Results 1 to 16 of 16

Thread: Spectera eye exam reimbursement?

  1. #1
    OptiBoard Novice
    Join Date
    Jan 2018
    Location
    connecticut
    Occupation
    Dispensing Optician
    Posts
    6

    Spectera eye exam reimbursement?

    Good afternoon fellow optical friends.

    I'm looking to find out a little bit about spectera. We are considering taking it once again in our practice and before we start the month long process I'd like to know if its even worth the effort.
    Is there anyone who knows offhand what they pay for a routine exam? Also, I heard that they are similar to Davis where they have their own lab and selection or frames. Is that accurate? What is the average payout from spectera?

    Thanks!!

  2. #2
    Master OptiBoarder AngeHamm's Avatar
    Join Date
    Apr 2010
    Location
    Richmond, VA
    Occupation
    Optical Retail
    Posts
    1,803
    Following.
    I'm Andrew Hamm and I approve this message.

  3. #3
    OptiBoard Professional
    Join Date
    Apr 2014
    Location
    wisconsin
    Occupation
    Optometrist
    Posts
    145
    In my area, exam pays $55. They do have their own lab and provide most of the frames as well. Consider yourself a showroom for materials. It is a step above Davis. Don't confuse that for an endorsement. Without itemizing everything (because I assume this falls into a gray area of what information is allowable on this forum), do NOT expect much over the exam for exam + glasses. You will likely have a negative balance from time to time after all the chargebacks. I'd rather not get too negative, but I wish my book was full enough to drop specterible.

  4. #4
    What's up? drk's Avatar
    Join Date
    Mar 2004
    Location
    Ohio
    Occupation
    Optometrist
    Posts
    7,505
    What's the point?

    They always offer a sop to the OD in the form of an offensive--but not too offensive--$55 or somesuch.

    But it's the optical and the CL supply that screws you over.

    Run--don't walk--away from Specterrible.

  5. #5
    OptiBoard Apprentice
    Join Date
    Aug 2016
    Location
    Oklahoma
    Occupation
    Optometrist
    Posts
    10
    On contacts S will say they have 150 dollars worth of contacts but will only reimburse 120 dollars. You will get negative balances if they person gets more than basic add ons. They will give you cost for frames if you supply them. But that is the way everyone else is. You have to send the glasses to their lab. They also have covered contacts. you do better with them than non covered contacts. You get about 100 to 110 for glasses including the exam. The malls get a different plans than private practice. Like the previous person said RUN

  6. #6
    Master Jedi King of the Lab's Avatar
    Join Date
    Jul 2012
    Location
    Los Angeles, CA.
    Occupation
    Optical Laboratory Technician
    Posts
    310
    Spectera is terrible, other than the exam reimbursement which is OK, ...the materials and the lab will for sure screw you over and the same can be said for Davis Vision as well. I remember when Spectera had the ugly frame box of horrors. At least that is gone.
    Erik Zuniga, ABOC.

  7. #7
    Master OptiBoarder
    Join Date
    Nov 2007
    Location
    NA
    Occupation
    Optometrist
    Posts
    1,141
    If your state laws and/or their contract let you opt out of using their Specterible lab it's no different than EyeMed or VSP give or take $10-$15 on the eye exam reimbursements.

  8. #8
    Master OptiBoarder
    Join Date
    Feb 2013
    Location
    PA
    Occupation
    Dispensing Optician
    Posts
    1,088
    Quote Originally Posted by pbrownlee View Post
    They will give you cost for frames if you supply them. But that is the way everyone else is. You have to send the glasses to their lab. The malls get a different plans than private practice. Like the previous person said RUN
    This sounds a lot like Eyemed!

  9. #9
    OptiBoard Professional LadyDie's Avatar
    Join Date
    Mar 2007
    Location
    Tinley Park, Illinois
    Occupation
    Dispensing Optician
    Posts
    113
    I thought I heard that Spectera became United Healthcare??? I certainly could be wrong on this.
    goodsearch.com vosh

  10. #10
    Master Jedi King of the Lab's Avatar
    Join Date
    Jul 2012
    Location
    Los Angeles, CA.
    Occupation
    Optical Laboratory Technician
    Posts
    310
    Quote Originally Posted by LadyDie View Post
    I thought I heard that Spectera became United Healthcare??? I certainly could be wrong on this.
    Spectera is associated with United Healthcare, however, some UNH members aslo have VSP.
    Erik Zuniga, ABOC.

  11. #11
    OptiBoardaholic
    Join Date
    Mar 2014
    Location
    CT
    Occupation
    Optical Retail
    Posts
    245
    I have been for years trying to get my OD to stop taking Spectera, lab quality is not terrible more on the poor side. Payouts are very low. sometimes not worth the time it takes to service the patient.

  12. #12
    Master OptiBoarder AngeHamm's Avatar
    Join Date
    Apr 2010
    Location
    Richmond, VA
    Occupation
    Optical Retail
    Posts
    1,803
    Quote Originally Posted by LadyDie View Post
    I thought I heard that Spectera became United Healthcare??? I certainly could be wrong on this.
    You heard right... kind of. Some UHC plans have VSP. Some UHC plans have what they call "United Healthcare Vision." That is Spectera. So now we have the conversation, about five times a week, where we have to explain to a patient that yes, we accept their United Healthcare if they have a medical diagnosis, but no, we don't accept their United Healthcare Vision if they are a routine visit. It's infuriating.

