To VT or Not To VT – The Root of All Evil – Part 2

For the love of money is the root of all evil; which while some coveted after, they have erred from the faith, and pierced themselves through many sorrows. ~ Timothy 6:10

There are many reasons patients and their families choose against enrolling in Vision Therapy, and although a few are tough to swallow from my side of the table, all of them are to be respected.

Some will not partake because they truly do not have the financial resources. If you cannot afford the services and have to say no, I get it.

Then there’s the families who choose not to enroll simply because they don’t buy into the notion of Vision Therapy being effective, or the “where’s the science?” folks.  OK,  if you don’t think it will work and choose to say no, then fine. I’m good with that.

But here’s where the trouble stirs in my brain…

When we allow third-party money-making machines (namely, your insurance provider) to overrule the prescribed care of a doctor simply because they have chosen not to cover said intervention as part of the plan you’re currently enrolled in, that’s a problem.

My question is why?

Why do we let someone whom we’ve never met, someone who for all intents and purposes considers us (or our kids) to be nothing more than a group or ID number, someone who is employed by the insurance company whose job it is to help manage the collective bottom line, decide what’s the best course of action? Even worse, why do we let the corporations the insurance companies have become decide what’s best for our child? Why do we let them make the final decision?

I don’t get it.  Do they really have your best interests in mind?

I promise all of you, if one of my kids needed a treatment which had the potential to improve their quality of life for the rest of their lives and I couldn’t afford it, I’d be sending out a mass emails to family and friends begging for help. I’d take a second job, a third job, even find other ways to cut back in life to make it happen. So long, Starbucks! Money would go from a necessary evil to an insignificant function of entering the office, and I have a VERY hard time believing I am alone in this conviction. Many, many, many parents I’ve met have made the sacrifice for their kids, as I’m sure many parents around the world are doing right now.  If we allow the improvement of our kids’ live to be about the money, we lose.

Every time.

But let’s discuss the other way we lose, beyond allowing someone else decide our child’s medical care and beyond letting money be the deciding factor for treatment.

I’m talking about expectations. When people enter our office and they have been informed Vision Therapy is a “covered benefit”, what they really heard is “it’s free”. The expectation becomes the medical coverage they are paying for every month is taking care of this, and they will have no further out-of-pocket expense to get the services their child so richly needs.  That’s how it should be, right?

Yeah, not so much.

This put us (as providers) in the tough spot of informing patients of the reality of the situation, a conversation usually beginning with “well, actually, your coverage only pays a portion and the rest is out-of-pocket. Your insurance doesn’t cover this at 100%”. Or my personal favorite, “your insurance company may have told you they cover this, but they have denied every code we can possibly bill, so…”.  Insert your favorite comment on VT being “experimental” or “smoke and mirrors” here. The relationship quickly goes from “oh, I’m so happy we found your office”, to “if our insurance doesn’t cover it, then we’re not interested.”

So, again, I’m asking, who is really making the decision as to the patient’s quality of life?

Stay tuned…

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Posted on June 20, 2017, in From My Perspective.... Bookmark the permalink. 3 Comments.

  1. So if in Part 1, the #1 answer to your survey of “What is the single most important factor in your decision to enroll your child in Vision Therapy?” was Quality of Life (My Child is Smart and Deserves Better) with 28 votes, with no one saying Insurance (Understanding My Coverage) was an important factor (0 votes).
    Would it be fair to speculate then, that if you did a survey of parents who did not elect to proceed with VT and asked what the single most important factor in their decision not to enroll their child, the answer would be “lack of insurance coverage”?

    Like

  1. Pingback: To VT Or Not To VT – The Final Act – Part 3 | VT Works

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