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Vision Service Plan (VSP) Audits/Hearings
Dr. Steinberg regularly represents optometrists and ophthalmologists being audited by third-party payers such as VSP, or, more commonly, appealing the results of targeted audits by VSP's Special Investigations Unit (SIU). VSP audits typically result in either disciplinary orders (e.g. probation or removal from the VSP panel) and/or restitution orders demanding the repayment of tens, and often hundreds of thousands of dollars, plus audit costs of more than $5,000. And, recently, EyeMed has increased it's doctor auditing activity.
A new law that tokk effect in 2019 changed the VSP audit and collections process, and another new law in 2025 dramatically changes the arbitration process in VSP disputes. It is essential, before you engage with VSP to dispute the results of an audit, that you consult with experience counsel. Anything you talk to VSP about will be used by VSP to prove their audit is correct and to try and collect from you. And make no mistake about it -- VSP wants to recover money from you, every dollar they can. VSP needs to know you have counsel that knows their tricks, and is not afraid to challenge them.
If you've been audited by VSP and received a Notice of Adverse Action, click here for information you will want to know.
VSP's "Fair Hearing Process"gives doctors a right to appeal these orders and have VSP's decision reconsidered by a panel of three VSP doctors, and to be represented by counsel during the appeals process and hearing. Dr. Steinberg handles all aspects of the appeals process and represents doctors at VSP's administrative hearings and during post-hearing legal proceedings challenging these VSP orders. As a VSP doctor himself, and having spent the past fifteen years representing colleagues from across the United States in VSP hearings, Dr. Steinberg is uniquely experienced and skilled at guiding you through this often confusing, and always intimidating process.
Please Click Here to read more about VSP Audits and the VSP Audit Process.