Optometric Management

FEB 2017

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F E B R U A R Y 2 0 1 7 • O P T O M E T R I C M A N A G E M E N T . C O M 53 BUSINESS CORPORATE O.D. A S IS the case with the managed care plans that private practice optometrists accept, corporate O.D.s must also honor dis- counts that can affect their bottom lines. To offset these discounts and provide a higher level of care, I advocate embracing the medical model. e first step in doing so is the appropriate classification of patients prior to the exam. (is may require some staff training, see below.) Diligence in monitor- ing the patient's chief complaint and medical history will not only provide the highest standard of care for the patient, but also se- cure accurate reimbursements. Here are some action points to start with the medical model. 1 TRAIN STAFF Staff members should be able to identify the patients' reason for visit, prior to the exam. One way to achieve this is by providing them with a list of questions. Once the reason for the visit is identified, the staff member can inform the patient whether his or her medical plan or managed vision care plan will be applied to the visit, setting clear expectations for services ren- dered and payment. 2 INVEST IN DIAGNOSTIC EQUIPMENT When embracing the medical model, diagnostic equipment, such as an OCT, can elevate your standard of care and provide a return on investment. For exam- ple, a medically necessary retinal photo for a diabetic or glaucoma patient, code 92250, can reim- burse as much as $80. 3 REVIEW PRE-TEST PROTOCOLS Embracing the medical model does not increase chair time. Review protocols so staff takes retinal photos and visual fields, leaving the O.D. to evaluate the results and provide treatment. 4 SCHEDULE FOLLOW-UP VISITS Medical model patients typi- cally need to be seen more oen than annually. ese appoint- ments can be short visits; create time in your schedule for them. Typically, schedule these as first patients in the morning or during the week during non-peak hours. 5 MONITOR FEES Medical service fees should be adjusted according to the stan- dard. Check your explanation of benefits (EOBs) to determine the standard for these procedures. 6 PERFORM A CHART AUDIT Review charts to see what was wrongly billed as vision care plan vs. medical, and discuss these with your staff to ensure better manage- ment in the future. OPEN ARMS Embracing the medical model in a corporate setting differenti- ates your practice and keeps pa- tients coming back to your office for all their eye care needs! OM GO MEDICAL PROVIDE ELEVATED CARE, WHILE MAKING UP FOR MANAGED CARE PLAN DISCOUNTS Average Transaction Per Patient O.D.s should be aware of their average transaction per patient. To calculate this: Average transaction = Total visit fees collected / number of patients You may also separate this calcu- lation into medical and non-medical visits. The average transaction for a routine eye exam can range from $55 to $75. The average transaction for a medical exam can range from $100 to $200. If you are not falling into this range in either category, the seriously evaluate your exam, insur- ances taken and billing. MARIA SAMPALIS, O.D, DR. SAMPALIS is the owner of Sampalis Eyecare in Warwick, R.I., and affiliated with Sears Optical. Dr. Sampalis is a practice management consultant, the founder of Corporate Optometry on Facebook and founder of corporateoptometry careers.com and corporateoptometry. com. She can be reached at msam palis@hotmail.com. To comment, visit tinyurl.com/OMComment.

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