Officemate VSP Interface Contact Lens Fitting Pricing Fix

There was a big problem with how Officemate VSP interface calculated contact lens fitting fee slips. 

I am very pleased that Officemate has taken one my feature requests seriously and has acted very promptly to resolve a very important issue with VSP Interface pricing.  This fix is featured in 11.2.  I will go into detail about contact lens fitting presentation in the future, but check out the excerpt from the feature request I submitted on 11/13/2014:

Two different VSP Plans
When pricing contact lenses in the VSP interface, this is the clause it takes into account in the VSP authorization, either:

CL Exam Covered w/ Copay
Contacts  The routine eye exam is covered.
CL Exam Services: Charge the patient $60.00 copay or 85% of U&C, whichever is lower.
CL Materials: The patient receives a $130.00 allowance towards contact lens materials. 

or 

CL "Exam And" Plan
Contacts  Exam And Allowance. The routine eye exam is covered and the patient receives a $105.00 allowance towards the contact lens exam services and materials.The patient receives a 15% savings off contact lens exam services prior to applying the allowance. If your patient receives contact lens exam services only without purchasing materials, the maximum allowance is reduced to $60.00. 

So typically, the former is always priced correctly (with the $60 copay and the allowance applied to contacts).  The latter is priced correctly, but from a sales perspective it makes it extremely difficult for ALL OFFICES to explain it to the patient this way.  This is where I would suggest a change in feature.  Let me explain why.


How VSP Interface prices "Exam And" plans
This is how Officemate will calculate all items would have the following lined items:
With an "Exam and" plan of $105 allowance, Officemate VSP Interface will ALWAYS calculate it like this:

Example of $105 Allowance
Contact Lens Exam: $90 - 15% = $76.50 - 76.50 ($105 VSP Allowance) = 0
Contacts Right Eye: $120 - 28.50 ($105 VSP Allowance)  = 91.50
Contacts Left Eye: $120

($76.50 + $28.50= $105) VSP Allowance

So this is what the patient sees when we review their account for contacts:
Contact Lens Exam: $0
Contacts Right Eye: $91.50
Contacts Left Eye: $120
Total: $211.50

Industry Perspective
I know you don't work in Optometry, but let me give you some perspective of one of our biggest challenges.  No matter what office, you will always have a patient complain about the "Contact Lens Exam".  The contact lens exam is: an exam on top of your standard eye exam, that is needed to get/renew your contact lens prescription.  A lot of people contest that.  

So let me tell you what is wrong with the way VSP Interface prices the Contact Lens Exam: the patient will initially be relieved that the contact lens exam is fully covered, but then will contest the remainder of the 105 allowance (28.50) going towards the contacts.  Most will respond with "I only get $28.50 towards the contacts? It says I get $105."  That then leads to, "Contact Lens Exam? Why do I have to pay for a contact lens exam? Doesn't my insurance cover that?"

Many optometrists have recognized this issue years ago and have decided the smoothest way to appease the patient is to use the vsp authorization clause: "The patient receives a 15% savings off contact lens exam services prior to applying the allowance". So after VSP Interface prices everything:

Contact Lens Exam: $0 we manually change it to: $90-15%= $76.50
Contacts Right Eye: $91.50 we manually change it to: $120-105= $15
Contacts Left Eye: $120 we manually change it to: $120
Which gives us the same total: $211.50

This is what the patient sees after we manually adjust it:
Contact Lens Exam: $76.50 (We back this up by showing patients the 15% off contact lens exam services clause)
Contacts Right Eye: $15 (We show the patient $105 allowance applied to contacts)
Contacts Left Eye: $120

Feature Request
So the feature I'm requesting is generally, ANY PATIENT WITH AN "EXAM AND" PLAN to price the CONTACT LENS EXAM -15% and APPLY THE ALLOWANCE TOWARDS CONTACTS.  It has been almost three months since we've activated VSP Interface and I have done everything in my power to train the staff properly to reflect our goal in presenting the patient with a hassle-free review of their charges, but (human) errors are still being made because we choose to price it this way.  

I firmly believe that EVERY single office with Officemate would agree with me that this is the way the VSP Interface should work when pricing "Exam And" contact lens plans.  Here is my Algorithm:

IF PLAN = "EXAM AND"
IF CLRIGHTEYE_FEE > ALLOWANCE
CLRIGHTEYE= FEE - ALLOWANCE
CLLEFTEYE= FEE
CLEXAMFEE= FEE - 15%
IF CLRIGHTEYE_FEE + CLLEFTEYE_FEE > ALLOWANCE
ALLOWANCE_REMAINDER = ALLOWANCE - (CLRIGHTEYE_FEE + CLLEFTEYE_FEE)
CLRIGHTEYE= 0
CLLEFTEYE= 0
CLEXAMFEE= FEE - 15% - ALLOWANCE_REMAINDER
IF CLEXAMFEE<0
CLEXAMFEE=0
IF CLRIGHTEYE_FEE < ALLOWANCE
ALLOWANCE_REMAINDER = ALLOWANCE - CLRIGHTEYE
CLRIGHTEYE= 0
CLLEFTEYE= FEE - ALLOWANCE_REMAINDER
CLEXAMFEE= FEE - 15%


The ticket number for the feature request I submitted was: OM-3016

Here is the email:


I have helped resolve other issues on Officemate, like getting the near variable focus lenses to work with VSP Interface (ticket# OM-2443), which sometimes makes me feel like a software beta tester.  I hoped my fix has helped many of you.  Let me know your views on presenting contact lens fittings for my next article.  Respond to this article or tweet me @caquinoconsult using the hashtag #contactlensfittings
Post a Comment

Popular posts from this blog

4 Steps to Creating your Procedure Manual in Google Docs

How to Properly Implement Officemate's Lens Loader

Patient Communication Tools: A Side-by-Side Comparison