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  1. #1
    OptiBoardaholic OptiBoard Silver Supporter Optical Roy's Avatar
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    Vsp

    Am I missing something on VSP, I just filed a frame that's non Marchon/Altair, frame allowance $130.00, so patient owed 79.20 for over benefits, but the saving statement shows the frame completely covered. This isn't the first time, but I cannot find any added specials for VSP patients anywhere.
    Roy W. Jackson, Sr. ABOC

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    OptiWizard
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    Quote Originally Posted by Optical Roy View Post
    Am I missing something on VSP, I just filed a frame that's non Marchon/Altair, frame allowance $130.00, so patient owed 79.20 for over benefits, but the saving statement shows the frame completely covered. This isn't the first time, but I cannot find any added specials for VSP patients anywhere.
    Been like this for a couple months now... frustrating.

    Was talked about here too:
    https://www.optiboard.com/forums/sho...ight=VSP+frame

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    When in doubt charge the overage. You can adjust the Savings Statement but be sure to adjust everything or you're asking for trouble from some patients. That is if you give patients a SS.

    Be aware auto filled wholesale prices listed in Frames Data sometimes are not current and your upcharge is legit.

    I can't shake feeling a disturbance in The Force that VSP and Eye Med are looking to join forces soon to crush all competition and rule the universe.

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    Quote Originally Posted by Uncle Fester View Post
    When in doubt charge the overage. You can adjust the Savings Statement but be sure to adjust everything or you're asking for trouble from some patients. That is if you give patients a SS.

    Be aware auto filled wholesale prices listed in Frames Data sometimes are not current and your upcharge is legit.

    I can't shake feeling a disturbance in The Force that VSP and Eye Med are looking to join forces soon to crush all competition and rule the universe.
    Click image for larger version. 

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    OptiBoardaholic KrystleClear's Avatar
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    The savings statements are wildly flawed and frequently wrong. I was collecting out of pockets based on the savings statement until I kept seeing discrepancies on our VSP remittances where the amounts were completely different. A VSP rep told me the savings statements are wrong and have been wrong and they basically aren't going to do anything about it. That being said, this frame thing is apparently a new problem. Just remember that if the wholesale is under the "WFA" allowance, it is considered covered in full. If the authorization says "WFA70" that means any frame up to $70 wholesale is considered covered in full.
    Krystle

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    OptiBoardaholic OptiBoard Silver Supporter Optical Roy's Avatar
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    Quote Originally Posted by KrystleClear View Post
    The savings statements are wildly flawed and frequently wrong. I was collecting out of pockets based on the savings statement until I kept seeing discrepancies on our VSP remittances where the amounts were completely different. A VSP rep told me the savings statements are wrong and have been wrong and they basically aren't going to do anything about it. That being said, this frame thing is apparently a new problem. Just remember that if the wholesale is under the "WFA" allowance, it is considered covered in full. If the authorization says "WFA70" that means any frame up to $70 wholesale is considered covered in full.
    Thanks
    Roy W. Jackson, Sr. ABOC

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    OptiWizard
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    Quote Originally Posted by KrystleClear View Post
    The savings statements are wildly flawed and frequently wrong. I was collecting out of pockets based on the savings statement until I kept seeing discrepancies on our VSP remittances where the amounts were completely different. A VSP rep told me the savings statements are wrong and have been wrong and they basically aren't going to do anything about it. That being said, this frame thing is apparently a new problem. Just remember that if the wholesale is under the "WFA" allowance, it is considered covered in full. If the authorization says "WFA70" that means any frame up to $70 wholesale is considered covered in full.
    I have found the lens and exam cost to be decently accurate, but you are 100% correct on VSP not caring about it. My VSP rep said the same thing lol, 'We have no plans on fixing that at this time' is the email I got back.

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Print or look for the "Service Report" and look for the 2 letter codes at the bottom to see if charges apply.

    Find on your "Lens enhancement Chart" that 2 letter code and verify that is the price you are applying. Here's where I will bet the difference arises.

