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Frequently Asked Questions..................................................................................
Vision Care Direct FAQS: What is an IPA?: Why should an independent doctor join?: Answers:Frequently asked questions: 1. What is an IPA? An Independent Physician Association that is typically structured as a Limited Liability Company. An IPA is organized in each state to help its members compete through IPA owned and control managed care and marketing programs. Through an IPA, bad plans that employers choose can be replaced by good plans using Vision Care Direct vision plans. 2. Why should an independent doctor join the state IPA? Because doctors can’t compete against forces like WalMart, Luxottica, Davis, Spectera on their own. Employees want vision benefits. As doctors unite together doctors can offer better vision plan and managed care options such as Vision Care Direct. An IPA is a network. As a network, doctors can contract with health plans for full-scope care. However, you MUST have the network first. Help build one in your state. 3. Why should I be an owner/doctor member versus a participating provider? The owner members set the reimbursement, own and control the bank accounts, own and control the contracts written with in-state employers and enjoy the profits should any be generated. Owner doctors determine how fast claims are paid. Many owner doctors in a state enable the IPA to remain strong for many years without fear of hostile takeover. 4. How does the IPA generate money for operations & marketing? Through Preferred Vendor Rebates and or member dues. But not from the sell of Vision Care Direct vision plans. Only admin fees and insurance brokers’ commissions are covered by vision plan sales member fees. 5. If an annual profit is made, who gets the money? The owner members. However, the system is set up to not create very much profit. The money generated comes back as higher reimbursements for all members. The state IPA leaders have a goal of creating the best benefit for the money for plan members with higher reimbursements for the doctors. Under this environment patients get the best care and a great value on eyewear. IPAs and VCD cut out middlemen creating the best value for both. 6. How does the National Coalition of Eye Care IPAs get it revenues? The NCECIPA is an association of IPAs. It doesn’t own or control bank accounts, vision plan contracts, or the name Vision Care Direct. However, is a great and needed support system for the state IPAs. The NCECIPA keeps things moving smoothly between states and works at a national level to add more power with vendors for the state IPAs. Its operating budget is covered by dues paid by the state IPAs and vendor rebates. Another goal of the NCECIPA is spread the IPA movement to all states. 7. Where does the money go that is collected from plan members? All revenues collected through VCD plan sales go into a separate IPA trust account that can’t be co-mingled with other money. The money from those accounts pay the doctor claims, sales commissions and administration fees. Marketing dollars for the IPA sales rep(s) and marketing materials come from vendor rebates and/or IPA member dues. Money from vendors and dues is deposited in the state IPA operations checking account. 8. What is the doctor reimbursements for our state? That is determined by your state’s owner doctors. Once the network is mostly built, the owner doctors through KNA conduct a survey. A fair and competitive reimbursement is determined following a strict procedure that complies with Anti-trust rules. 9. What kind of monetary return can I expect on my owner membership investment? Not much for the first years. Over time the IPA does make a small amount of money that can be paid back to the owner doctors as determined by the owner doctors. Please remember, the goal of an IPA is to help private practices survive and compete in an increasing unfriendly managed care market place. 10. How are claims filed? All claims and eligibility checks are handled by Eyedox.biz through the Internet site at www.vcdplans.com. The Internet is very cost effective and fast. It allows you to receive information 24/7 and real time through www.vcdplans.com. Eligibility checks are fast. Claims can be files in less than a minute. A few mouse clicks will do the job in most cases. 11. How are the costs of claims and administration paid? And by whom? Plan administration and claims processing are paid from money collected by vision plan membership sales. The amount charged to the IPA plan trust account is an extremely low, eight percent (8%) of paid in membership fees. 12. How are claims paid and how quickly? Claims are paid weekly in most states. The state IPA board (which is made up of owner members) determines how often and how quickly claims are paid. Soon www.vcdplans.com will enable IPA boards to select the immediate payment option through Electronic Funds Transfer (EFT) with an electronic EOB sent back to the email address submitting the claim. 13. How does Vision Care Direct differ from VSP? VCD fees are determined by the owner doctors in each state. The moneys collected through VCD are deposited into a checking account owned and controlled by the owner members in their state. The vision plan contracts are owned by each state. The reimbursements are always higher than VSP. 14. How does the IPA differ from Vision Source (VS)? An IPA is open to all private practice doctors in a state who meet the standards and have been credentialed. The primary purpose of an IPA is to unite the independents into a force that can compete against bad plans and unfriendly managed care organizations. Vision Source and the state IPA are complimentary. Many states have VS members in their IPAs, some VS members are IPA board members. 15. How do VCD plans differ from the competition? VCD plans are extremely flexible and unique to the market. Anybody can enjoy VCD benefits, even individuals and their families. VCD plans can be offered directly or through a member’s employers. VCD plans enable patients to get a great deal on materials and superior eye health care at the same location, a private practice eye doctors office. 16. How does our state IPA get lives into our chairs? It simple, sales and marketing. Through the dues and/or Preferred Vendor funds, the IPA hires a sales rep. Doctors can also help affect VCD sales in your community by providing quality referrals to your IPA sales rep. Doctor referrals help build the business faster. 17. Who pays for the marketing and sales rep costs? The IPA does from the money it receives through vendor rebates and/or monthly dues paid by IPA member doctors. Once again, each state decides all aspects regarding the operations, management and objectives of the IPA. An Independent Physician Association that is typically structured as a Limited Liability Company. An IPA is organized in each state to help its members compete through IPA owned and control managed care and marketing programs. Through an IPA, bad plans that employers choose can be replaced by good plans using Vision Care Direct vision plans. Why should an independent doctor join?: Because doctors can’t compete against forces like WalMart, Luxottica, Davis, Spectera on their own. Employees want vision benefits. As doctors unite together doctors can offer better vision plan and managed care options such as Vision Care Direct. An IPA is a network. As a network, doctors can contract with health plans for full-scope care. However, you MUST have the network first. Help build one in your state.
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