Vision Questionnaire
1. How long has your organization been providing vision care services nationally?
2. How many lives do your currently cover? How many employers? Use the chart below:
Number of Employees / Number of EmployersNationally
County
County
County
County
4. Provide the name, address and telephone number of the office that will service the City. Also provide the name of the person who will have overall responsibility for this account.
5. Describe the enrollment assistance that you will provide the City during Open Enrollment. Include samples of materials that would be included in the enrollment package.
6. How are updated provider directories made available to participants? Describe alternative means for plan members to obtain information on network provider (i.e., the Internet, an automated voice response system, etc).
7. Are patients subject to any ordering limitations (frequency or selection of eye wear)? Yes No. If yes, explain.
8. Can a member receive an exam from one provider and materials (frames, lens or contacts) from another provider? Yes No.
9. How would your plan handle a situation where a patient orders additional materials or services that are not covered?
10. Indicate how glasses and contact lenses may be obtained ___ in office, ___ by phone, ___ or by mail.
11. What is the turnaround time (number of days) after an order for glasses and contact lenses has been placed?
12. Do you have a centralized distribution facility? Yes No. If yes, where is the facility located?
13. If the vision care provider has a facility located in their office, can they fill the prescription for the glasses / contact lenses? Yes No.
14. At what frequency, and under what conditions, can an employee change providers?
15. What is the current number of participating providers? Indicate by Optometrist, Ophthalmologist, and Dispensing Facility for each of the local counties. Use the chart below.
Number of Locations / Percent Of Independent Providers / Percent of Chain Providers / Number of Optometrists / Number of Ophthalmologists / Number of Opticians / Number of Dispensing Facilities16. Provide a breakdown of number of providers by independent practitioners and/or chain stores for each of the local counties. Use the chart below.
Number of Independent Providers / Number of Chain Stores17. What percentage of your participating Ophthalmologists are Board-certified or Board-eligible?
18. Describe how you would handle a situation where a provider refuses to give agreed upon discounts to the member.
19. Describe your customer satisfaction guarantee (i.e., materials, warrantee programs, etc.).
20. Provide references for your three (3) largest multi-state clients, by enrollment, using the following format:
Employer Name / Number of Employees / Date Services Commenced / Contact Person / Address / Phone Number1.
2.
3.
21. If you offer a materials mail order program, what is your performance standard for turnaround time? What is your average turnaround time? Do you offer overnight delivery service? Yes No. If yes, at what additional cost?
22. Describe any benefit pre-certification or vouchers that members would be required to obtain before benefits are provided.
23. Provide a current 2017 directory in a usable Excel format (NOT PDF) of your network providers, by location, including TIN, Name, address and zip code, for your proposed network(s).
24. What standard reports are available? Are there additional costs associated with any of these reports? Yes No.
30. How frequently are these reports available? ___ daily, ___ weekly, ___ monthly, ___ semi-annually, ___ annually.
31. Describe, in detail, the claim processing and payment systems that your company will use for the vision plan.
32. What information is available to employees via a voice response unit? Website?
33. Are you willing to add providers specifically requested by the City? Yes___ No___.
34. What would you anticipate your role and the City’s role being in the implementation process?
35. What is your average wait time to speak with a live customer service representative?
2015 / 2016 / 2017(YTD)Average Time to Answer
Call Abandonment Rate
36. What are the hours of operation for your customer service lines?
38. Can you accept open enrollment and new hire data electronically through a third party?
If yes, explain.
39. Are ID cards issued for the Vision coverage? Yes No. If yes, are these issued annually or only once? Is there a charge for additional ID cards? Yes No. If yes, what is the charge?