VSP’s New Policy Limits Patient and Provider Choice

October 8, 2020
James Ashford

3 MIN. READ

Back in the beginning of June, Vision Service Providers (VSP), a large vision insurance company, announced a new policy that had some pretty serious impacts on providers that are contracted with VSP. Effective Sept. 1, the policy sharply reduces provider reimbursement levels for lenses and coatings that are not “preferred” brands. What does this policy mean for your customers?

VSP’s new policy

According to the American Optometric Society, under VSP’s policy, if a provider prescribes a coating or lens that is not one of VSP’s preferred brands, the provider will be reimbursed as much as 50% less than if they had prescribed a “preferred” brand. This has severe financial impacts on providers, which could, in turn, impact your customers’ pocketbooks.

How this affects patients

First, doctors may feel financial pressure to prescribe your customers lenses or frames that they don’t necessarily want or that aren’t the best choice for them. This is especially the case in the time of the coronavirus, when many doctors have already had to reduce hours or the number of patients they see. Second, the costs of other services, such as exams or frames, may go up in price as a result of the reduced reimbursement rates for lenses and coatings. Although not required under this new policy, doctors might also ask your patients to “make up the difference” between the lens or coating they want to prescribe and the new reimbursement rate, thus directly costing customers more money. Finally, reducing reimbursement rates may lead to doctors leaving your customers’ provider networks altogether.

What is being done?

There was a large outcry after VSP announced this change. Optometrists were furious, and articles in trade magazines and websites criticized VSP. Furthermore, the American Optometric Society encouraged its members to share their criticism with Vision Service Providers. VSP responded by sending its providers a strongly-worded email and created a website with FAQs to address the controversy. However, this did not quell the dispute. Laws currently exist in many states (23 to be exact) against this sort of practice. In fact, a federal law – the Dental and Optometric Care (DOC) Access Act – has now been proposed to prohibit such manipulative practices by both dental and vision insurance companies.

What can you do?

As a broker, you can also make an impact by recommending insurers and vision plans that do not engage in these sorts of practices. Vision Care Direct of Oklahoma is one such customer-focused vision plan. Vision Care Direct is owned by providers. We focus on helping customers get the best care for their money. We take the policy of “if we prescribe it, we cover it” and don’t try to steer customers to any specific lens or coating. There aren’t any “preferred” and “non-preferred” brands, and we don’t own retail stores or labs that manufacture certain brands. Instead, your customers get the prescribed lenses and coatings they want. Because we aren’t an insurance company (but rather approved as a pre-paid plan), we aren’t focused on profits or stakeholders. We’re focused on your customers.

Customers’ needs and choice

VSP has made a decision to steer their customers towards certain brands and services. Your customers pay good money for their vision plan, and in return, they want to be able to obtain the goods and services they desire. Vision Care Direct of Oklahoma wants your customers to get the care and services they and their providers think is best, not the care that will make them the most money. Contact us today to learn more about how we can help.

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.

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