OD Boot Camp: 5 Steps to Expand Your Scope & Profit
Step 1: Embracing the Medical Model
With practices needing to expand profits outside of their optical dispensary, the comprehensive medical exam is becoming an attractive option. Also, the rising need for medical screenings can heighten the pressure to expand your practice scope. Organizations like Medical Optometry America move away from a refractive-based model and help ODs practice the full extent of their licensure to provide the important medical eyecare services patients need. From educating your patients on the benefits of a dilation to understanding the return on investment of medical exams, here's where to start:
Video: Gaining Confidence with the Medical Model
Dr. Dustin Krassin & Dr. Justine O'Dell
In this frank conversation, Dr. Krassin and Dr. O'Dell discuss how they implement the medical model, how to charge patients, and what documenting and exam tools make their lives easier.
- Why medical optometry is necessary today
- How to start providing medical exams
- The ROI of medical exams
- Necessary tools & software
Set Yourself Up For Success With Medical Exams & Billing
Uprise EHR & PM bundled with VisionWeb's billing team provides the full functionality discussed in the video above. Dr. Leslie O'Dell uses Uprise to support her influential medical-only practice. She says,"Uprise has been a critical piece of the puzzle for successfully starting this first practice cold. The customization and functionality have helped us scale our medical side as we build our patient base."
Read Dr. Leslie O'Dell's full story here.
Step 2: Expanding Care for Senior Patients
Especially due to the aging baby boomer generation, practices are prioritizing showing senior patients how to prevent or recognize signs of retinal detachment, glaucoma, macular degeneration, and cataracts. Stocking specific products, providing necessary disease screenings, tweaking your communication style, and making your office wheelchair-accessible are just the beginning. You can also use tools to improve your patient education, website accessibility, and create a senior-friendly experience from appointment request to checkout.
Start with your practice's website.
Your website is possibly the first part of your practice that many patients experience. We highly encourage that you remove any barriers to entry if you're looking to expand your patient base to the seniors of your community, and that begins with an accessible website that patients can use to schedule appointments.
The following video from EyeCarePro shows several steps you can take to make your website ADA compliant like adding image descriptions, alt text, high contrast imagery, and responsive modules. There are plenty of simple apps you can use to test color contrast for accessibility. The one mentioned in this video is Color Contrast Checker.
Incorporate seniors in your email campaigns.
According to a study a few years ago from the AARP and marketing researchers, Boomers, and certainly Gen-Xers are heavily into email. Make sure you’re putting out campaign messaging by email to this audience whether it’s a fabulous new frame line or messaging about advanced dry eye treatment.
Address your patient education.
A big portion of providing the best care for aging eyes is health literacy, ADA accessibility of your practice, and providing patients clear explanation of their options. Patient education materials assist you in expanding how your practice supports the older patient generation.
Creating your own videos on the various diseases and precautions associated with aging can be time consuming or out-of-budget. Uprise EHR & PM includes a library of patient education videos through Rendia. Rendia can introduce you to tools outside the limit of just videos and graphics. You can make sure patients have an understanding of what their visual outcomes could be after cataract surgery using Rendia's Outcome Simulator. While you're managing patient expectations, don't forget to account for shifting priorities with age. Guiding your senior patients starts with asking them questions specific to their needs. In this blog, Seniors and Shared Decision Making: Discussing Quality of Life, the team at Rendia unpacks why you should ask these 5 questions before recommending or beginning treatments:
- How does your health affect your day-to-day life?
- When you think about your health, what’s most important to you?
- What are you expecting to gain from this operation?
- What health conditions or treatments worry you most?
- What abilities are so critical to you that you can’t imagine living without them?
2 Ways To Improve Health Literacy
Health literacy impacts your patients’ outcomes and your bottom line. Addressing it can enhance your reputation and generate more referrals for your practice. Through narrated animations and the teach-back technique, you can ensure that your patients are understanding more complex diagnoses and treatment.
