10/4/2023  When working our unpaid AR accounts, our billers identified a common problem: missing VSP payments for glasses jobs completed at Hoya labs. We immediately escalated the problem, and Hoya discovered they had not been billing VSP for their glasses jobs. Apparently there was an IT glitch in their system. Today we received a notice from our contact at Hoya that the issue has been resolved. All claims have now been sent to Eyefinity, and offices should start to receive payment in the next one to two VSP payment cycles. Hoya also confirmed that they have put measures in place to prevent a reoccurrence of the problem. The problem started 9/6/23, so offices who sell a lot of Hoya products will notice a drop in their last couple of  VSP checks. However, we expect all missing accounts to be paid by month’s end.

We all know that HMO plans won’t pay for medical care without a referral, but you’d be surprised how often we get denials from insurance companies because the office saw the patient for medical care and no one got a referral. How can you avoid this? Always check the patient’s card! If it says “HMO” or has a primary care physician (PCP) listed, then the plan requires a referral for medical eye care.  Many of your insurance contracts put the burden for obtaining a referral on the provider, and the EOB shows the denial as a contractual write off. Even if your contract doesn’t stipulate and it’s your office’s policy that patients are responsible for getting all referrals, a courtesy reminder to patients can go a long way in gaining goodwill and saving the patient from a large bill they didn’t expect.