Article Date: 1/1/2010

Your Coffee Is $4, Including The Cup
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Your Coffee Is $4, Including The Cup

Here's how to determine exactly what to list on the patient's receipt.


If you were to give your patients a very detailed and itemized bill of all the services and costs associated with their newly dispensed eyeglasses, it could easily contain more than 1,000 items. For example, remember that night you went to the Pizza Hut “All you can eat” buffet during your sophomore year in undergraduate school and spent $11.48? The expense incurred by that meal has some bearing (admittedly miniscule and yes, I'm stretching to make a point) on your ability to deliver your patients' glasses.

Less of a stretch might be the electricity you consume to run the edger. How about the postage charged by the frame manufacturer, or the continuing education meeting your optician attended? Even less of a stretch would be the case that you dispense with the glasses or the adjustments you'll provide when you dispense them.

What is free?

The question arises then, when you finally do deliver the eyeglasses, what products and services should be listed on the patients receipt? A seemingly simple question like, “Is the case free?” will set off a maelstrom during a break at an O.D. meeting. Well, is it free?

Here's how we've counseled our clients to deal with this topic. Obviously, the more the patient receives for the price, the more value that is assigned to the purchase — within limits. So, if your receipt said something like, “Your fees for your frames, lenses with XYZ, unlimited adjustments during the life of your frame, no-charge prescription re-check within 30 days of you picking up your glasses is $Y,” you'd probably be on safe footing. Including the Pizza Hut buffet, however, would not be a good idea. But what about gray areas like “the case” issue and similar items?

Patient expectations

The challenge we face, like it or not, right or wrong, or any other clichés you'd like to throw out there, is that patients expect a case (among other things) for free. In fact, many expect the aforementioned “unlimited adjustments” for free. There becomes then a line, which if we cross over, we appear to be including things with no value since they were expected.

Consider the cashier at Starbucks saying, “Your grande skinny latte is $4, including your cup.” The cup is expected and your rightful reaction would be, “What? You're charging me for the cup?”

One easy way to assess what things are valued vs. expected is to ask patients. This can be done via survey. List the line items you include when you dispense glasses. Here you could include things (with any needed explanations like) case, prescription rechecks (and for how long), warranty and adjustments. Next to each item ask, “How much is this service worth?”

While you have the patients' attention, consider asking similar analogous questions about the contact lens side of your practice. Include a starter solution kit, how many trial lenses, number of follow-ups over how much time, etc.

Commitment to change

If you see distinct preferences and patterns that are very different than your current practices, make the changes — or else don't ask the questions in the first place.

So, if your current policy is to offer eyeglass remakes within 30 days of dispensing and a large majority patients indicate they think 90 days is fair, make the change.

Who knows — maybe patients will assign some value to your college pizza buffet. I doubt it, but at least you'll know for sure. OM


Optometric Management, Issue: January 2010