Affordable Eye Care – Do Your Vision Plans Meet Your State’s Vision?

AFFORDABLE EYE CARE
March 4, 2022
James Ashford

The practices of US vision insurance companies do not always match up with state regulations. To avoid potential conflicts, employee benefits professionals need to take care when considering which products to offer to their clients. Vision Care Direct can help you make these decisions about providing affordable eye care in OKC, all over Oklahoma and nationwide.

Downsides of Dealing with the Larger Plans

Some of the larger plans see themselves and their providers as being simple sellers of products. Providers are expected to bring through as many clients as they can. If possible, they should do this by using the products and services closely associated with or owned by the large plan. In other words, the large plans, through their market power, can impose what are in essence conflicts of interest on the providers who use them. Professionals are torn between wanting to act in the best interest of their clients and providing the most profitable products for their plan. In the meantime, the actual professional services are reimbursed at really low rates, again putting pressure on providers to stress product sales over service.

Discount Practices

These conflicts of interest are particularly evident where discounts are involved. Large insurance companies have held firm to policies that require doctors to provide discounts, some of which conflict with state laws. This creates a danger of shrinking networks as these insurance companies are choosing to force doctors to give discounts that are illegal or go against their client’s best interests.

Additionally, because discounts are typically offered on non-covered items, this puts the insurance companies in a position to set the cost. This is one reason why balance bills are commonly over $500 even with built-in discounts.

By contrast, if providers are allowed to choose their own labs and are not forced to discount on certain items, balance bills could come down by as much as 30% which is the case with Vision Care Direct compared to large insurance companies.

Take care with reimbursement terms

Vision insurance companies that change their reimbursement terms can potentially violate state law. For example, 14 states have patient protection laws that prohibit limiting a healthcare provider’s choice of labs, materials, and suppliers. However, some large vision plan carriers violate the spirit of these provisions by limiting what they will reimburse. By doing this, they force the use of certain materials, labs, or suppliers. Indeed, one large provider’s recent differentiated reimbursement policy for some products and coatings will not only have the effect of restricting patient and provider choice, it will also undermine doctor-patient decision-making. Worst of all, it may well also violate patient protection laws of those 14 states. Some vision care providers and service plans are actively challenging these kinds of policies. They consider these policies as violations of the law and as possibly causing providers to violate the law.

Large plans throw their weight around

Large vision plans with millions of clients and contracts can afford to use their power to force health care providers to grant unreimbursed discounts and use specific labs or products. Their power in the marketplace makes it virtually impossible for a service provider to decline to contract with these providers. VCD of Oklahoma may have the solution you need for this.

Let Vision Care Direct help you offer affordable eye care in OKC and nationwide

Vision Care Direct of Oklahoma can help you steer clear of these legal issues. We are a pre-paid vision care plan, offering services paid for in advance. We are not a discount service. VCD helps you avoid any conflicts with state and federal laws. VCD also helps you protect patients while offering excellent affordable eye care in OKC.

Not sure where to get started with recommending self-funded plans? Vision Care Direct of Oklahoma is pre-paid plan provider with and extensive of specialists who deliver eye care in Tulsa and nationwide with excellent value for employers and plan recipients.

Find out more about our self-funded plans and other flexible options.

GET AN INSTANT PROPOSAL

Have a group in mind that you’d like us to quote? It’s simple! Fill out the online questionnaire and we’ll prepare a personalized quote.

Let's Talk About You

Let us know if you have any questions or if you’d like to chat.

Popular blog posts

Top 5 KPIs to Track When Assessing Plan Performance and Satisfaction

Top 5 KPIs to Track When Assessing Plan Performance and Satisfaction

As a broker, you need to maintain a diverse product portfolio so you can help companies build packages adapted to their needs and budgets. Tracking these 5 key performance indicators when comparing plans will help you better identify the ones that are more likely to...

How to Get Discounts on Frames and Discontinued Lines

How to Get Discounts on Frames and Discontinued Lines

Eyewear and contact lenses are vital to the optometry field. Keeping this in mind, doctors should be aware of the purchase costs of these goods to boost their revenue. Frame reps make commissions on sales, so they’re incentivized to sell as much as possible, but are...

Designing a Modern Optometry Practice

Designing a Modern Optometry Practice

One question that optometrists should consider is, “When patients walk into your optometry office, how do you want them to feel?” Naturally, patients desire comfortable, welcoming, and modern environments, as these characteristics put them at ease. Therefore,...

November 2022: Native American Heritage Month

November 2022: Native American Heritage Month

Native American Heritage Month celebrates a rich culture and educates people about issues unique to the Native American community. It’s an opportunity to draw attention to health issues that disproportionately affect Native Americans. It’s a group that is at higher...

Top 3 Reasons to Work with Smaller Plan Providers

Top 3 Reasons to Work with Smaller Plan Providers

In the healthcare benefits industry, brokers are essential in helping small businesses find plans. Smaller companies might not have the resources or experience to do thorough research into the options available. Fortunately, there are brokers who understand that...

3 Signs It’s Time to Review and Upgrade Your Benefits Package

3 Signs It’s Time to Review and Upgrade Your Benefits Package

A routine inventory of your benefits package can tell you where you may be able to reduce spending and, equally importantly, can also ensure that it continues to meet the needs of employees. That’s why Vision Care Direct of Oklahoma recommends reviewing your benefits...

October 2022: Breast Cancer Awareness Month

October 2022: Breast Cancer Awareness Month

It’s Breast Cancer Awareness Month. You might be wondering about the link with vision health. The truth is that a simple eye exam can sometimes detect early signs of cancer. Breast cancer can result in metastasis. When cancer cells break away from the main tumor, they...

Understanding the Ins and Outs of the Vision Plans You Accept

Understanding the Ins and Outs of the Vision Plans You Accept

For eye doctors in Tulsa OK, as well as other states, a regular review of the plans you’re currently accepting, and their ins and outs, is something you should be doing. By understanding the vision plans you accept, you can better identify how you are paid and the...

Top Strategies for Helping Plan Providers Meet Their Goals

Top Strategies for Helping Plan Providers Meet Their Goals

When trying to reduce healthcare spending, employers who offer employee benefits in the state of Oklahoma, as well as anywhere else, should be aware of one fact: there are options available that don’t increase the costs to employees via high deductibles. As a broker,...

Rethinking How You Offer Value Part 3: Build Digital Connections

Rethinking How You Offer Value Part 3: Build Digital Connections

The pandemic has sped up the digital transformation. Many professionals are embracing the virtual world because they realize connections matter. We've been sharing tips about how to rethink the way you offer value as a broker who offers plans accepted by an...

eGuide: Top 10 Ways Vision Care Direct Makes a Broker’s Job Easier

eGuide: Top 10 Ways Vision Care Direct Makes a Broker’s Job Easier

Top 10 Ways eGuide - Vision Care Direct Makes a Broker’s Job EasierOur eGuide is chocked full of ways Vision Care Direct can simplify working with a vision plan.  When you quote a vision plan certainly you are looking at the price and size of the network, and so is...

Search blog posts