Article Date: 11/1/2009

Developing a Medical Model

Developing a Medical Model

QUESTION: How does a new optometrist starting out in clinical practice establish an anterior segment disease specialty?

By Paul M. Karpecki, OD, FAAO, Cincinnati

Answer: Building an anterior segment disease specialty can be an enjoyable aspect of clinical practice. But learning how to effectively diagnose and treat anterior segment disease is only part of the equation. First, you'll need to increase your knowledge of this specialty. Here's how to begin:

■ Register for webinars and attend lectures on anterior segment disease at regional and national optometry meetings. Read up on the subject and take continuing education courses.

■ Contact optometrists and ophthalmologists in your area who specialize in anterior segment disease and ask to visit their practices. Look at the forms, questionnaires and handouts they use to educate patients, and incorporate similar materials into your practice.

■ Host weekly staff meetings to discuss the implementation of a medical model in your practice.

■ Inform patients about your new specialty. They need to know that a new service is available and you'll need to explain a little bit about it, too.

Billing and Reimbursement

Once you've become knowledgeable about anterior segment disease, it's important to learn how to bill accurately, so you'll be reimbursed in a timely manner. Rejected claims, mounds of paperwork and the expense of hiring an insurance claims manager often may discourage new ODs from specializing in anterior segment disease.

To ensure accurate and timely reimbursements, follow these guidelines:

Obtain vision and medical insurance information from every patient. If several of your patients are using a particular medical insurance, consider offering it and becoming a member of the panel.

Based on the patient's chief complaint, decide if you're going to perform a medical exam or a vision exam. In some cases, performing either one is acceptable. Be sure to perform both when necessary. For example, if a patient complains of blurred vision and says she needs new eyeglasses, but you determine she has dry eye, perform the medical exam, so you can treat the dry eye before prescribing the new eyeglasses. If the patient has never been treated, consider billing for the vision exam first and supplying her with artificial tears. Then, have her return for a medical eye exam to determine if she needs more comprehensive dry eye treatment.

■ Tap into valuable resources, such as Optometric Medical Solutions, LLC, a service that facilitates the implementation of the medical model, enhances clinical patient care and maximizes medical reimbursements.

Once you've taken these steps, you'll be well on your way to establishing a successful anterior segment disease specialty. You'll be able to focus on your ocular disease treatment skills, build your practice and deliver services to patients who have a variety of eye health needs. nOD

Dr. Karpecki works in cornea/external disease and advanced ocular surface disease research at Koffler Vision Group in Lexington, Ky. You can reach him at

Optometric Management, Issue: November 2009