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Thread: VSP Non-IDC lab

  1. #1
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    Confused VSP Non-IDC lab

    Just got off the phone with VSP (2 separate calls with 2 different reps) I asked them if I was to choose the Non-IDC lab invoice option for billing purposes only, could I use my own private lab and just pay the private lab bill. They stated yes and they would not charge any lab chargebacks, as we would not be using a VSP contracted lab.

    On certain jobs like SV poly, or orders without AR, it makes most sense to order through VSP contracted lab. But with Progressives (O), trivex with AR, it's costing a lot in chargebacks.

    Has anyone tried this with success? TIA!

  2. #2
    Master OptiBoarder OptiBoard Gold Supporter
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    If you do this more than once in a while prepare for audits of your lens invoices.

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    I also read on optiboard that the lenses must be VSP approved to even qualify for non-idc, but the VSP rep mentioned nothing about it. I do not want to open a can of audit to save a few bucks. Thank you for your input!

  4. #4
    Master OptiBoarder OptiBoard Gold Supporter
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    Quote Originally Posted by Hollybabette View Post
    I also read on optiboard that the lenses must be VSP approved to even qualify for non-idc, but the VSP rep mentioned nothing about it. I do not want to open a can of audit to save a few bucks. Thank you for your input!
    No problem! Plus almost all lenses are VSP approved these days for the most part. I definitely do it once and a while. Like maybe 3-4 times a year.

  5. #5
    Bad address email on file Randle Tibbs, ABOM's Avatar
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    If you have an in-house finishing lab, you are allowed to process SV but according to the VSP guidelines you must order the finished lenses from VSP.

  6. #6
    Master Jedi King of the Lab's Avatar
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    VSP Signature, Access Indemnity & Advantage plans are easier to Non IDC.
    Erik Zuniga, ABOC.

  7. #7
    Master OptiBoarder OptiBoard Gold Supporter
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    Quote Originally Posted by King of the Lab View Post
    VSP Signature, Access Indemnity & Advantage plans are easier to Non IDC.
    Yeah I think on advantage and indemnity I always NonIDC, I think VSP even told me to.

    Signature I don't play around with much, if I surfaced maybe, otherwise I just use their IOF program

  8. #8
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    Hello, I am on the IOF program now. I just recently purchase a pretty new surfacing lab and would like to surface progressives in house. can I use the NonIDC lab option to do this?
    Thank you.

  9. #9
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    I am trying to set up VSP, Davis, Spectra, Eyemed, Supior, Avesis, Medicaid. I do not have a doctor as I am only selling frames and lenses to my customers. I am so lost as to what my next step is I have my NPI #
    I have mostly VSP coming in. If I am not signed up with the insurances I will be an out of net work. Can some one please help me. I started my business two weeks ago.
    What will I get reversed out of the net work?
    Renny Allen

  10. #10
    OptiWizard KrystleClear's Avatar
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    You're new and they are making you do all that?

    Just a heads up - Davis makes you go through their own lab. They will also send you frames of their own for Davis members, so you will need to have a place to store or display them. There are some other Medicaid vision plans that do this also, but they vary from state to state. You don't end up making much on the lenses since your company is not actually producing them. Davis will just give you a dispensing fee.

    For patients who are using insurance we do not accept, my office just provides them with an itemized receipt. The patient can try to submit for reimbursement on their own. We will help them with filling out a reimbursement form if necessary.

    Maybe call each insurance and see what you will need to provide them with to start accepting it. I have never had to do this myself - this was always handled by upper management/the office manager. Good luck!
    Last edited by KrystleClear; 09-07-2021 at 03:03 PM. Reason: typo - oops!
    Krystle

  11. #11
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    Quote Originally Posted by KrystleClear View Post
    Just a heads up - Davis makes you go through their own lab. They will also send you frames of their own for Davis members, so you will need to have a place to store or display them.
    Actually.... in the state of PA, Governor Wolf signed a bill that says the insurance can't require you to use their lab/materials. We just got a contract with Davis for us to use our own frames and use our local lab. We just started as providers on 9/1. So far, it's working out well and we have several patients now coming here who used to go to VisionWorks. We have not been doing this long enough to actually get Davis payments so only time will tell if this was a horrible idea or a pretty good one. I will say that our OMD office participates with Davis for routine exams so we lost a lot of patients with us not participating with materials. I'm really hoping that changes with this new contract.

  12. #12
    OptiWizard KrystleClear's Avatar
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    Quote Originally Posted by mervinek View Post
    Actually.... in the state of PA, Governor Wolf signed a bill that says the insurance can't require you to use their lab/materials. We just got a contract with Davis for us to use our own frames and use our local lab. We just started as providers on 9/1. So far, it's working out well and we have several patients now coming here who used to go to VisionWorks. We have not been doing this long enough to actually get Davis payments so only time will tell if this was a horrible idea or a pretty good one. I will say that our OMD office participates with Davis for routine exams so we lost a lot of patients with us not participating with materials. I'm really hoping that changes with this new contract.
    Ah, interesting! Do you still have to have their frames? It's been a few years since I dealt with Davis at my old office. I didn't mind getting the Davis patients because the pricing was usually straightforward and submitting the claim was easy. However, that was all through Davis's lab though, which was horrific. It was about a 30% chance they would lose a frame that we sent them. I would have to warn patients who wanted to reuse a higher end frame that their insurance might just straight up lose their frame. And their lab was SO SLOW. Patients would get so upset at the slow turn around. They could care less when we tried to explain that it was being made by their insurance and then mailed to us. I'm interested to hear how it goes for you because if the payments are worthwhile it might be a consideration for us to at least accept it for glasses/contacts.
    Krystle

  13. #13
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    Quote Originally Posted by KrystleClear View Post
    Ah, interesting! Do you still have to have their frames? It's been a few years since I dealt with Davis at my old office. I didn't mind getting the Davis patients because the pricing was usually straightforward and submitting the claim was easy. However, that was all through Davis's lab though, which was horrific. It was about a 30% chance they would lose a frame that we sent them. I would have to warn patients who wanted to reuse a higher end frame that their insurance might just straight up lose their frame. And their lab was SO SLOW. Patients would get so upset at the slow turn around. They could care less when we tried to explain that it was being made by their insurance and then mailed to us. I'm interested to hear how it goes for you because if the payments are worthwhile it might be a consideration for us to at least accept it for glasses/contacts.
    Nope. We don’t have to have their frames. We don’t use their lab. We just do what we always do and use our local lab. It’s easy to submit but billing is not as straight forward as I thought. I used Davis before at another office and it’s pretty easy when you’re using their lab. With this contract, it’s a bit confusing to me. It’s more the reimbursements and lens classifications. We just became participating providers on September 1 so it’s a challenge right now. I’m hoping to get things ironed out within the next couple months. I think profit is about the same as using their stuff and their lab but none of the headaches that go with it! Since you’re in PA, you’re welcome to PM me and I can tell you more as I figure things out.

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