Prepared calculations can increase efficiency
For most eye care practices, managed care patients make up 50% of the patients seen, according to The Vision Council. While there are some common vision plans that the optical staff has to become familiar with, there are often many options and various optical benefits within each.
Once the patient has selected a frame and lens, the optical staff has to calculate how much is covered and how much is the patient’s responsibility. It’s common practice to do so at the dispensing table, but there are problems that can arise when this happens:
- It can be disheartening to the patient to watch the cost go up, as different items are calculated. They can feel like they are being “nickel and dimed” to death, and this can result in lost sales.
- It is easy to miscalculate the amount that the patient owes with all the variables on lens materials, coatings and frame allowances. The last thing you want to do is have to call the patient back and tell them they owe more money than what was initially calculated.
- It ties up your optical staff for extended periods of time, and it makes the patient wait unnecessarily.
- Standardize your offerings: Our doctors make specific lens recommendations in the exam room, and most of them follow a similar trend. For progressive lenses, we prescribe the newest digital design that is polycarbonate, most of the time. We use non-glare coatings and materials that block blue-violet light in all the lenses we dispense. We have a similar recommendation for our single vision patient, with polycarbonate, non-glare coating, and blue-blocking technology.
- Pre-calculate the patient benefits: Because so many patients receive the same type of lens design and lens features, we started pre-calculating how much each patient’s plan would cover for our normally recommended lens the day before their exam. By doing it this way, we could then double-check our math before patient arrival to make sure we weren’t over or under-charging them.
- Record the results on the benefits sheet: Our calculations are written on the vision plan benefits sheet that is printed for each patient the day before their exam. Now, when the optical staff works with patients, they can tell them immediately what their plans will cover. There are some times when an adjustment must be made, such as if the patient needs high index, but those are quick and easily understood by the patients who need those changes. This process has resulted in faster and more accurate patient encounters, while continuing an excellent patient experience. Consider these small extra steps when preparing your patient charts for the next day. OM
BACK-OFFICE MATH BACKFIRES
We had attempted a solution in which we were doing the insurance calculations in the back office, having a second optical staff check the math, and then show the patient the result. While we eliminated the errors, it resulted in a poor patient experience, as they waited for us to complete the process.