Taking Too Long with Optical Orders and Fee Calculations
March 2, 2016
As we all move our office procedures to electronic records and online ordering, I refuse to let software programs ruin the patient experience and staff efficiency in my practice. As a follow-up to last week’s tip about staff being too busy to sell a second pair of glasses, I urge you to look at how long it takes staff to write up an eyeglass order and calculate the fees due from the patient when using a vision plan.
I recently consulted with a doctor and optical manager who felt their optical checkout process was inefficient. Patients had to wait too long, staff were stressed and the patient experience was poor. We implemented some changes in job duties which resulted in a dramatic decrease in time needed with the patient in optical.
There are several good ways to overcome a problem with slow checkout and not every practice has the same issues. Here are some ideas to consider as you customize the solution for your office.
Don’t wait for the handoff
This is really not part of the checkout process, but I see so many practices that make the patient wait at the start of frame selection that it is worth bringing it up. It is possible if we improve efficiency for opticians, they will be able to handle more patients and will be more available to accept a handoff and get started. If no one is often available when the doctor pages an optician or walks the patient into optical, you need to fix that. Having patients wait or begin to try on frames by themselves is inviting them to become impatient and think about taking their Rx elsewhere. Get them engaged in the selection process with an eye care professional right away.
Move the billing aspect to the front desk
Many offices now have the optician enter the charges for frames, lenses and lens options into the electronic health record (EHR) and practice management (PM) system. This task may also include charges for the exam and other services, possibly screening retinal photos, contact lens services and contact lens products.
It can work quite well to begin a patient’s fee slip in the exam room or optical dispensary and enter fees as services are provided or products are sold. But some PM systems are rather cumbersome when it comes to closing out the fee slip. There may be diagnosis codes to enter, insurance plans to transfer to, discounts to be applied, payments to be posted and that all could be on a line by line basis. Watch the time element of this and if it takes opticians a long time to complete, consider having some or all of the billing process handled by the front desk staff.
Of course, that creates more work for the front desk staff and it could be shifting the work from one place to another, but I’m very protective about the patient experience. In some cases, the data entry can be saved until a time after the patient leaves and the office is not so busy. There must be a good system for this, however, such as a walkout receipt for the patient and a method to be sure the charges are not overlooked.
You could design a specialized superbill for each vision plan you accept that has the names of optical products and places for other fees like exams, contact lenses, and retinal screenings. The optician can write the usual and customary fees in one column and what the patient owes for each item (if any) in a second column. The difference is simply billed to the vision plan. Your staff also needs the printed benefit authorization from the vision plan for complete pricing information. We use a different superbill for medical eye care which has CPT and ICD-10 codes preprinted.
Don’t place the optical order at point of sale
Some ODs have the opticians place the eyeglass order to the lab directly through the vision plan claims website while the patient waits. My staff is pretty fast at filing eyeglass orders electronically, but I would not want that happening in front of the patient. We have a specialized staff for our in-office optical lab and their job is to manage all aspects of the eyeglass orders, whether it goes through a vision plan or if we make the glasses in our lab. We have an administrative assistant in the lab who enters all online vision plan orders.
Our opticians quickly write up eyeglass orders on an order form that is prepopulated with the patients name and new Rx. The paper form is half-page size (5.5 by 8.5 inches), which fits into an optical job tray.
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
Dr. Gailmard's new book, Practice Management in Optometry: A Blueprint for Success Based on the Optometric Management Tip of the Week, is now available on Amazon.