Management Tip of the Week

Optometric Management Tip # 254 - Wednesday, November 29, 2006
Fee Information at Your Fingertips

This is a practical little tip. Just a simple idea that someone in my office thought of years ago, but it occurred to me last week how handy it is, so I thought I’d share it. All of our technicians and opticians carry a laminated, miniature printed fee list in their uniform pocket. The fee list has spectacle lens prices on one side and the other side has our exam fees, special testing fees and contact lens material prices. It is surprising how many times per day an assistant whips out her little fee schedule and quotes a fee.

A lot of data

I’ll admit it took some space planning on the word processor to get the fee schedules on a 5 X 7 inch piece of paper. We typed up the price lists and printed them on standard paper and then reduced them repeatedly on the photocopier. The two sheets of paper are cut with scissors and placed back to back and then placed in our office laminating machine. The print is small, but quite readable. We make enough copies so every employee has one. When fees are changed we simply make new sheets and discard the old ones. The system is low-tech, but it works anywhere, anytime.

Why the need for fee information?

I think it’s important to proactively tell patients about fees. As I discuss recommendations for treatment, the issue of cost often comes up. It’s only natural. And even if the patient doesn’t raise the question of cost, I like my technicians and assistants to discuss fees at appropriate intervals as we progress through the office visit. I think patients generally want to know and have a right to know, plus doing so prevents misunderstandings that are harder to deal with later. After all, services and products are not expected to be free and I’m not defensive about the fees. They are what they are. In some cases the fees are billable to insurance, but even in those cases there may be deductibles, co-payments and other factors of interest to the patient.

Here are some examples of how and when we present fees:

After examining a presbyope wearing monovision contact lenses with visual complaints, I recommend that we try bifocal contact lenses and I explain the benefits of binocularity. As my technician inserts trial contact lenses, she consults her fee card and informs the patient of the fitting fee and the price per box of lenses.
I see a patient with a large cup-disc ratio and borderline IOP. I want to reappoint for nerve fiber analysis and visual fields. Our office does not accept this patient’s medical insurance. My technician informs the patient about the fees for the tests and that they will be due at the time of the visit, and that we will assist the patient with filing a claim for reimbursement.
I recommend to a patient in my exam chair that we order progressive lenses instead of the FT-28 bifocals she has worn for years. After explaining all the advantages, I mention that the progressives are more expensive, but they are the best lenses available. The patient accepts the idea, but wonders how much more the cost will be. I have an assistant scribing for me and I ask her to quote the prices for both lens types.

I find the more open and direct I am about fees, the more readily they are accepted. My staff is quite comfortable talking about fees because they quote them so often and our fee system is simple.

Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management