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Thread: VSP Out of Network claims

  1. #1
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    VSP Out of Network claims

    Do you take VSP out of network? Have you noticed an extreme delay on getting claims processed and paid?
    They have a new address now. We have not received for over 4 month.

    Vision Service Plan
    Attention: Claims Services
    P.O. Box 495918
    Cincinnati, OH 45249-5918
    Last edited by optician2601; 07-11-2023 at 05:31 PM.

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    OptiBoard Professional Michael I. Davis's Avatar
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    We have not been paid in months but for a revolving number of reasons. Wrong tax number, wrong procedure code, wrong diagnosis codes. We had been paid out of network for years with no problem, but the last few months they are messing with us

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    Quote Originally Posted by Michael I. Davis View Post
    We have not been paid in months but for a revolving number of reasons. Wrong tax number, wrong procedure code, wrong diagnosis codes. We had been paid out of network for years with no problem, but the last few months they are messing with us
    Have you tried to resubmit the claims? I tried to resend them all to the new address, but still have not received payments.

    Is there a way to get a hold of someone? VSP representatives never wants to talk to out of network providers.

  4. #4
    OptiBoard Professional Michael I. Davis's Avatar
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    Yes some have been resubmitted 3x with different rejection codes each time.

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    The address I send my VSP out-of-network form is: PO Box 385018 Birmingham, AL 35238-5018
    Is that the address you've been mailing the forms to as well? (I mail the form for my patients)

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    We use Anagram and have zero issues. Anagram lets you file for most out of network plans including VSP, EyeMed, Davis, Spectera, etc. There is a monthly fee to use it though.

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    Wow-all those plans you listed have out of network forms that I mail in (Eyemed you can fax in) for patients. That service is something patients don't count on and are happy that they're getting some kind of reimbursement and don't have to process it themselves. Happy to share my OON forms and info so you're not paying Anagram- I cannot believe people pay Anagram to submit OON claims- What's Anagram charge??
    Pay yourself!! (respectfully)

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    Well, we match the out of network on eyewear as an additional discount too. Anagram also verifies eligibility and we can file electronically and it takes all of 30 seconds to file a claim. Payment can be set to send to the patient as well, which is what we do.

    To each his own, but it is worth it for us.

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    OptiBoardaholic OptiBoard Bronze Supporter
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    We have also not been getting paid for VSP OON claims ever since they switched mailing addresses. We used to be able to file electronically through our EDI clearinghouse but VSP kept making changes to block OON claims. It really feels like VSP is doing this intentionally to discourage OON claims from providers.

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    Quote Originally Posted by kittyeyes View Post
    The address I send my VSP out-of-network form is: PO Box 385018 Birmingham, AL 35238-5018
    Is that the address you've been mailing the forms to as well? (I mail the form for my patients)
    Thats the old address, if you are still using it, your patients are not getting reimbursed.

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    Do you file the claim on behalf of the patient, and receive payment from VSP?

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    anybody have the correct address to mail the VSP claim to?

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    Quote Originally Posted by kittyeyes View Post
    anybody have the correct address to mail the VSP claim to?
    Per the website:

    Vision Service Plan
    Attention: Claims Services
    P.O. Box 495918
    Cincinnati, OH 45249-5918

    We just resubmitted a bunch of claims from april and may that were sent to the old address and never paid. Have only received two back so far.

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    Quote Originally Posted by Elvis Is Alive View Post
    Well, we match the out of network on eyewear as an additional discount too. Anagram also verifies eligibility and we can file electronically and it takes all of 30 seconds to file a claim. Payment can be set to send to the patient as well, which is what we do.

    To each his own, but it is worth it for us.
    This^

    We did something similar, 100 buck allowance on frames and 75 off lenses. But, we didn’t file for them or check eligibility or wait to be reimbursed buy an insurance company. If you’re gonna do all that extra leg work, you might as well be on the insurance panel of providers. We simply had the forms for OON on most insurers, filled out our part, price, location..gave them a stamped envelope to send it off, that was it.

    Granted, most of our clients purchased from us because they wanted to, the discounts and reimbursement from their insurers were just bonuses to most.

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    Just signed up for Anagram. Hope the service will help us keep track of claims.
    Thank you!

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    Quote Originally Posted by Elvis Is Alive View Post
    Well, we match the out of network on eyewear as an additional discount too. Anagram also verifies eligibility and we can file electronically and it takes all of 30 seconds to file a claim. Payment can be set to send to the patient as well, which is what we do.

    To each his own, but it is worth it for us.
    that is interesting. we get a lot of calls for NVA which has really low reimbursement. may be worth it

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    Any updates? Have you received any VSP payments? We are still waiting for payments from April 2023

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    Quote Originally Posted by optician2601 View Post
    Any updates? Have you received any VSP payments? We are still waiting for payments from April 2023
    We have been getting paid after sending to the new address. Seem to be getting a lot more denied claims than previously though.

  19. #19
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    Just received check payments this week. VSP is alive!!

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    OptiBoardaholic OptiBoard Bronze Supporter
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    Our office just noticed VSP has been making direct deposits in our bank account without authorization and not providing any remittance reports to show which patients the payment belong to. Does anyone know who I should contact to ask about this? They wont accept a phone call from out of network providers and when you email, they just send you a excel form to fill out to inquire about specific claims.

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    how did they get your bank acct info? Did you used to be in network?

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    Quote Originally Posted by chamilun View Post
    how did they get your bank acct info? Did you used to be in network?
    We used to be in network, maybe 10 years ago, but they never did direct deposit back then it was always a paper check. We have been doing OON claims for years and always received paper checks and then all of a sudden we are getting direct deposits with no remittance reports whatsoever.

  23. #23
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    Quote Originally Posted by optical24/7 View Post
    This^

    We did something similar, 100 buck allowance on frames and 75 off lenses. But, we didn’t file for them or check eligibility or wait to be reimbursed buy an insurance company. If you’re gonna do all that extra leg work, you might as well be on the insurance panel of providers. We simply had the forms for OON on most insurers, filled out our part, price, location..gave them a stamped envelope to send it off, that was it.

    Granted, most of our clients purchased from us because they wanted to, the discounts and reimbursement from their insurers were just bonuses to most.
    I honesty don’t believe if you go with the above you’ll loose your vsp, eyemed or whatever ins is out there. You’re out of network for a reason. You’re really not out of network if you wait for reimbursement from an ins company. You’re patients will still use you and wait for their reimbursement. I’ve ran and observed many a location that stay’s totally away from reimbursement from ins.

    Don’t be scared to go totally out. Give them an itemized receipt, fill out your part of their OON, give them an addressed and stamped envelope to their ins and dust your hands. You’re done, you got paid up front and the patients have their reimbursement in their hands, as far as you’re concerned. That’s it, and it’s easy!

  24. #24
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    Quote Originally Posted by optician2601 View Post
    Just received check payments this week. VSP is alive!!
    been following this thread, thanks for the OP and updates on mailing address.

    I also received checks about same time you did (after a likewise long delay), from claims from spring of this year.

    followed by another looong remittance silence, until today when I received 71 checks in the mail.

    Strange way to run a railroad!

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    Quote Originally Posted by Skol View Post
    been following this thread, thanks for the OP and updates on mailing address.

    I also received checks about same time you did (after a likewise long delay), from claims from spring of this year.

    followed by another looong remittance silence, until today when I received 71 checks in

    Strange way to run a railroad!
    (bold mine) I rest my case.

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