    The frames are now not showing up so after looking up the current wholesale cost you may need to enter the upcharge and adjust the savings statement accordingly. Be aware prices are sometimes changing so frequently now as hot sellers get increased sometimes multiple times a quarter that VSP has given up trying to keep up.

    I think your rep is feeding you a line as lens enhancement charges on savings statements are, in my experience following this practice, rarely wrong but we tend to be misreading the correct charge and VSP's found that undercharging for reimbursements is outweighing any extra money they may pay out. So they are very happy to just let everyone assume the numbers you come up with are correct.

    I do a dozen or more of these a week without issues on the savings statement.

    I do not match the costs after payment as the back office is supposed to do that so if that's where the problem lies then shame on our Doc's for not holding VSP accountable.

  9. #9
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    Man, the savings statements are absolutely borked. Frame pricing being magically covered in full, irrespective of reality, is routine. Putting a patient in a digital SV? The thing just errors out rather than even attempt it. Poly, for some inscrutable reason, is ALWAYS 3 dollars off on standard lenses than what's listed in any documentation I can find. I don't even worry about the stupid thing. If a patient desperately needs it (they don't and they never do), I'll print it off for them, otherwise I save the paper

  10. #10
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by juno View Post
    Man, the savings statements are absolutely borked. Frame pricing being magically covered in full, irrespective of reality, is routine. Putting a patient in a digital SV? The thing just errors out rather than even attempt it. Poly, for some inscrutable reason, is ALWAYS 3 dollars off on standard lenses than what's listed in any documentation I can find. I don't even worry about the stupid thing. If a patient desperately needs it (they don't and they never do), I'll print it off for them, otherwise I save the paper
    Note code "BA" for SV Digital Aspheric $45*

    "TA" applies here as a Technical Add On. SV it's $10.

    "BD" poly

    "BV" for UV

    *You will find these codes on the service report.

    Frames have stopped being auto filled because we let them.

    "QV" for Elite AR try to always use TechShield Elite UVR
    Last edited by Uncle Fester; 10-11-2022 at 04:19 PM.

  11. #11
    OptiBoard Professional IIxIPariahIxII's Avatar
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    The data they have for the frame Wholesales aren't 100% accurate, and ALWAYS make sure you check what the wholesale kicks over as on Eyefinity when you plug the frame in whether it autopopulates or you have to build it.

  12. #12
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    I never used the savings statements for VSP. If I patient wanted a quote, I would always highlight each code in the service report and total all of the charges on it and give it to them (and then delete the authorization if one was made)

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    Vsp

    Quote Originally Posted by Elvis Is Alive View Post
    I never used the savings statements for VSP. If I patient wanted a quote, I would always highlight each code in the service report and total all of the charges on it and give it to them (and then delete the authorization if one was made)

    VSP savings statements are never reliable, I hand fill out one to give to patients.

  14. #14
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by CLaughner View Post
    VSP savings statements are never reliable, I hand fill out one to give to patients.
    You are doing them wrong from what I've found with few exceptions.

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    Nope

    Quote Originally Posted by Uncle Fester View Post
    You are doing them wrong from what I've found with few exceptions.
    Not really, I do a ton of VSP (Premier) and I have talked to my VSP rep, he told me not to depend on the savings statement

  16. #16
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Follow my suggestion and tell me where the Doctor Reports codes do not match the total price on a Savings Statement for lenses. Lens add on's almost always match for me (when the SS is even made available;).

    The frame overage is routinely left out these days but as long as our OD's stay quiet where's VSP's incentive to fix that? They're just reimbursing the wholesale cost.

    Do you know how to access the Eyefinity websites Product Index to see lists of products and their codes?

    Remember that rep's do not necessarily have your best interest$ in mind.

    Also ask yourself- Why does Eye Med seem to have no problems auto filling charges???
    Last edited by Uncle Fester; 10-27-2022 at 09:38 AM. Reason: tweak...

