Article Date: 11/1/2009

Learning the Ins and Outs of Vision Discount Plans
If I Had to Do It Over

Learning the Ins and Outs of Vision Discount Plans

Placing a high value on your services will improve patient care and help your business thrive.

By Jennifer E. Davis, OD, Waynesboro, Va.

I WISH I'D LEARNED more about vision discount plans before I began my optometric career in 2001. In optometry school, I spent countless hours learning about eye disease and pathology but considerably less time learning about practice management. As a new OD, it's imperative to learn how to manage the business side of your practice while offering patients the best eye care. One way to do this is to carefully scrutinize vision discount plans before accepting them.

In this article, I'll discuss how to choose the best vision discount plans for a more profitable practice. I'll also outline the steps you can take to increase your knowledge about this important aspect of owning a practice.

Calculating Cost

When you begin practicing, you may be inclined to accept all of the vision discount plans available, but that's not necessarily a good idea. Before signing up, evaluate each plan based on the type of practice you want to create (one that provides mostly wellness vision exams, one that offers a medical model or a combination of both). You need to calculate chair cost (the amount it costs you to conduct an eye exam) to help you determine how much revenue you must generate to stay in business.

Some vision discount plans require you to disclose your fees for each service. Be sure to reevaluate these fees every year to ensure they're at least equal to or above the allowable amount Medicare establishes for your region.

Read the Fine Print

Once you've decided on the type of practice you want, carefully read and understand the rules of each plan. Knowing your chair cost will help you assess reimbursement schedules to determine which plans will provide a sufficient reimbursement. Remember to evaluate reimbursements for optical materials as well as for eye exams. Other important steps:

Learn the plan's billing codes. If you use the wrong code, your claim will be rejected, and you'll have to resubmit your bill, which will delay payment.

Become familiar with the quality of lab services. Most plans require you to use a particular optical lab, so make sure the lab is easy to work with and delivers quality products in a timely manner.

Know how often patient services are covered. For example, some plans will reimburse for patient visits once a calendar year, others once a year from the previous date of service and some once every 2 years. Because each plan is different, select a staff member to keep abreast of the various rules and regulations. Be aware that some vision plans contain a clause that allows them to automatically reduce reimbursements if the insurance company is losing money.

Weigh Your Options

If you decide to accept vision discount plans, don't rely too heavily on one plan for your income. Like everything else, moderation is key. The upside to vision plans is that they can attract new patients and encourage existing patients to return regularly. The downside is that some plans pay poorly and the rules and regulations can be restrictive.

The beauty of being a new OD and opening a practice cold is that you're the one who decides what patient base you want to attract and the type of services and care you want to provide. If you decide to take vision discount plans, just remember to choose your plans wisely. nOD

Dr. Davis is a graduate of the University of Houston's College of Optometry. She's in private practice at Vision Tech Optometry Center, Inc., in Waynesboro, Va. You can reach her at jedavisod@hotmail.com.


Optometric Management, Issue: November 2009