CLINICAL
contact lenses
Fitting Fees Re-Examined
What is right for your practice and your patients?
JASON R. MILLER, O.D., M.B.A., F.A.A.O.
Contact lens fitting fees may be one of the most asked about fees by patients. Remember that contact lenses are a specialty, and the contact lens exam requires extra time and expertise to perform it well.
Sure, we could fit the same lens on every patient, but comfort and vision are difficult to predict. Giving this service away in hopes the patient purchases their lenses from you does not make good business sense in light of today’s online shoppers.
The goal of fitting fees is to be fairly compensated for our time and provide a good experience so that patients continue to seek our services every year. There are very few instances in which patients can go to any other doctor without an associated fee per visit. Why are contact lenses different?
In a previous column, I discussed how many O.D.s set their fees based on a contact lens evaluation for previous wearers vs. a contact lens fit/re-fit fee for those who require a new or fresh start. The fit fees can be adjusted based on the expected time and number of follow-up visits needed.
It may be time to consider a fee-per-visit structure. Here, I discuss the positive and negative aspects of having a fee per follow-up visit type of structure in place.
The positive
Contact lenses are a medical device and deserve appropriate attention. A fee per contact lens follow-up places the responsibility on the patient to return if he or she is experiencing any contact lens problems, such as discomfort or dryness. That means you are going to provide the patient exactly what you perceive to be the best lens for his or her vision in the hope that it will work. If all goes well on that first try, the patient orders contact lenses from you and will have saved a little on the fitting fees. This may be a positive experience in the patient’s eyes and a win for your practice, as it’s a “one and done” deal.
The negative
The challenge with this is that patients may not return even if they are having a problem simply because they don’t want to pay the fee. If the lenses you prescribed dry out or feel uncomfortable in their eyes, they may continue to wear them or decide to go somewhere else because of the bad experience. Paying more fees as a result of the perception that “my doctor could not fit contact lenses on me very well” is a tough situation to be in.
The answer
The answer is most likely somewhere in between. It may be re-examining the global fees for specific fits and how many follow-up appointments it includes. If a fit goes beyond that number, then it reverts to a fee-per-visit structure. The key, like all fees, is to discuss them up front so there are no surprises.
Change is never easy. The important thing is to be comfortable with your fee structures and be able to defend them if and when they are questioned. OM
DR. MILLER IS A PARTNER IN A PRIVATE PRACTICE IN POWELL, OHIO, AND IS AN ADJUNCT FACULTY MEMBER FOR THE OHIO STATE UNIVERSITY COLLEGE OF OPTOMETRY. SEND COMMENTS TO OPTOMETRICMANAGEMENT@GMAIL.COM.
