Insurance Company
Pays for LASIK

Pottstown Mercury
Sunday, May 20th 2001
Vol I Issue 20

Doylestown Intelligencer
Sunday, May 20th 2001
Vol II Issue 14

Courier Post
Sunday, May 20th 2001
Vol III Issue 7



Proof Positive that Blue Cross of Pennsylvania has a history of Paying for LASIK
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In My Opinion:

Blue Cross of Pennsylvania began to dabble in LASIK surgery in 2000 and 2001. They insisted that bilateral LASIK surgery should be reimbursed at a rate of $575.00 per eye. In fact, I was threatened with exclusion from the Blue Cross Provider Network if I did not accept this payment as payment in full. Fortunately, the above full page newspaper articles allowed Blue Cross to reconsider its LASIK experiment and they elected to withdraw from the market.

Lately, Blue Cross throughout the country has made special arrangements with TruVision™. TruVision claims to be the largest third party provider of Laser Vision Correction Services and Mail Order Contact Lenses. If you follow their link you will see their use of the Blue Cross Official Logo as well as the logo of TLC. You may remember than TLC filed forbankruptcy earlier this year failing to pay their surgeons, vendors and cutting staff pay. TLC emerged from bankruptcy and is now owned by a handful of high-powered bankers.

If you search for an approved Philadelphia-based LASIK Surgeon on the TruVision site you will be directed exclusively to the TLC LASIK Center in Plymouth Meeting. Nearly a dozen LASIK Surgeons perform LASIK at this center. There are at least 50 other surgeons in the area who also provide LASIK services at alternative locations, often using their own equipment. Some of these surgeons are nationally and internationally respected experts in the field.

Essentially, by partnering with TruVision, Blue Cross is preferentially recommending one group of LASIK surgeons over another. I do not know one Ophthalmologist in Pennsylvania that is not a participating provider for the Blue Cross Network. In fact, I doubt I or any other ophthalmic provider could make a living without them. Blue Cross does not preferentially refer cataract patients to a select group of providers. I do not understand why they allow TruVision to divert patients to a select group of surgeons. I do not know if Blue Cross checks the accreditation of these surgeons, their malpractice coverage for refractive surgery or if you can even lodge a complaint against a surgeon as you can in their covered services.

To the best of my knowledge these surgeons are selected because a substantial part of the surgical fee goes to the TruVision parent company, TLC. TruVision was once owned by LASIKPlus and then later by LVCI. LVCI was a LASIK provider who dominated mobile excimer laser services (roll on-roll off lasers-originally developed for rural areas). Many experienced LASIK surgeons do not believe the quality and reliability of mobile excimer lasers can compete with a fixed-site excimer laser. In my opinion, their FDA approval status is marginal.

Is TruVision trying to look like a part of Blue Cross Blue Shield?

This is the color scheme of the Independence Blue Cross website

This is the color scheme
of the TruVision website



This is a list of the TruVision participating health plans

  • Allied Eye Care - Florida
  • Altius
  • Anthem East (Blue Cross Blue Shield CT, ME, NH & VA)
  • Anthem Mid West (Blue Cross Blue Shield IN, KY & OH)
  • Anthem West (Blue Cross Blue Shield CO & NV)
  • Blue Choice
  • Blue Cross California
  • Blue Cross Blue Shield of Arkansas
  • Blue Cross Blue Shield of Delaware
  • Blue Cross Blue Shield of Florida
  • Blue Cross Blue Shield of Georgia
  • BlueCross of Idaho
  • Blue Cross Blue Shield of Illinois
  • Blue Cross Blue Shield of Iowa
  • Blue Cross Blue Shield of Kansas
  • Blue Cross Blue Shield of Minnesota
  • Blue Cross Blue Shield of Missouri
  • Blue Cross Blue Shield of Nebraska
  • Blue Cross Blue Shield of New Mexico
  • Blue Cross Blue Shield of North Dakota
  • Blue Cross Blue Shield of Oklahoma
  • Blue Cross Blue Shield of South Carolina
  • Blue Cross Blue Shield of South Dakota
  • Blue Cross Blue Shield of Tennessee
  • Blue Cross Blue Shield of Texas
  • Blue Cross Blue Shield of Wisconsin
  • CareFirst BlueCross BlueShield
  • Coventry Health Care of GA
  • Empire Blue Cross Blue Shield
  • Excellus (BCBS NY Central)
  • Health Net
  • Health Net of the Northeast
  • Horizon Blue Cross Blue Shield of New Jersey
  • Humana
  • Kaiser Foundation Health Plan of GA
  • Kaiser Foundation Health Plan of the MidAtlantic states
  • LifeWise
  • PacifiCare
  • Physicians Health Services
  • Premera Blue Cross
  • Providence Health Plan
  • Regence Blue Cross Blue Shield of Utah
  • Regence BlueCross BlueShield of Oregon
  • Regence Blue Shield of Idaho
  • Regence Blue Shield of Washington
  • Regence Life and Health
  • UNICARE
  • Unity Health Plan
  • Wellpoint
  • Wellspring Healthcare, Inc.
Advantage Program

