Important Information for VSP Patients – Effective July 1, 2023
Since 2019, our office has routinely billed VSP (Vision Service Plan) as an “Open-Access Provider.”
What is Open Access?
Open access means that although our office is not “In-Network” for your plan, that we “accept assignment”, bill VSP, and have them send your out-of-network reimbursement directly to us versus you. Until earlier this year, VSP was relatively reliable in sending payment checks within 4-6 weeks.
What has Changed?
VSP is now denying claims on arbitrary and nonsense reasons, OR they are not paying claims at all – no response or denial, even after repeated claims submissions. VSP also refuses to speak with doctors who have questions, unless you are an in-network provider – they will only speak with you, their customer/patient. In addition, when our office cashes a reimbursement check from VSP, we have to accept terms including potential audits from VSP even though we have no contract with them!
What does this mean for you?
As of July 1st, all VSP patients will be required to pay in full for your eye exam at the time of service, and then file directly with VSP for reimbursement.
WE WANT TO STRESS THAT YOUR TOTAL OUT OF POCKET COST WILL NOT CHANGE!
The only difference is that the check will be mailed to YOU instead of US (typically in 2-3 weeks.)
We will be happy to provide you with an itemized receipt and detailed instructions on how to claim your reimbursement. It’s easy and only takes about five minutes.
Still Confused?
Here are a couple of examples:
OLD Procedure (we bill VSP):
Basic Exam Fee:
$99.00 – Your cost $45.00, VSP pays us $45.00 – Your total cost $54.00
NEW Procedure (You submit to VSP):
Basic Exam Fee:
$99.00 – Your cost $99.00, VSP pays YOU $45.00 – Your total cost $54.00
We are sorry for the inconvenience, and we hope we can resume billing your plan directly in the future. If you have further questions, please contact our office via text or email at 702-341-0255; eyedoc@DrRiffel.com