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Frequently asked questions:
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
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