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    [QUOTE=Uncle Fester;569977]Follow my suggestion and tell me where the Doctor Reports codes do not match the total price on a Savings Statement for lenses. Lens add on's almost always match for me (when the SS is even made available;).

    I’ve always used the saving statement as a double check to make sure that I have entered everything correctly as I want it
    usually when the saving statement does not add up it means that I made a mistake and I can go and rectify it

  18. #18
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    I've never used the vsp savings report because it is never right. I manually write them out on a sheet we have. I know it's old school but it shows the patient what they are saving and what the insurance is paying and that usually answers about 80% of their questions.

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    Stick out tongue exactly

    Quote Originally Posted by iD View Post
    I've never used the vsp savings report because it is never right. I manually write them out on a sheet we have. I know it's old school but it shows the patient what they are saving and what the insurance is paying and that usually answers about 80% of their questions.
    I do the same thing and it works just fine. I do believe the rep has my best interests in our practice. If we do well so does VSP!

  20. #20
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by CLaughner View Post
    I do the same thing and it works just fine. I do believe the rep has my best interests in our practice. If we do well so does VSP!
    And if your numbers are less than what they should be they love you even more!

    Someone want to put up an example of when they are off and what the service report codes show and what the authorization allows?

    I'm seeing a steady increase in the number of "No Patient Savings Statement Available" and speculate that the SS is heading towards being phased out as our Doc's seem to be uninterested in pursuing it.

    Years ago I remember having a VSP phone rep tell me the lack of the SS is initiated by the employers business but I seem to find the more complicated and number of the add on's the more likely you cannot see one.

    I used to bring one up before submitting and it allowed me to correct any discrepancy. VSP apparently didn't like this and changed it to require a void back and who wants that hassle. So VSP will continue to pay what they do by the codes on your report and if you should have been paid more so be it. If VSP should have been paid more you can be sure that is collected.
    Last edited by Uncle Fester; 11-01-2022 at 12:38 PM. Reason: add speculation...

  21. #21
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    VSP has no interest is serving its clients properly. They would rather you miss putting in a code (say backside UV of an AR, oversize blank size, etc) and save a few dollars than auto-filling codes based on the order entered. Dollar >>> service

  22. #22
    Eyes eastward... Uilleann's Avatar
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    Quote Originally Posted by Elvis Is Alive View Post
    VSP has no interest is serving its clients properly. They would rather you miss putting in a code (say backside UV of an AR, oversize blank size, etc) and save a few dollars than auto-filling codes based on the order entered. Dollar >>> service

    "This is the way."


    ...Of *every* managed care and insurance company on the planet.

  23. #23
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    Quote Originally Posted by Uilleann View Post

    "This is the way."


    ...Of *every* managed care and insurance company on the planet.
    I hate the norm.

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    I give VSP extra grief for removing a feature (auto-coding) that they used to incorporate. IMO, the main (or only) reason for updating the claim filing format was to remove this. If VSP was a person, I'd punch it in the face lol.

  25. #25
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by Elvis Is Alive View Post
    I give VSP extra grief for removing a feature (auto-coding) that they used to incorporate. IMO, the main (or only) reason for updating the claim filing format was to remove this. If VSP was a person, I'd punch it in the face lol.
    I still say we have met the enemy and he is us!

    VSP phone reps must have been going crazy trying to walk through our complaints with codes and numbers that didn't match and so reps just tell us it's all wrong because that is much easier than trying to fix it over the phone and has proved more profitable for VSP.

    Almost always the auto coding is correctly made- we are just not careful in matching the code to what we sold. The exceptions being a loss of auto frame overage and outlier lenses on Savings Statements.

    Wholesale frame costs are changing too frequently these days for VSP to keep up and the OD's are not making enough fuss for them to go back to the old method imo.

    I do not know if payments are what they should be as the back office chases receivables. I think Dan Liv mentioned that this is a mess that persists.

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