    This same nonsense is why I won't "refer to this coverage as Cigna Vision" for Cigna VSP jobs.
    I'm Andrew Hamm and I approve this message.

  13. #13
    OptiBoard Novice
    Join Date
    Dec 2016
    Location
    Colorado
    Occupation
    Dispensing Optician
    Posts
    1
    Quote Originally Posted by AngeHamm View Post
    You heard right... kind of. Some UHC plans have VSP. Some UHC plans have what they call "United Healthcare Vision." That is Spectera. So now we have the conversation, about five times a week, where we have to explain to a patient that yes, we accept their United Healthcare if they have a medical diagnosis, but no, we don't accept their United Healthcare Vision if they are a routine visit. It's infuriating.

    This same nonsense is why I won't "refer to this coverage as Cigna Vision" for Cigna VSP jobs.
    We have been having the same discussions. Yesterday we had 5 patients ask if we took United Health Care and had to explain this. I was here looking to see if maybe there was something showing they had improved and UHC Vision was worth taking a look at again, but it seems like it's still terrible. It's really frustrating to not be able to give our local patients the service they deserve because of low reimbursements which wouldn't help keep the practice open and poor lab quality would give us a bad name and our patients bad vision.

  14. #14
    OptiBoard Apprentice
    Join Date
    Aug 2016
    Location
    Oklahoma
    Occupation
    Optometrist
    Posts
    10
    If they give the patient 150 for contacts you will get reimbursed 120. If they have covered contacts you actually do better and get about 100+ from patient and Spectera but you do not get anything for the fit. You will get statements in the mail that you owe them money or pay you wth them. They do not take credit cards and you have to pay with a check. Transition warranty is only good for 90 days. We have to use their lab and it take at least 5 to 10 business day her in Oklahoma.

  15. #15
    OptiBoard Novice
    Join Date
    Mar 2018
    Location
    Picayune, Ms
    Occupation
    Optometrist
    Posts
    1
    With all insurances, you can negotiate. That is the key. If they tell you they would pay this for a frame, offer something reasonable. If they won't play, don't play with them. Our worst problem is private companies taking over the state medicaid programs. One company, March Vision will reimburse you what you paid for the frame, up to $30 or so dollars. I told them no, and only do eye exams for them. Wal-Mart is giving free frames. They recently asked me to not refer any more patients to them, lol. Private businesses need to network better. This is the call to arms!

  16. #16
    OptiBoard Apprentice
    Join Date
    Apr 2016
    Location
    California
    Occupation
    Optometrist
    Posts
    22

    Hard to profit

    I think it's almost impossible to do well with the frames. There are two choices when it comes to frames: (1) you can sell them a frame that is supplied directly from Spectera itself (2) you can supply a frame that you have purchased. In the first case, whatever you get paid is basically a "dispensing" fee. This fee will vary a little depending on the retail price of the frame but averages to around $15. In the second case, where you provide the frame, there is a little more leeway here to make a profit. Once again it depends on the retail price of the frame and your particular cost. Spectera itself will send you an explanatory sheet where they've "done the math" for you. For example, a frame that retails for $300 will yield a "total frame reimbursement of $88". If you've purchased that frame for $100 you will actually LOSE money and it would have been better to go with option 1 where you don't buy the frame. Some other options may be for you to bypass Spectera entirely by offering their patients a frame for the same "over frame allowance" that they would have paid anyway. The reason why that may work is that the Spectera chargebacks sometimes wind up costing you money even on frames that you supplied yourself (doesnt' that sound crazy?) Bottom line is that even with a lot of fancy footwork, effort and concentration I think it is impossible to do well with the frames. My employee service costs are higher than what they reimburse. We only accept Spectera because there are some contractual issues that force us to do so. I would love to find out if there are other strategies here that I'm missing.

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Similar Threads

  1. Optimized Eye Care - Online Eye Exam by a licensed Optometrist
    By optician2601 in forum General Optics and Eyecare Discussion Forum
    Replies: 10
    Last Post: 12-30-2017, 11:56 AM
  2. Eye exam
    By braheem24 in forum Just Conversation
    Replies: 6
    Last Post: 07-27-2010, 05:34 AM
  3. EYE MED "Provider Reimbursement Survey"
    By eyecare4U in forum General Optics and Eyecare Discussion Forum
    Replies: 4
    Last Post: 10-28-2006, 11:06 PM
  4. Eye Exam
    By obrien040362 in forum General Optics and Eyecare Discussion Forum
    Replies: 12
    Last Post: 04-26-2006, 12:26 AM
  5. No drops in eye exam?
    By Dd in forum General Optics and Eyecare Discussion Forum
    Replies: 26
    Last Post: 12-27-2005, 01:40 PM

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
OptiBoard is proudly sponsored by:
BC College of Optics, Younger Optics and Vision Equipment