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Thread: Alternate Eyemed contract is now illegal, supposedly.

  1. #1
    Master OptiBoarder
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    Alternate Eyemed contract is now illegal, supposedly.

    It's been quite a while since I posted here, so Hello to everyone. Our practice was bought by a new doctor. We had to recredential our EM account. Previously, since we have our own surfacing lab, we were on a different contract from EM that allowed us to use our own lab instead of LLS. Now they are telling us that the old contract isn't available anymore. The said it's a South Carolina state law that we aren't allowed to pick our own lab network. Does anyone have information on this? It sounds like a load of crap. In effect it will double our lab bills, or worse.

    EM is a complete scam! I'd love to know how some of you are doing after dropping them. If I had a clear plan forward, I would definitely speak to my new boss about it.

    Thanks

    I spoke with some of my lab contacts and they are unaware of any changes to the law in our state. I'm sure this yet another piece of misinformation from the EM reps. They are the worst in the industry. Is there a governing body that regulates insurance companies?
    Last edited by KStraker; 08-02-2021 at 03:31 PM.

  2. #2
    What's up? drk's Avatar
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    I am not an expert by any means, but I think I might know what's happening, but it would need to be validated.

    I know that several states (GA, OH, OK?) have created laws that keep EyeMed or any vision care plan from dictating where lab work is done. I'm guessing SC is NOT one of those states.

    Therefore, when a new contract was written, the old, grandfathered contract became void and now you're being treated like all new contracts, everywhere, that don't have state laws prohibiting that behavior.


    Short of having the SC Optometric Association lobbying the legislature, I think there can be some other "work arounds", if you ask enough people who want to do their own finishing.

  3. #3
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    1) We dropped Eyemed when we were having payment issues from them. After everything going on and everything people are saying, we couldn't be happier. GREAT decision for us!
    2) In PA, there is a new bill that states your insurance can't dictate what lab you use. Since everyone around here has Davis, we have finally gotten approval to be a Davis provider (it took us over a year) and we can use our local lab and our own frames. NO Davis tower. We just got our approval and haven't gone live yet so fingers crossed.

  4. #4
    OptiBoard Professional IIxIPariahIxII's Avatar
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    Currently only a few states have passed bills to keep them from doing that, I wouldn't be surprised if they're saying you can't when you can. It may also be due to the new credentials. Had an IOF (we still sent surfaced to Dallas) and now I'm in GA which we aren't dictated to so. Reach out to others in the area and get their input as well

  5. #5
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    Hawaii's largest insurer is outsourcing their vision plans to eyemed starting next year and we are not planning on participating. We have been doing fine without VSP, which is given to all state and county employees, but I'm a little worried that we will see a big decline in revenue once eyemed takes over.

  6. #6
    OptiBoard Professional KrystleClear's Avatar
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    When I worked for an office that accepted Eyemed, it seemed like no matter what, we were always getting chargebacks from Eyemed and never could get clarification from them as to what we were doing wrong. We would get this weird plans for patients through the Saudi Arabian embassy of all places under Eyemed that stated on the authorization that they got $400 towards glasses, even plano sunglasses, and then when we would bill, they'd deny it because of having plano lenses.

    My current office only accepts Medicare for post-cataract glasses and VSP. I wish we would stop taking VSP too. We really don't make much profit, sometimes none.
    Krystle

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