Managed Care

How I Dropped a Major Insurance Provider from My Practice & Am More Profitable than Ever

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By Robert Davidoff, ABOC

Sept. 16, 2020

Insurance providers can be a guide to many patients in where they seek care. For that reason, I was nervous when we had to drop a major one from our practice.  However, thanks to an exciting technology, Anagram, we are able to continue serving those patients. We are able to facilitate their reimbursements from their vision benefit even though we no longer are a part of that insurance panel.

Here is how this technology works and why it has made such a difference in our ability to serve patients and grow our practice.

A Risky Transition Made Smooth
We were providers of that insurance for almost 20 years. One day last year our doctor received a certified letter saying the insurance provider was removing him from its panel without explanation.

At first, we were thrown by the insurance company’s decision and unsure of how we would avoid losing all of our patients who rely on it for their vision benefits. Fortunately, a friend who happened to have interned with Anagram, filled me in on how it provides an easy way for providers to help patients get reimbursed for office visits, regardless of whether the practice’s doctor is on the patient’s insurance company panel.

We joined Anagram right away and transitioned smoothly into using the technology. We never filed out-of-network (OON) on any claims from that insurance provider prior to joining Anagram. However, suddenly we were facilitating OON claims on behalf of patients with ease and efficiency.

A Simple Solution to a Potentially Difficult Problem
One of the great things about Anagram is how seamlessly and simply it solves the difficult problem of how to continue serving patients with OON benefits.

Anagram is a cloud-based web application that provides a streamlined experience for managing vision insurance benefits for all kinds of eyecare providers, including optometrists, opticians and ophthalmologists. It’s as easy for our staff as obtaining the patient’s insurance member information, logging onto Anagram, seeing the patient’s benefits information appear on the screen and creating a claim for the services and product purchases. The process takes no more than around one minute per patient.

Patients Appreciate Being Able to Keep their Eye Doctor
We were careful to explain to affected patients how we would be able to continue serving them while facilitating their reimbursements from their vision benefits. We were able to retain most of our patients by showing each patient how they could continue optimizing their vision benefits in our office, even though we are no longer on their insurance company’s panel.

Anagram trained our staff on how best to explain the new technology to patients, including how easy it would be for them to use their OON insurance benefits in our office.

Overall Patient Service Has Improved
When we were in-network with the insurance provider who dropped us, we had to send the glasses to contracted labs for fabrication. The turnaround time was 2-3 weeks to get completed eyewear back and ready for pick-up by patients. We also had to purchase expensive lens brands, as well as specific frame brands. Now that we are able to operate without being on that insurance panel, we edge all lenses in our in-house lab. This way, we can offer patients a 2-3 day turnaround time for eyewear. In addition, we are able to offer patients more affordable options on frames and lens brands.

The Proof is in the Profitability
As our Anagram-based strategy and approach developed, we saw a huge conversion in patients opting for OON benefits. The first six months after implementing Anagram, we have retained over 80 percent of our patients. Our profits have increased and we’re passing on the savings from no longer being a part of the insurance company panel to patients.

The expanded selection we are able to provide to patients in our optical and the improved speed of eyewear delivery, combined with our greater profitability, makes Anagram among the most valuable tools to our practice’s success. Our patients benefit from the use of this technology as much as we do.

Robert Davidoff, ABOC, is manager at Davidoff Optical in Rego Park, N.Y. For questions: marketing-team@anagram.care

 

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