Frequently Asked Questions & Direct Eye Care
What is Direct Eye Care?
At Specs, we are proud to be providers in the Direct Care movement, with the goal to improve healthcare by having a direct, transparent relationship with patients, no longer separated by insurance companies.
When healthcare providers are contracted with insurance companies, prices are inevitably artificially inflated, to account for the large percentage the insurance company keeps. Furthermore, insurance companies often dictate how the exams are performed, what lenses are “covered”, what labs options to use, and what tests are to be included. This systematic approach puts limitations on the service provided by the doctor to cater to individual needs of each patient as well as what optical products we may offer.
Instead of compromising our level of care, products, and services to fit what insurance companies deem as necessary, the Direct Care model allows us to deliver the most comprehensive level of eyecare, ensuring our patients have the best care and products available.
When healthcare providers are contracted with insurance companies, prices are inevitably artificially inflated, to account for the large percentage the insurance company keeps. Furthermore, insurance companies often dictate how the exams are performed, what lenses are “covered”, what labs options to use, and what tests are to be included. This systematic approach puts limitations on the service provided by the doctor to cater to individual needs of each patient as well as what optical products we may offer.
Instead of compromising our level of care, products, and services to fit what insurance companies deem as necessary, the Direct Care model allows us to deliver the most comprehensive level of eyecare, ensuring our patients have the best care and products available.
What are the benefits of Direct Eye Care?
Anyone is Welcome!
We accept new patients and will not turn you away due to what insurance plan you have. If you have vision insurance, you may utilize your out-of-network benefits for products or services at our office.
Increased Access to Dr. Ly
Comprehensive eye exams are scheduled for up to 60 minutes so Dr. Ly may fully understand your lifestyle needs and so you may have all your questions answered. Additionally, this allows for enough time before/after each patient to fully sanitize our equipment to prepare for the next exam.
Due to low reimbursement from insurances, many contracted offices spend less than 30 minutes with patients to maximize the amount of patients they may see. We believe your eye exam experience should never feel like a drive through and we strive to deliver the best quality of care.
Affordable and Transparent Pricing
Since we have cut out the middleman, large insurance companies, we are able to pass along the savings to our patients in the form of affordable exam visits, as well as frame and lens costs.
For example, many insurances give you a $200 "discount" on frames and require providers to give you a 20% discount on the remainder of any frame purchased. However, the reimbursement to providers from insurance companies for frames are rather marginal, so to make up for it, providers will often charge MSRP or over MSRP on their ticketed prices. In comparison, all of our frames are marked under MSRP, providing our patients a clear discount when purchasing frames in store.
**Pro-tip: Since prescription glasses are medical devices and not subjected to sales tax, you can get a designer frame, at a discounted rate, tax free!
Additionally, we have frame and lens options at every price point, to fit any budget. Our options at all price points are still screened for the best quality and best values.
Simplified & Concierge Experience
Insurance companies often dictate how a provider practices and what products and services they may provide to be "covered" for. Our goal is to simplify and redefine the eyecare experience for our patients through standard pricing and our concierge experience, eliminating the middleman. We don't charge membership fees as we're committed to delivering thorough, fun, authentic eyecare experiences. We will recommend options for you at every price point, different style options, and let you make the choice to best fit your lifestyle needs. When you're here, we treat you like family and won't push any products or services on you!
We accept new patients and will not turn you away due to what insurance plan you have. If you have vision insurance, you may utilize your out-of-network benefits for products or services at our office.
Increased Access to Dr. Ly
Comprehensive eye exams are scheduled for up to 60 minutes so Dr. Ly may fully understand your lifestyle needs and so you may have all your questions answered. Additionally, this allows for enough time before/after each patient to fully sanitize our equipment to prepare for the next exam.
Due to low reimbursement from insurances, many contracted offices spend less than 30 minutes with patients to maximize the amount of patients they may see. We believe your eye exam experience should never feel like a drive through and we strive to deliver the best quality of care.
Affordable and Transparent Pricing
Since we have cut out the middleman, large insurance companies, we are able to pass along the savings to our patients in the form of affordable exam visits, as well as frame and lens costs.
For example, many insurances give you a $200 "discount" on frames and require providers to give you a 20% discount on the remainder of any frame purchased. However, the reimbursement to providers from insurance companies for frames are rather marginal, so to make up for it, providers will often charge MSRP or over MSRP on their ticketed prices. In comparison, all of our frames are marked under MSRP, providing our patients a clear discount when purchasing frames in store.
**Pro-tip: Since prescription glasses are medical devices and not subjected to sales tax, you can get a designer frame, at a discounted rate, tax free!
Additionally, we have frame and lens options at every price point, to fit any budget. Our options at all price points are still screened for the best quality and best values.
Simplified & Concierge Experience
Insurance companies often dictate how a provider practices and what products and services they may provide to be "covered" for. Our goal is to simplify and redefine the eyecare experience for our patients through standard pricing and our concierge experience, eliminating the middleman. We don't charge membership fees as we're committed to delivering thorough, fun, authentic eyecare experiences. We will recommend options for you at every price point, different style options, and let you make the choice to best fit your lifestyle needs. When you're here, we treat you like family and won't push any products or services on you!
How do I get reimbursed with my insurance?
Let us know what vision insurance you're currently enrolled with and we'll print out their out-of-network claim forms for you to fill out. We can help you mail in your form with your itemized receipt, or we can email you a PDF for you to submit online. If you have eligible benefits at your time of service, you should receive a check in the mail within 2-4 weeks.
**We encourage you to check if you have benefits and whether or not you are eligible to use them.
**We encourage you to check if you have benefits and whether or not you are eligible to use them.
Can I use pre-tax medical dollars, such as FSA (Flexible Spending) or HSA (Health Savings)?
Yes! We encourage you to use your FSA/HSA dollars for your visit and optical purchases. If you have a debit/credit card for your FSA/HSA account, you're welcome to swipe it at our office for any products or services.
If you don't have it on you when you come in, that's not a problem either! We like to advise you to use any credit card which you have the best reward points program on, and get points for your office visit/purchases! We will send you a PDF of your itemized visit and you may use it to redeem your FSA/HSA dollars! We're all for racking up on points so you may use it to travel when the world opens up again!
**REMINDER: Unused FSA dollars expire at the end of the calendar year and you essentially lose it to insurance companies! HSA dollars typically roll over to the next year. Be sure to know which you have.**
If you don't have it on you when you come in, that's not a problem either! We like to advise you to use any credit card which you have the best reward points program on, and get points for your office visit/purchases! We will send you a PDF of your itemized visit and you may use it to redeem your FSA/HSA dollars! We're all for racking up on points so you may use it to travel when the world opens up again!
**REMINDER: Unused FSA dollars expire at the end of the calendar year and you essentially lose it to insurance companies! HSA dollars typically roll over to the next year. Be sure to know which you have.**