Rendia's health literacy whitepaper goes over the following:
- What health literacy is and why it matters
- How it affects your patients’ adherence to instructions
- Strategies to improve health literacy at your practice
- Teaching techniques to set your practice apart and increase referral rates
Show, Don't Tell.
As part of vision loss prevention, include explainer videos with your diagnoses about recognizing signs of vision deterioration. Although videos are useful for all patients, they can be extremely beneficial for patients who can spend limited time in your practice, those who have trouble with understanding lengthy pamphlets, and telehealth patients.
Start with uploading or linking to videos in your patient portal. You can also use educational videos as part of your email campaigns, blogs, and social media posts. For example, these videos on Macular Degeneration and Cataracts are just a snippet of content made specifically for your patients and available through Rendia's library.
Step 3 | Scaling Claim Reimbursements
Catering to your patient base, choosing the best medical devices, and delivering a great patient experience can only help build a successful practice if you're also filing insurance claims effectively. Especially with coding regulations and updates, managing your claim filing in-house can take up a large chunk of precious time. In our library of interviews and information on optometry billing, the most common mistakes and best practices become clear quite easily. We'll go over common areas for improvement, correct coding procedures, and a webinar on medical billing in this section.
Part 1: 4 Areas Where Practices Struggle
1. Not pulling benefits early
Unfortunately, one of the downsides of running a busy optometric practice is that the task of pulling patient benefits usually doesn’t happen until the patient is already in the practice for their appointment. Starting the process earlier and pulling patient benefits a few days before the appointment will give you enough time to contact the patient to confirm information and provide the OD with a full scope of coverage. Pulling patient benefits earlier can help you reduce rejections from inaccurate information, coverage termination, or the payer not supporting the frequency of service.
2. Understanding primary insurance with Medicare
For starters, it's not a cut and dry process to determine which insurance is primary, especially when Medicare is involved. Half the time patients don't recognize Medicare as insurance, or understand that it is applicable to their optometrist visits. There are four choices: Medicare, Replacement, Supplement, and Secondary. If a patient has a Non-Medicare insurance card but has "Medicare" printed on it, that card is likely going to be a replacement or supplemental policy. Supplements typically pay what Medicare approves but doesn't actually pay, such as deductibles and co-insurance. A tell-tale sign that it's a supplement is that the card will usually list a "plan" on the card, most common being Plan F. The plan is the supplement, which makes Medicare the primary.
Someone that presents you with a card that mentions names like Medicare Advantage, Secure Horizons, or Medicare Gold is providing you with a replacement. It's replacing Medicare and that makes it primary. Your tipoff that you're working with a replacement plan is the mention of co-pays or deductibles. Lastly, if the card looks like any other insurance cards, meaning there's no mention of Medicare anywhere on it and it doesn't have a cryptic name that insinuates the patient is older (like Secure Horizons), then it's probably secondary to Medicare. That means it has its own set of benefits that aren't developed in relation to Medicare. Often those cards don't pay for copay and co-insurance.
3. Letting claim denials get you down
Experiencing denied claims requires you to examine your claim performance through metrics and reports to see why you're being denied and how you can better optimize your management efforts. Especially if you are seeing the same mistake multiple times, it's good to figure out if it's an error with your claim submissions, the biller, or a case-by-case situation. The most common reasons that claims get denied are lack of insurance, late filing, duplication submissions, the payer doesn't cover the service, bundled payment, termination of coverage, or the payer doesn't support the frequency of service. If you're experiencing these reasons for denial, you can learn why, fix them, and your practice will become more resilient.
4. Utilizing Advance Beneficiary Notice of non-coverage
Practices should attempt to bill the patient three times before writing off a bill. Leaving an Advance Beneficiary Notice (ABN) of non-coverage as part of the front desk paperwork will ensure that patients know they are responsible for any remaining charges. You also want to collect full payment when the patients are still in your practice. Once they leave, your chances of collecting payment drastically decreases. But, if some patients do walk out of your office without making full payment, paying attention to your reporting can help you keep track of balances that are still outstanding. A few reports that are important for keeping track of outstanding claims are your accepted claims report, ERA report, aging report, and accounts receivable.
