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    ODs’ top 4 gripes about vision care plans

     

    3. Competing with ODs for retail sales, patients

    ODs are feeling the pressure as VCPs move toward a model that not only cuts reimbursement but competes with ODs for patients, goods, and services.

    Recent vertical integrations, combined with increasing overt online presence and direct marketing to patients, was a common complaint. ODs expressed frustration that materials profit has to the potential to be diverted after they have already taken reduced fees for service.

    • “Their newest ploy to drive patients to purchase their glasses or contact lenses online and use their benefits from the website the insurance company owns.”

    • “Two [VCPs] that I know of are actively emailing patients about using their benefits online as soon as the exam authorization is pulled. We've resorted to waiting to pull those until patients are in office.”

    • “Promoting their own online contact lens sales when they are already giving me extremely low reimbursements.”

    • “Vertical integration means they push patients to their physical entities vs. private practice ODs.”

    Related: 10 tips to surviving an insurance audit

    4. Misleading and incorrect information

    Of all the categories, this one has the most responses and raw emotion. The general tone of the responses, and conversations with my colleagues, is that VCPs mislead patients about what is covered and what is not covered.

    A great amount of this confusion and discontent centers around patients with a known medical diagnosis who expect medical care from the VCP.

    • “Too many patients come in with medical complaints and think they are covered. Many times the caring doc feels compelled to take care of people so he takes care of the patient. Thus, insurance companies get away with not paying for medical care.”

    • “Patients with medical complaints think these plans should cover the visit. When the patients call the VCP, customer service always respond that the plan will cover the exam. These plans have created a huge issue when we try to explain this. Also, these plans are simply discount plans!”

    • “One of the plans says it covers diabetic exams and to pay an extra $5 or $10 for the diabetic exam.”

    There you have the top four categories of complaints. I know the list is not inclusive, and I expect to have a lot of feedback. I will also tell you that within the comments and complaints are some very real misunderstandings and opportunities for practices to minimize these challenges.

    Our offices accepted every VCP and were able to build a successful and thriving business by understanding the insurances, developing processes, and providing high-quality customer service. In my next four blogs, I will share ideas on how ODs can view these problems as opportunities to grow their practices.

    Got a gripe I didn’t address? Have a comment? Email me at [email protected] or contact me via distinctivestrategies.com.

    Dr. Carl Spear’s lecture “What’s My Beef with Vision Plans?” was heard at SECO 2017 in Atlanta and was a part of SECO’s “What’s My Beef” series of lectures.

    Read more from Dr. Spear here

    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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