The American Association
Doctors of Optometry
A National Association of Eye Care Providers
Working Together to Improve Eye Care in America
AADO is Committed to Defending Vision Care Plan Providers
From Unfair and Illegal Business Practices by Vision Care Plans
Recent Concerns and Issues
- EyeMed: In Texas and a few other states it is illegal for a plan to require discounts on non-covered services/materials. EyeMed is asking providers to give the discount anyway, and is notifying beneficiaries which providers having not agreed to provide discounts and which ones have.
- VSP: VSP has notified providers that they will be offering a better (more money) frame benefit for their company-owned Marchon and Altair frames, and will be advising benficiaries that they will obtain better benefits by going to a provider that carries those two VSP-owned frame lines.
- Vision Care Plans are increasingly requiring that all eyeglasses be manufactured at their designated labs, prohibiting providers from using in-house labs or labs with favorable rates or services. This anti-competitive behavior inevitably results in higher costs to consumers, and lower quality of care that providers can offer their patients, in that patients must wait days, sometimes weeks, to receive glasses.
- Blue View (Anthem): At least one OD is reporting that a patient advised him that, when calling to confirm benefits, she was told that she should purchase her contact lenses from 1-800 Contacts (owned by Blue View parent WellPoint) because, "the doctors are usually more expensive."
- VSP: VSP announced that it has opened a VSP operated office on the campus of Apple to serve the eye care needs of Apple's 44,000 employees. VSP claims it will have minimal impact on surrounding doctors because only 6% of Apple employees are currently obtaining care from the VSP operated office.
- EyeMed: EyeMed is now using your billing data to send YOUR patients a notice encouraging them to use their EyeMed benefits, reminding them it is time for an exam, BUT, listing up to 10 offices that accept EyeMed that are located close to the patient's home, including LensCrafters and other EyeMed owned locations. EyeMed says they will include your office. The impact, however, is to inform YOUR patients that they can user their benefits at commercial EyeMed associated locations like LensCrafters.
- EyeMed: Under the new contract, Multi-focal lenses cannot be fabricated in-house unless you have your own surfacing system (effectively permitting LensCrafters to fabricate in-house, while most others must send the frame out to an EyeMed approved lab)
- EyeMed: Under new contract, doctors cannot bill medical insurance without first obtaining the patient's approval, even if the visit is for a purely medical problem, and any patient for whom you can get a "good" refraction must be billed to EyeMed, whether or not medical conditions are present and whether or not the reason for the visit was medical in nature.
- EyeMed: In at least some situations, providers cannot bill Aetna for annual or "routine" eye exams if the patient has EyeMed coverage, even if Aetna provides coverage for these services.
- VSP: Has begun identifying high volume sellers of Marchon and Altair frames as "Premium" VSP providers and featuring them in on-line doctor searches and on the VSP website, giving those that sell a lot of VSP's own frames an advantage in obtaining new VSP patients. Those that carry and sell a lot of VSP product are displayed first in online searches, and those that do not are listed last.
- VSP: In addition to their expanding network of VSP supported out-of-network commercial retail locations, VSP now has its "own" offices on the campus of certain large employers, putting them in direct competition with nearby VSP providers that often depend upon those large employers for a significant part of their business.