WellPoint to Allow ECPs to View Patient Medical History and to Include 1-800-CONTACTS as In-Network Provider


WellPoint's Richard Hom (l) and
Jeff Spahr.
INDIANAPOLIS— WellPoint, Inc. (NYSE: WLP) has introduced three new initiatives intended to enhance its vision care offerings by “improving the provider/patient relationship,” Jeff Spahr, president, vision services, told VMail in an exclusive interview today. The health benefits company will begin allowing in-network eyecare providers to view and print patient medical history, will include 1-800-CONTACTS as an in-network provider of contact lenses on its vision plans and will create a vision care advisory board.

To link medical and vision plans, WellPoint has added a unique “View Medical History” button to its online claims systems that will allow in-network eyecare providers to view and print relevant patient medical history via HIPAA-compliant data transmission. It will enable eyecare providers to view appropriate patient summaries, medical diagnoses, clinical laboratory studies and prescription history while leaving out sensitive information that should not be shared.

Richard C. Hom, OD, MPA, FAAO, WellPoint’s national optometric director, stressed that the information shared will be vetted information that falls within parameters specific to eye health and accessed from claims data. He told VMail that after surveying eyecare providers, more than 90 percent said they could provide better care if they had a patient’s medical history. In addition, it would “cut about 10 minutes off exam time,” he said. The “View Medical History” button went live yesterday.

WellPoint also announced that it will add 1-800-CONTACTS as an in-network option for vision care plan members beginning in the third or fourth quarter of 2013. Intended as a benefit for members, WellPoint also views the new option as a powerful referral mechanism for its in-network vision providers. “Our members have requested we add an option that would allow them to purchase contact lenses online,” said Jeff Spahr, WellPoint’s president of Vision Services. “By adding 1-800-CONTACTS as an option, WellPoint is meeting the needs of a fast growing segment of our member base.” 1-800-CONTACTS is the largest direct-to-consumer retailer of contact lenses in the U.S., delivering more than 200,000 contact lenses every day directly to customers. 1-800-CONTACTS was acquired by WellPoint last June, as reported by VMail June 4, 2012.

Spahr told VMail that many patients as well as providers are unaware that 1-800-CONTACTS employs 150 staff members focused on contact lens Rx verification and has to date canceled $500 million worth of orders due to prescriptions that could not be verified. Under the new initiative, when patients place orders with expired prescriptions, 1-800-CONTACTS will refer them back to their in-network provider by name. Patients who are not covered by a WellPoint plan can still order contact lenses from 1-800-CONTACTS as well.

WellPoint’s third initiative is the creation of an advisory board to assist in furthering its relationship with its network of eyecare providers. “This new board will be tasked with finding new ways to help address patients’ vision wellness needs, leverage WellPoint’s powerful referral mechanism and improve provider growth and profitability,” said Hom, chair of the new advisory board. “This includes an opportunity to evaluate models of medical eyecare delivery.” Still in the planning stages, the board is actively soliciting members now for a launch by the end of the third quarter of this year. It will be comprised of from five to seven members representing a cross section of providers in regards to age, practice setting, location, etc.

“The industry will change over the next 18 months and we intend to invest in these areas for the long term to be not only a player but a leader,” Spahr told VMail. WellPoint serves more than 36 million people in its affiliated health plans, nearly 67 million people through its subsidiaries and approximately 4.5 million members in its vision care plans.