Lacrivera

Specterible... share your disdains!

J

Jonathan Duong

Member
Dec 13, 2001
76
1
8
School/Org
Southern California College of Optometry
City
Irvine
State
CA
Insultingly low professional fees, no dispensing fees, mountains of paper work, outsourced phone responses to India and the Philippines, angry patients w/ attitudes who call our office every 15 minutes to argue about their $10 copay, unprofessional and rude Spectera professional relations, more paper work... AM I ALONE HERE? Please share your experiences regarding this insurance and how to handle it...
 
Jonathan Duong said:
Insultingly low professional fees, no dispensing fees, mountains of paper work, outsourced phone responses to India and the Philippines, angry patients w/ attitudes who call our office every 15 minutes to argue about their $10 copay, unprofessional and rude Spectera professional relations, more paper work... AM I ALONE HERE? Please share your experiences regarding this insurance and how to handle it...
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Just do exam only. I have a lot of patients who come to our office from a local OMD with thier Rx to fill thruu Spectera. The OMD basically is using our office as a Spectera dumping ground.

I no longer accept Rx only from Spectera. I let the patients know their OMD should have accpeted the Rx in thier own office. If they want glasses thru our office, pay for an exam and we will give a 30% discount on our own frames.
 
Jonathan Duong said:
Insultingly low professional fees, no dispensing fees, mountains of paper work, outsourced phone responses to India and the Philippines, angry patients w/ attitudes who call our office every 15 minutes to argue about their $10 copay, unprofessional and rude Spectera professional relations, more paper work... AM I ALONE HERE? Please share your experiences regarding this insurance and how to handle it...
Click to expand...


Drop it....Problem solved.
 
Jonathan Duong said:
Insultingly low professional fees, no dispensing fees, mountains of paper work, outsourced phone responses to India and the Philippines, angry patients w/ attitudes who call our office every 15 minutes to argue about their $10 copay, unprofessional and rude Spectera professional relations, more paper work... AM I ALONE HERE? Please share your experiences regarding this insurance and how to handle it...
Click to expand...

You have a plan that has:

1) Insulting fees
2) No dispensing fees
3) Mountains of paperwork
4) Outsourced phone response
5) sends you "angry patients with attidutes"

Please tell us all WHY you are taking this plan???
 
To clarify, we're still biting the bullet w/ Specterible because we're a new, cold-start 1 year old practice that can't afford to pick and choose at this time.
 
Jonathan Duong said:
To clarify, we're still biting the bullet w/ Specterible because we're a new, cold-start 1 year old practice that can't afford to pick and choose at this time.
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Jon,

You realize that if no one took it, you could be taking much better plans because it wouldn't exist?

During OD school I worked for a start up practice that took it. After awhile they weren't even breaking even with spectera and they were loosing patients because of the crappy frames/lenses.

They dumped it.
 
Tim Hendricks said:
We threatened to drop them and they "allowed" us to be exam only. We'll see how that goes. They are the first one on the chopping block.
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I would think that alone would reduce the headaches by 80-90%, less staff time figuring out the various plans, etc. What would you say your conversion to buying spectacles for those patients in office would be? Can they do out of network reimbursement at all? Vary by plan?

thanks
 
We just became exam only this week. I think they have very little out of network coverage for materials, but at worst case I'm not sending Spectera a check every other week for materials co-pays. I agree that 90% of our problems with spectera are related to material coverage headaches. We'll see how it pans out.
 
Tim Hendricks said:
We just became exam only this week. I think they have very little out of network coverage for materials, but at worst case I'm not sending Spectera a check every other week for materials co-pays. I agree that 90% of our problems with spectera are related to material coverage headaches. We'll see how it pans out.
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We're not sending them a check at all. Some how they manage to deduct material copays and everything else from our exam fees... So whatever that we can collect from patients for material copays and surcharges are the only thing we can keep. But the problem is that they usually deduct more from us than what we can collect from patients, therefore hurting our profit margin. That's why "exam only" makes sense w/ Specterible. Best of luck!
 
J Sunday said:
thanks,

isn't there going to be a huge change with them? Name change, perhaps more?
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Talked with a United health Care VP in charge of vision plans at an Essilor event 2 weeks ago (he used to be a VP at Essilor, now he's a liaison from UHC/Spectera to the Essilor laboratories I believe). Very nice guy, he said things would get better with the "new" company. I ribbed him mercilessly. He was a good sport, and had heard all the analogies.

specterrible
sucktera
shitterra

etc.

