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Thread: VSP Change in redo procededure just got a lot harder (I think)...

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Confused VSP Change in redo procededure just got a lot harder (I think)...

    Do we now need to send a First -Time Redo Verification form for all redo's?

    It looks like the labs will now require this as they will now bill each office for a redo then VSP will reimburse us for the redo as long as we send the job back with a completed form.

    Am I reading this right?

    If so- Oy Vie!!!

    After further discussion with my main VSP lab it looks like it needs to be done with the less common authorization where "Lens Enhancements" are involved.

    In this case where a sv changed to a Comfort- after credit for the sv and the $20 enhancement charge he would have paid anyway- we would apparently lose about $20 if we do not send in the form for VSP to reimburse.

    Stay tuned if this changes further as their main VSP guy was gone for the weekend...
    Last edited by Uncle Fester; 07-13-2018 at 02:18 PM.

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    Please keep us update Fester. This could complicate a lot of things for us, where lots of the employees don't like doing extra work.

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    Master OptiBoarder rbaker's Avatar
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    Another case of a third party managing your business forcing you into indentured servitude. As long as you drop your skives and grab your ankles you are going to get screwed. Take a good look at your business model and do an inventory of what processes are in your sole control. It usually ain't pretty. And, its getting worse.

    Y'all gotta figure out a way to stand on your own two feet.

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by rbaker View Post
    Another case of a third party managing your business forcing you into indentured servitude. As long as you drop your skives and grab your ankles you are going to get screwed. Take a good look at your business model and do an inventory of what processes are in your sole control. It usually ain't pretty. And, its getting worse.

    Y'all gotta figure out a way to stand on your own two feet.
    Not my call but if it were---Advocate single payer health care to weaken managed care in eye wear business is my thought- but we can't get into possible solutions involving political policies here.

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    Quote Originally Posted by Uncle Fester View Post
    Not my call but if it were---Advocate single payer health care to weaken managed care in eye wear business is my thought- but we can't get into possible solutions involving political policies here.
    Says a guy who drops a possible solution and doesn't want to discuss any alternatives because it might "involve political policies."

    Regardless, while Medicare does not have materials coverage, many state plans (incl. medicaid/exchange plans) have a routine vision plan. And it's as glorious as you can imagine. In my area, the most common vision plan associated with it is MARCH vision.

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    Master OptiBoarder OptiBoard Silver Supporter lensmanmd's Avatar
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    In our current political situation, Uncle Fester is correct. Big government siding with big business. Apologies for the political tone here, but this is our reality.

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    Master OptiBoarder OptiBoard Silver Supporter
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    I haven't had this happen, and I edge a lot of my own VSP jobs. Most labs (including VSP) have required me to send back lenses for credit, until they get to know me and that I don't play around trying to get free lenses for my own mistakes.

    All my credits in this situation have come from the lab (after they bill me for the redo) Are you saying we are going to be sending these lenses to a VSP inspection unit and the credits will be issued from them instead of the lab I got them from??

    VSP is the last of the MVC mohicans in our office... I hope they don't screw up too, too much bad stuff and adios friends, usually we make a decent amount from the average pair... there are a few plans that are just... well ridiculously bad in what we make... I'm keeping my eye on it.
    Last edited by Tallboy; 07-14-2018 at 08:51 AM.

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    Master OptiBoarder AngeHamm's Avatar
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    I think it may be lab-specific. I have never had to do this.
    I'm Andrew Hamm and I approve this message.

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by AngeHamm View Post
    I think it may be lab-specific. I have never had to do this.
    Some things changed (a few prices so update those Patient charges!) starting July 1st and I'm not sure if this is new or a change from past procedure as I do not handle the reimbursement. from what the bookkeepers tell me it is not as easy to decipher the charge-backs by VSP which is not true of Eye Med which show them upfront. What we've flagged for review is when this months lab statement comes in to see what is being billed by the lab and them make sure a payment for the difference comes through from VSP.

    Again I think this is not going to be a common issue as most redos are not upgrades but non-adopts so the redo is in a lower cost catogory and no money is collected from the patient. It also seems to be only with high benefit plans where Enhancements are covered with much lower copays- In this example the patient went from sv to progressive and had only a $20 copay as opposed to a $105 upgrade which would cover it without a need to submit a First -Time redo form.

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    Master OptiBoarder OptiBoard Silver Supporter
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    Quote Originally Posted by Uncle Fester View Post
    Again I think this is not going to be a common issue as most redos are not upgrades but non-adopts so the redo is in a lower cost catogory and no money is collected from the patient. It also seems to be only with high benefit plans where Enhancements are covered with much lower copays- In this example the patient went from sv to progressive and had only a $20 copay as opposed to a $105 upgrade which would cover it without a need to submit a First -Time redo form.
    I really appreciate you pointing this out. I am keeping my eyes on those exact types of plans to see how the payment comes through for all the different types of things.

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