  • Advantica Eyecare (subsidiary of Allied Eyecare)
  • Access
  • AdvanTech Solutions
  • Block Vision
  • Optical Vision Designs
  • Coast-to-Coast Vision Plan (New Benefits)
  • Community Eye Care (CEC)
  • CompBenefits (Vision Care Plan)
  • Davis Vision
  • Deseret Mutual Benefit Administrators (DMBA)
  • Eye Benefits
  • Eye Care
  • International HCA
  • Health Allies
  • Health InfoNet MT
  • Lumenos
  • MedBen
  • MESVision
  • Mid Atlantic Medical Services (MAMSI)
  • Mtn. States Managed Care & Health Alliance Physician Hospital Organization
  • MVP Health Plan
  • National Optic Provider (NopticPro)
  • National Vision Administrators (NVA)
  • Outlook Vision Services
  • SafeGuard Vision
  • Starmount Life Insurance Company
  • UFCW Local 324
  • Vision Benefits of America (VBA)
  • WellCall, Inc.
Corporations

  • J.B. Hunt Trucking
  • Allied EyeCare
  • Walmart


 

In summary:

Blue Cross of Pennsylvania treats all of its participating providers equally. They do not direct patients to one group of eye surgeons over another. They do not direct their patients to certain hospital networks like Jefferson, University of PA, or Main Line Health. In fact, they do not even provide guidance to patients seeking a cataract surgery even though Blue Cross is well aware of the compication rates of virtually all ophthalmic providers in the state.

The presence of the Blue Cross Logo on the TruVision site is basically an endorsement of those surgeons with absolutely no knowledge of surgical skill or patient satisfaction. Blue Cross is allowing its name to be used by a private company whose motivation is purely financial.

TLC is a large organization with many talented surgeons, but, there are many unaffiliated talented LASIK surgeons who do not participate with TLC. As providers and subscribers the people of Pennsylvania expect equanimity from Blue Cross not side-deals with a select group of providers for what is probably financial consideration.

LVCI merged with TLC years ago. The resulting company was called TLC and TruVision became their subsidiary.

Blue Cross has endorsed a company at the expense of Pennsylvania LASIK surgeons who do not use TLC centers.

The two largest malpractice settlements in the history of LASIK were against TLC surgeons. Several years ago TLC was described in the media as the McDonalds of LASIK.

I respectfully request Blue Cross in Pennsylvania and elsewhere extricate itself from their discount programs and endorsement of TruVision providers.

LASIK pricing is available to everyone from $299 an eye to $3500 an eye. We do not need TruVision or Blue Cross to replace natural market forces.

Finally, I suspect there is some violation of anti-trust rules, the "every willing provider rule", or some other regulation of the Federal Trade Commission in this sordid arrangement.

I hope Blue Cross, as market leader, can eliminate this peripheral portion of their business and focus on the much larger business of healthcare.

These opinion represent only my opinions and rely on no special knowledge or data outside the public domain..