The Burr Bill and Your Contact Lens Patients
Many existing and new contact lens regulations have tough standards, but abiding by them doesn't have to mean losing your patients.
BY RICHARD S. KATTOUF, O.D., D.O.S., Warren, Ohio
Optometry has to deal with the Health Insurance Portability and Accountability Act (HIPAA) of 1996; privacy regulation; The Ophthalmic Practice Rule (1978), which states that the optometrist or ophthalmologist must provide a patient with a copy of the patient's eyeglass prescription; Medicare and Medicaid regulations; and managed care regulations. The newest law to pan is the Burr Bill (named after Congressman Richard Burr, serving North Carolina's Fifth District).
It's important that all eyecare professionals be aware of the particulars of this bill. It's critical to stay within the law, but you must also change your professional behavior pattern to prevent patient erosion brought on by this law.
ILLUSTRATION BY SIMON SHAW
Know the rules
Here's an outline of H.R. 3140, otherwise known as the Fairness to Contact Lens Consumers Act (FCLCA):
► Eyecare practitioners (ECPs) must give their patients their contact lens prescriptions
► ECPs cannot require:
- Patients to purchase contact lenses from their ECPs
- Patients to sign waivers or releases to obtain their prescriptions
- Patients who want their prescriptions to pay up front for the eye exams if that requirement is not in place for all patients.
► Non-ECP contact lens sellers (such as Wal-Mart and 1-800-Contacts) must do the following to sell contact lenses:
- Obtain and/or verify prescriptions with ECPs (ECPs must respond to contact lens sellers requests for patients' prescriptions within one business day)
- When seeking verification, provide complete patient information to the ECPs
- Maintain records on all verification communication with ECPs
► ECPs can't alter a prescription, exchanging a private-label lens with an identical lens from the same manufacturer.
► Unless documented medical reasons exist, a contact lens prescription can't be valid for less than one year.
Stay ahead of them
You can do a number of things to prevent your patients from their filling contact lens prescriptions elsewhere. Below are some ideas.
Watch your fees. Your contact lens material fees should be no higher than those of the Internet companies. (Of course I realize that local huge discount outlets may be lower.)
Don't let them forget. You and your staff must educate the patient of the benefits they receive by purchasing from your office. To make sure you adhere to the law, make sure you educate before you complete the contact lens fitting.
Following are some of the benefits to offer your patients:
► Most contact companies offer patients monetary rebates when they purchase a one-year supply. This could save the patient up to $30.
► Offer supplies such as contact lens solutions in three-, six- nine- or 12-month packages. Keep the fees just above your cost. Demonstrate these savings on paper.
► Your office will replace any lens torn or damaged from the blister pack. (No Internet company offers such a promise -- benefits, benefits, benefits!)
► Your office will automatically mail the patient contact lenses and solutions as needed. Your fee to the patient for a ground (UPS, Fed-Ex, etc.) delivery could be as low as $3. Consumers pay Internet carriers two to three times this amount. List all of the savings. Contact lens companies can direct ship to the patient at a low cost. The patient can have his "credit card on file" for such transactions.
Many patients (consumers) love coming home and finding their lenses and supplies on their doorsteps. No thinking on their part and Americans love the instant gratification.
► Offer three-, six- or 12-month contact lens-related visits at no additional charge.
► GP contact lens polishing services at no charge, if included in the professional fees.
► Savings (professional courtesy) on plano sunwear and prescription eyewear.
Get paid. The decision of when to give the contact lens prescription to the patient is open to interpretation. Many doctors use have the patient wear diagnostic lenses for a few days and return for a finalized fitting. If you do this, I suggest collecting all contact lens professional fees on the day of the diagnostic evaluation. Educate your patients so that they understand that this is fee for service and includes no materials. The doctor must control the patient with staff support.
Using this type of example guarantees that the original doctor is paid for his time, skill, knowledge and risk. The completion of the fitting and obligation to give the prescription wouldn't be necessary until the finalization of the contact lens prescription. In essence, the doctor is assured of getting at least his contact lens professional fee.
Make your message heard
To find success, it's necessary to use your power (influence) in the examination room. Refer the patient to a trained technician to present your benefit package. Educate, motivate and make the patient enthusiastic about your program and his savings. Be specific about how much savings the patient receives annually. It is not about the box (of contact lenses). It is the benefit package that will keep the patient from eroding from your practice.
Dr. Kattouf is president and founder of two management and consulting companies. For information, call (800) 745-EYES or e-mail him at
Optometric Management, Issue: April 2005