EYEMED credentialing denial

[Betsy Day Thurman]

We have been an Eyemed provider for many years here in Virginia ~ Jan 1,2018 ~ the networks for Va medicaid realigned forcing us to reapply as a provider for Va medicaid patients whose benefits are processed by Eyemed ~ after waiting 34 days we were told they already have enough providers in our area ~ this loss is enormous as a large percentage of our customers are Va medicaid patients ~ i have tried contacting EyeMed and Optima (the health network for Va medicaid) and i'm being told there is nothing I can do. This loss could cause me to have to close my business. I am hoping someone can provide some help or any direction for me to find some help ~ is there an optician liaison that would be able to assist me ? TIA

[David_Garza]

EyeMed Medicaid? Consider it a blessing you don't have to mess with it anymore.

[drk]

EyeMed gonna EyeMed.

Essilux didn't agree to see all those patients to have them go to you...they want the Medicaid patients tromping into Sears or Target (or if they're fake Medicaid eligible and can afford it Lenscrafters or Pearle).

The real idiot is the Virginia Medicaid Smarties, who decided to hand over the tax dollars to Luxottica. What the heck are they thinking? Are they fooled into thinking EyeMed's a...provider network? A vision care plan? HAHAHAHAHAHA! Look at it..it's listed on Luxy's website as a "retail brand"! http://www.luxottica.com/en/retail-brands

And if you want to fight this, you're going to need to band together with other optometrists that are losing Medicaid and raise hell in Richmond. That's the only way.

[drk]

I see you're quite rural (white-boy Medicaid).

You're simply going to have to offer out-of-pocket stuff that your clients will be happy to afford.

No way they're going to like their Target experience.

Can you provide for the exams? That's key. Get them in, and sell them an el-cheapo package and tell them to hoof it over to Tar-jay for a second pair.

Meanwhile, find a way to make it without Medicaid for awhile.

Then lobby your butt off.

Any willing provider for Medicaid should be relatively easy to accomplish. Make the VA legislature FORCE Luxottica to allow you on panel. That should be a slam dunk.

[Chris Ryser]

Make the VA legislature FORCE Luxottica to allow you on panel. That should be a slam dunk.

.............................good advice

[ajonesgirl]

I would start with a phone call to the insurance commissioner's office (804) 371-9741. Or the state Medicaid office (804) 786-7933. Hopefully, one or the other can offer suggestions to get you reinstated as a provider. Wishing you the best of luck!