Finances

Four Ways to Add Direct-Pay Products & Services

By Lisa Shin, OD

Concierge medicine was featured in Time Magazine as an intriguing experiment. It’s a simple model: pay primary care doctors, not insurance, a fixed monthly fee. The cash-only model isn’t right yet (or ever) for most optometric practices, but in the meantime, there are other ways that we can get more direct-pay cash into our practices.

Publicize use of health savings accounts. Make sure all patients are aware that optometric care qualifies toward health savings accounts (HSAs). In the waiting room, we have HSA information alongside our office policies. An HSA is a tax-advantaged savings account used toward deductibles, co-insurance, prescriptions, vision and dental care. Combined with a high deductible, low premium health insurance, it is a win-win for patients and doctors, and meets ACA requirements.

Make some specialty services cash-pay only. I learned that a colleague is offering orthokeratology as a cash pay, specialty service. He likes that he doesn’t have to worry about billing and coding rules in order to get paid. Another long-time friend offers vision therapy and dry eye exams as cash services. I recently visited a colleague who tells patients: “VSP covers fundus photos with a $39 copay.” Without additional medical billing headaches, her staff instead focuses on patient service. Further, there is no need to “justify” the procedures to insurers with fear of an audit if the record falls short of documentation and reporting mandates.

Prioritize sales of safety and computer glasses. Many employers provide safety glasses for employees, in compliance with the Occupational Safety and Health Administration (OSHA). This is an excellent opportunity to emphasize your important role in eye safety for the community. Often, this is a fixed, cash allowance and additional options are an out-of-pocket cost to the employee. We also provide computer glasses for a large employer based near our office. In addition to standard, single-vision computer glasses, sales of computer progressives have also been a great practice builder.

Upgrade to advanced lens technology & second-pair sales. Benefits that are not covered by insurance can greatly improve visual function and quality of life. My staff is well trained to discuss free-form progressive technology, aspherics, high-index lenses, polarization, anti-reflective lens treatments and trivex materials. I have also taught my employees to promote second-pair sales. We offer higher discounts than is required by the insurance. Once, we had a patient come in with a “birthday discount coupon” from another office. We let him know that we could do better and captured the sale. Our lab gives us competitive pricing, as well as a second-pair discount, which allows good profit margins on these sales.

It’s important that we educate our patients on the importance and value of optometric care, goods and services. We need to send a message that the extra cost is well worth the improved vision and quality of life. We shouldn’t be restricted in the prescriptions we write by what insurance covers.

Stop going along with the nonsense that insurers dictate what patients can and can’t have! Insurance payments will always come with strings attached. Cash is king; let’s get more of it into our practices!

Are you adding direct-pay products and services to your practice? Why or why not? What direct-pay additions to your practice have offered the greatest ROI?

Lisa Shin, OD, is the owner of Los Alamos Family Eyecare, P.C. in Los Alamos, N.M. To contact: lshin87@gmail.com

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