Part 2: Medical Billing 101 Video
Your practice will have an influx of medical claims to file. To help you maximize your medical reimbursements, VisionWeb's Revenue Cycle Management team are subject matter experts on filing clean medical claims to prevent denials. We've also honed our process for filing medically necessary contact lens claims, which is a frequently underutilized piece of vision billing.
Step 4 | Leveling Up Your Dispensary
With rising online retailers threatening both frames and contact lens sales, there's no time like the present to try something new and bold to manage the optical side of your business. For practices who rely on sales from their dispensary, we have a few solutions that can help you market your existing products, train your opticians, and elevate your bottom line. We've enlisted the advice of expert buying group, Healthy Eyes Advantage, and cutting-edge frame board management software company, GPN Technologies. See what they've learned from their decades adapting to the changing demands of the optical product industry.
Part 1: Develop an Optical Strategy
Justin Manning, OD, MPH, FAAO – Executive VP of Professional Strategies, Healthy Eyes Advantage
Robin Elliott – President of Consulting, Williams Group
When it comes to your dispensary, do you “know what you don’t know?” Are you an expert at both delivering the highest-level patient experience within the optical while seamlessly navigating the vast sea of sight, style, board space and Cost of Goods (COGs) management?
The reality is there are a number of critical things we don’t know about our businesses. While we can never know it all, it is important that we constantly strive to improve our knowledge and skills.
Let’s say you are the manager or optician, and your employer is looking to you to enhance optical performance for the practice. First, what does your day look like? Are you in the throes of the perpetual patient care/work balance tornado, trying to figure out how you are going to provide five-star patient care; stay on top of new staff training; manage your numerous optical vendors; and grow optical sales despite unexpected challenges, such as those presented by COVID-19? To top it all off, you are tasked with maintaining COGs at 24% or less! How do you manage it all?
The HEA PracticeAdvantage team, a partnership between Healthy Eyes Advantage and Williams Group, understands your challenges and appreciates your successes. Our personal experience and more than 30 years of working with independent eye care professionals can help you thrive.
Leveling up your optical is our passion because your success is our success. Our HEA PracticeAdvantage Program, with its live coaching, strategic planning, and online, on-demand training Optometric Success Center Learning, will help take not only your optical but also your entire team to the next level, and will give everyone in the practice the confidence necessary to succeed in creating an exceptional patient experience.
Have a solid inventory tracking system in place, with reporting that is accurate and modern. This helps guarantee your dispensary is not over- or under-stocked. We recommend inventory management software that utilizes Radio Frequency Identification (RFID) technology. Smart technology will streamline your production and empower you to have confidence in your COGs management.
Maintain monthly invoice and statement reconciliation. Thousands of dollars are lost annually simply by overlooking this important step. Set a monthly date and time to consistently reconcile your monthly vendor statements, credits and refunds. You might just be surprised. HEA’s consolidated billing makes this process simple.
There’s a great deal of information to keep track of in a successful optical. Leverage an analytics tool like HEA’s SmartData Solutions (SDS) dashboard to help you make critical decisions, saving time and money in the long-run. SDS pulls your optical sales information automatically from your PM system, helping you understand key information like capture rate, AR percentage, and your top selling frame lines.
Healthy Eyes Advantage is the next-generation marketplace for independent ECPs, delivering the most competitive vendor pricing and unique benefits to more than 10,000 independent eye care professionals nationwide. Williams Group Consulting is the eye care industry’s premier consulting firm, delivering innovative, relationship-based consulting, practice transition consulting, and accounting/payroll processing, to thousands of clients across the U.S. and Canada.