Anyhow, don't believe it. If they become "better" it would be the first and last time it happens in the history of insurance, IMO.
 
I had written letters to all Vision plans wanting more reimbursement and so far only Spectera responded back with a $10 exam increase and collecting 40% of surfees (was previously 0%).
 
I see over and over on this forum about OD's complaining about vision plans. The solution/advice from other OD's is to drop the vision plan. In all reality, it is a lot easier to say drop the plan than to actually drop it for some OD's. Some of us just don't have that option. I don't with Eyemed and I bitch constantly about it.

These vision plans are becoming a big concern in my mind with their low reimbursements and this mentality that they can do what they want to us because we don't have options. The one that really blew my mind was when some OD on this forum said that one vision plan actually charged the OD when reimbursing him/her. How unethical is that?

Does anyone else have these same long-term concerns? I feel these vision plans are bringing our profession down just as many feel the commercial empires are doing the same.

I'm not sure there is anything that can be done because we can't unionize and the AOA won't listen. This profession has a potentially scary future if things continue down this road. Thoughts anyone.
 
When looking at a potential practice purchase, it would be insanity to not look at the plans accepted while going over the number.

I've also heard of a lot of people who were scared to drop a plan and then were really happy financially when they did. Less work, less patients, more net.

But, the plans survive and will probably always survive because there are always going to be ODs who can't make these types of decisions, and there are those who can make these decisions and would rather see an extra 3 patients a day for $20 extra.
 
After reading all these posts, I don't see how anyone, including a cold start, can think this plan is worth taking.

As far as the name change goes, it's like The Who says: "Meet the new boss, the same as the old boss."
 
Jon you should try a cold start one day. For the sake of arguement, let's assume this "cold start" is in a large metro area (where most new ODs open). How long do you think you'd last?
 
Scott Sanders said:
I see over and over on this forum about OD's complaining about vision plans. The solution/advice from other OD's is to drop the vision plan. In all reality, it is a lot easier to say drop the plan than to actually drop it for some OD's. Some of us just don't have that option. I don't with Eyemed and I bitch constantly about it.

These vision plans are becoming a big concern in my mind with their low reimbursements and this mentality that they can do what they want to us because we don't have options. The one that really blew my mind was when some OD on this forum said that one vision plan actually charged the OD when reimbursing him/her. How unethical is that?

Does anyone else have these same long-term concerns? I feel these vision plans are bringing our profession down just as many feel the commercial empires are doing the same.

I'm not sure there is anything that can be done because we can't unionize and the AOA won't listen. This profession has a potentially scary future if things continue down this road. Thoughts anyone.
Click to expand...

I TOTALLY AGREE WITH YOU! That is why in 2008 I will vote for the presidential candidate w/ most sound ideas for health care reform. As for the AOA, any idea why they're not listening to our concerns? Or has managed care become "The Untouchables" for even the AOA or any other entity?
 
The only justification I have for keeping xxxxtera is that I do get referrals from these patients. A lot of these referrals are private-paying patients and patients with "better" vision service plans.

Without these referrals, I probably would've dropped the plan already.
 
Tony Vu said:
The only justification I have for keeping xxxxtera is that I do get referrals from these patients. A lot of these referrals are private-paying patients and patients with "better" vision service plans.

Without these referrals, I probably would've dropped the plan already.
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Same thing here. I try to be as nice as possible to these patients and they usually will refer their friends and family--usually on different (better-paying) plans or private. Luckily, we don't see a lot of Spectera.

I have Spectera patients that hate Spectera too. When we can't get their auth, the patients try to call the company. Guess what kind of responses they get--nothing. Just like us. We commisserate with those patients. We also gently suggest (due to the poor customer service and limited selection of frames) that they re-evaluate their vision plan when signing up for their insurances.
 
We only have one business in our whole county that has Specterrible, and that business, a factory, is slowing dwindling down in # of employees. I expect it will close in another couple years.

There is a business in a neighboring county that has Specterrible, another factory, that will be closed by the end of next year. That means the two largest employers in our multi-county area that have Specterrible are closing or going down hill rapidly.

I have a theory that when a business is going down hill, it switches to worse vision plans.
 
