Tuesday, November 02, 2010

Optum health Vision = Failure

As a new entrant to the business world 2 yrs ago, I was told that the best way to generate patient flow is to be signed on as many insurance panels as possible. That surely turned out to be great advice as more than 80% of the folks that walk through my door are driven by listing on the insurance company's website.
Most folks do not understand the unique nature of optometry and insurance plans.

Vision Insurance is separate from your Health Insurance and is sometimes called a "carve-out". It's usually from a different insurance provider and covers an annual eye exam for eyeglasses prescription. Most Vision Insurance has either a moderate allowance for a set of glasses or a fixed dollar amount for contact lens care. Only very rarely are both eyeglasses and contact lenses paid for by your insurance in the same enrollment year. The contact lens coverage typically includes professional evaluation and a supply of contacts.

Medical Insurance covers you for anything that has a medical diagnosis. This would include visits for an eye infection, corneal foreign body removal, sudden onset of flashes and floaters, dry eye problems, and chronic or acute allergy issues. Your Medical Insurance would also cover progress evaluations to monitor cataracts, glaucoma and other recurring issues.

Anyways, one such insurance company is Optumhealth - used to be called Spectera. Their name change might indicate their need to morph! I have consistently had poor service from them. They claim that
"Our members pay no more than $40 for an annual eye exam and save 20% on glasses"
We, as provides get shafted and are paid nothing! The contract insists that I mail all the lab work to their contracted labs and they are riddled with errors! When I write in to express my desire to cancel the contract, I get no response for months! When I call to speak to the manager they take a message and these calls are not returned.... Why are they in business?

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