Category: Uncategorized

Update on VSP Vision Plan Billing

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

 

Is digital device screen time affecting your child’s eyes?

A question I get asked all day, every day, is how much our digital device harms my child’s eyes. As we know, digital device use has become pervasive in our society, and our children simply can’t avoid screen time. We’re on our phones, tablets, computers, TV X, and DVD players in the car, so our kids are often exposed to screens. I always tell my patients that our eyes were designed for hunting mammoths and not for staring at screens.   I say that jokingly, but our eyes were designed for hunting and gathering and not to stare at tiny 4-inch screens inches from our faces.

When we look up close, our eyes have to work hard. Those muscles have to crank in and maintain an exhausting effort. Think of the analogy of picking up a 1-pound weight in the morning with your arm- early in the morning, your bicep thinks this task is effortless. Still, you continue to hold that 1-pound weight all day long, and your muscles are fatigued by the end of the day. The same thing is happening with our focusing muscles. The other thing to remember about looking at near –  we optometrists call that “near point” – is that it also requires aiming skills. Fifty percent of our time should be spent focusing, and 50% of our time should be spent aiming. Suppose you spend 80% of your effort focusing because of the near-point stress. In that case, there’s not enough muscular energy left to aim your eyes,  and this can lead to problems with reading speed, comprehension, missed words, and skipping lines. It can actually lead to learning difficulties.

We have kids in our practices who have been diagnosed with ADHD or dyslexia. They have visual ocular motor deficiencies, eye teaming, or eye focusing problems. If you suspect your child is having a learning issue,  speak with your school resource counselor to rule out any psychological, neurological, or health problems that could be underlying problems,  but don’t forget to bring your child in for a comprehensive eye exam so that we can check their eye teaming,  depth perception,  eye alignment, and focusing ability. Sometimes it can be that simple.