Spectera and United Healthcare

I'm under the impression that If I drop Spectera then I will be booted as a United Healthcare Provider as well....is that true?

I looked at my United Healthcare contract and didn't find a provision stating that taking Spectera was mandatory but I have heard from some docs that I can't be a United Healthcare provider if I don't take Spectera.

If this indeed the case, has anyone found a way around this? I really want to drop Spectera but see a fair number of United Healthcare medicals.
 
spectera

Hi all,
I dropped those fraudulent cheats long ago, and I can truthfully tell you that it hasn't cost me one thin dime. What I do have is a happier staff and way less complaints. I told their attorney to get me off of their "panel" that day, because their reputation was becoming MY reputation.
Drop 'em quickly before they do you harm. By the way I still get some of their(former) customers as patients...now they pay me cash:D
Jimmy.
 
SpecterriDaviBlockEyemediColeacrappy Plans....

When I opened up in 2003 we had the Davis rep come to see us. He helped us fill out our applications and looked over the new space we had just fleshed out. The Davis rep gazed around the optical and looked me in the eye and said: "You'll drop our plan within the next two years." He could've been Nostradamus.... Within the next 18 months of spinning the tower-o'-doom we finally dropped Davis and had to write them a check for the charge-backs. We sent them back their frames, and asked what we should do with the spinning tower. "Throw it away!" was their reply. (I gave it to another OD in town) Thankfully no one has ever asked us if we take Specterrible.

I agree that we as OD's have to take better care at evaluating the plans we are offered. It is a shame that we cannot argue as a profession for a better contract from these and other payors. I think this might be an avenue our state organizations would be better suited to handle as insurance rules and regulations differ from state to state.

Jon,... Dealing with these plans may take more of your time away from concentrating your practice on your low vision specialty. I'd consider dropping the plans in favor of cultivating more OD and MD low vision referral sources. Other OD's in your area whom are "on the plan" should refer their more difficult cases to you.

Oh, and Eugene... (whom said: "I'm under the impression that If I drop Spectera then I will be booted as a United Healthcare Provider as well....is that true?") Your status on the one should not affect the other. We dropped Davis, but continue to see our Blue-Cross/Blue-Shield patients thru their insurance. (Most of the BC/BS HMO's in my area have DAVIS as their vision plan.) They require referrals for the exam as most HMO folks do. Some of 'em we send out with their prescription knowing that they'll go across town to get "the free glasses" Others are willing to submit a claim on their own back to Davis as an "out of network" expense.
 
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Matthew J. Watson said:
When I opened up in 2003 we had the Davis rep come to see us. He helped us fill out our applications and looked over the new space we had just fleshed out. The Davis rep gazed around the optical and looked me in the eye and said: "You'll drop our plan within the next two years." He could've been Nostradamus.... Within the next 18 months of spinning the tower-o'-doom we finally dropped Davis and had to write them a check for the charge-backs. We sent them back their frames, and asked what we should do with the spinning tower. "Throw it away!" was their reply. (I gave it to another OD in town) Thankfully no one has ever asked us if we take Specterrible.

I agree that we as OD's have to take better care at evaluating the plans we are offered. It is a shame that we cannot argue as a profession for a better contract from these and other payors. I think this might be an avenue our state organizations would be better suited to handle as insurance rules and regulations differ from state to state.

Jon,... Dealing with these plans may take more of your time away from concentrating your practice on your low vision specialty. I'd consider dropping the plans in favor of cultivating more OD and MD low vision referral sources. Other OD's in your area whom are "on the plan" should refer their more difficult cases to you.

Oh, and Eugene... (whom said: "I'm under the impression that If I drop Spectera then I will be booted as a United Healthcare Provider as well....is that true?") Your status on the one should not affect the other. We dropped Davis, but continue to see our Blue-Cross/Blue-Shield patients thru their insurance. (Most of the BC/BS HMO's in my area have DAVIS as their vision plan.) They require referrals for the exam as most HMO folks do. Some of 'em we send out with their prescription knowing that they'll go across town to get "the free glasses" Others are willing to submit a claim on their own back to Davis as an "out of network" expense.
Click to expand...

Matthew,
Thanks for the insight. You're most definitely right about quitting these insurance plans (Davis, Spectera,...) and focus our energy on low vision services. Lately, our practice has suffered as a "Spectera dumping ground" for a nearby Kaiser HMO sending Spectera patients over for eyeglasses only.
 
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