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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.
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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.
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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.
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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.
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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.
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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.
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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.
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What is the fee reimbursement 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.
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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.
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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.
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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.
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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.
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How does Vision Care Direct differ from VSP? VCD
fees are determined by the owner doctors in each state. The money 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.
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How does the IPA differ from Vision Source? 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.
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How to 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.
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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.
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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.