market share" for if that were the case you could quickly rise to the top by offering $1.00 exams and $2.00 glasses. Of course you would soon find yourself living under an overpass on the I-75 toasting a squirrel in a stick for supper. But, hey . . . you did have a really really big patient base.
    Dick is right.

    Instead of offering insurance help get some inexpensive frames, even some discontinued ones.

    Sell untreated SV CR 39 lenses, and regular inexpensive CR 39 bi or multi focals,

    that you can process in your store and keep the prices extremely low, process them on your own premises. Do your own tinting, scratch resistant treatments and other additional services..............and charge extra for them, as the customer wants it.

    .............while having some regular going frames and lenses for the ones that want to pay full price for the value, .........
    advertise the prices from the lowest to the highest, you have it all and ...............

    you wont have to eat toasted squirrels under the bridge.

  4. #4
    OptiBoard Moron newguyaroundhere's Avatar
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    You can use any lab you want. Plans can vary as far as coverage goes.
    Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity

  5. #5
    OptiBoard Professional ThePinkRanger's Avatar
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    Opticare is part of medicaid isn't it? if so, it's just a bunch of problems. In Massachusetts their lab is at the jail.

  6. #6
    OptiBoard Moron newguyaroundhere's Avatar
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    Quote Originally Posted by ThePinkRanger View Post
    Opticare is part of medicaid isn't it? if so, it's just a bunch of problems. In Massachusetts their lab is at the jail.
    Not sure how the plans up there work with Envolve but the plans I have dealt with here in Pennsylvania allowed us to use whatever lab we wanted. Billing and reimbursements were not exactly the greatest nor easiest to figure out
    Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity

  7. #7
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    Here in Florida, we negotiaged with them in order to use our own lab. They also give their clients 100,150 and some 200 upgrades allowances. Now if they say the patient can use a 100 upgrade allowance on their frame OR lens, what that really means is you get about 71.00. So for Single vision, that allows us to put on an In house AR or use Poly instead of CR39. We can even make them photochromic, as long as we do it In House we profit well enough. As for frames, you can profit decently as well. You need to watch reimbursements though, because it fluctuates depending on the Vcodes and how much your Usual and customary charges are. It's the best Medicaid managed plan out there, IMO.
    ~Follow Your Bliss~

  8. #8
    Master OptiBoarder OptiBoard Silver Supporter Jubilee's Avatar
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    They are our largest MCO medicaid plan. Current issues are, they believe UV should be inherent in every lens, and thus won't pay for it. Though it is a part of the Indiana Fee Schedule. They require lab documentation and justification for aspherics, when no other group forces us to do this either.

    The just get the option to have an allowance instead of traditional coverage if they want contacts or non covered frames, etc in our state.
    "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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