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    ODs’ top 4 gripes about vision care plans

     

    1. Does it have to be this difficult?

    Many people commented on how difficult VCPs have made the entire vision coverage process. ODs were quick to point out that they think VCPs are nothing more than a discount for goods and services.

    Overall, the sense is that ODs invest too much staff time with VCP coverage before, during, and after the exam.

    Here are some comments:

    • “The fact that you need a PhD in ‘EOB [explanation of benefits] Understanding’ to know what you get paid.”

    • “Too time consuming for optical staff to explain to patients.”

    • “They never mail ID cards, so patients don't know what they have.”

    • “Lack of universal reimbursement across all plans within a VCP.”

    • “600-page VCP manual.”

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    2. Reimbursements

    I don’t think it’s surprising that a major gripe is reimbursements. What surprised me in conversations and correspondence with many ODs was reimbursements was not the top complaint.

    Many ODs recognize that VCPs bring patients into the office and help provide access to patients. Most might accept the reduced payments if the other problems were mitigated.

    Problems such as:

    • Patients knowing their plans

    • The VCP reimbursement process streamlined

    • Representatives available with consistent, accurate information

    • Clear distinction made between medical coverage and VCPs

    • Payment systems that are easy to understand

    If these other problems were addressed, then the trade-off in reimbursement might be easier to accept.

    Reimbursement is the complaint that has many ODs feeling frustrated and disenfranchised.

    Comments include:

    • “Low exam fees, terrible pay for frames and lenses.”

    • “In many years no increase in reimbursement (in fact a decrease) despite the cost of business going up—making profitability increasingly difficult.”

    • “Getting paid less for an exam than I did in 1984 when I started practice.”

    • “More and more documentation, less reimbursement.”

    • “Horrible exam reimbursement.”

    Related: 4 steps to opening a practice cold

    Carl H. Spear, OD, MBA, FAAO
    Dr. Spear owns a multi-location group practice with his wife Dr. Katie Gilbert Spear in Pensacola, FL. Dr. Spear is commander of the ...

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