Part 2: Frame Board Profitability
A step-by-step guide to better frame board management
Selecting, pricing, and managing a successful optical frame inventory is one of the most important keys to dispensary success. Watch this 5-part series on frame board profitability and learn how to create success - and profit - in this critical area of your optical business. This series will help you manage your frame inventory in a way that is good for your patients, good for your practice and good for your bottom line. Learn to select the right frames, price them correctly, hit the “sweet spot” with managed care plans, and monitor your results.
Session 1: How to Maximize Your Frame Board Space
In this session, you will learn how to take the emotion out of buying. By purchasing based on the needs of our patients and our practice, we can eliminate waste and maybe even uncover some unexpected opportunities. Learn how to make wise frame selections.
Session 2: Selecting Frame Brands That Build Profit in Your Optical Dispensary
In this installment of our step-by-step guide to better frame board management, we will discuss the ins and outs of frame categories, pricing strategies and price points. We’ll discuss what ratio of each frame category is appropriate for your practice and cover a few options for determining price point percentages in your frame collection.
Session 3: Maximizing Your Frame Inventory For Managed Care Success
In this video we’re talking about managed care, and the critical role your frame strategy plays in making your plan participation profitable for your business. Learn to leverage the right frames at the right price point and the right cost point. We’ll also take a look at some important tools in EDGEPro for tracking and improving your frame sales.
Session 4: Tracking Your Frame Strategies for Long-Term Success
The one thing every single frame strategy needs is a way to track the results. Remember, we don’t “set it and forget it;” your frame board needs to be constantly evolving. You should be looking at the performance of your frames very regularly and making adjustments as you go. In this session, we’ll examine the routines you need to establish to keep your finger right on the pulse of your optical frame inventory.
Session 5: Best Practices for Setting Up Your Frames in Inventory
Join this eye-opening session on leveraging the tools in EDGEPro to create concise records and get the best results from your frame inventory. Learn easy tips to separate your sun and kids lines from your ophthalmic frames, and track these important sub-categories. We’ll also look at some easy fixes for common mistakes in data entry and help you fine-tune your frame setups.
In these videos, Yvonne uses EDGEPro analytics to track and analyze her frame performance. You can use EDGEPro free in your practice for 90 days as a part of this program, and try these proven techniques to improve your profitability. Additionally, EDGEPRO is included in your Uprise Pro EHR & PM package.
Step 5 | Future-Proofing Technology
Watch Dr. Razzano Take a Tour of Uprise
Software Built for ODs, by ODs
As we've mentioned throughout the boot camp, Uprise Pro includes Rendia's patient education tools, CodeSAFE's verification capabilities, integration with EyeCarePro's marketing services, and EDGEPro's reporting dashboards at no extra cost. Here's what else you'll get when you implement Uprise EHR & PM in your practice:
Treatment Code Mapping
Accelerate your charting in the SOAP method by only documenting your exam findings and allowing the fully customizable Treatment Code Mapping to populate ICD-10 codes and treatment plans based on each problem’s severity.
Robust Patient Portal
Provide a robust fully-customizable patient portal where it replaces all paper intake forms, includes patient lifestyle questions, and gives patients a HIPAA compliant method to communicate with your practice.
Save 10-15 minutes of med entry and automatically pull and print a list of your patient’s medications and view flags of dangerous drug interactions in real-time. Manage your patients' medications safely and more efficiently than with paper. Send error-free, electronic prescriptions to retail pharmacies through the Surescript network.
Bundle either version of Uprise with our Revenue Cycle Management Services and take a hands-free approach to your claim filing so you can spend more time with patients in your practice. You'll receive full reporting and only pay for claims that YOU get paid for. Learn more here.
Scheduler Patients Love
Access your EHR system from anywhere, anytime with a cloud-based system making a healthy work-life balance even more achievable all while decreasing the IT burden on your practice. Your patient data will be securely stored and encrypted in the HIPAA-compliant cloud, safe from malware attacks.