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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AOA Pushes Children's Vision Benefit to HHS Secretary

Although the new national health care reform law - most commonly referred to as the Affordable Care Act - was approved by Congress and signed into law by President Obama in late March, the Washington, D.C. battles over health care reform are far from over.

Right now, Federal agencies - led by the U.S. Department of Health and Human Services (HHS), are going through the legislation's more than 2000 pages and are writing rules on how it will be implemented - mostly between now and 2014.

And in the first of many health overhaul implementation battles that will directly impact optometry, concerned ODs and students are urging their elected national leaders to join the fight and help AOA fully define the new children's vision benefit.

Through its all-out advocacy efforts in 2009 and 2010 focusing on Capitol Hill, the AOA helped make children's vision a top health care priority at the national level. In fact, an AOA-backed provision included in the new law specifically designates children's vision as an "essential health benefit."

This now means that in 2014 all health plans participating within the new state-based health insurance exchanges will be required to provide a children's vision benefit. However, how "children's vision" is ultimately defined has yet to be determined by HHS officials, though it will make an enormous difference to millions of American families.

That's why AOA has made it a priority to ensure that top HHS officials fully understand the issue and the stakes for America's kids. As evidenced in a special video message to the AOA from HHS Secretary Kathleen Sebelius (http://tinyurl.com/25qumop ), these efforts are making a difference.

In the coming weeks and months, however, it will be important that concerned Senators and House members who support comprehensive eye exams weigh-in with Secretary Sebelius and help make certain that the children's vision benefit is not hijacked or diminished in any way during what could be a very lengthy and confusing regulatory process.

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