Out-of-Pocket Patient Procedures: How to Make It a Bigger Part of Your Practice

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By Margery Weinstein
Editor-in-Chief
Review of Optometric Business

Dec. 9, 2020

Patient self-pay procedures, such as myopia management and some advanced dry eye treatments, can build practice revenues. With managed care vision insurance limiting reimbursement, giving patients a way to access services with out-of-pocket payments is a key to enhancing both patient care and practice profitability. Patient financing via a CareCredit credit card is one way to provide a bridge for patients to access these vital services.

Life-Changing Services
At Lancaster Optometry in Lancaster, Calif., CareCredit makes it possible for patients to receive the specialty contact lens fittings and purchases that change their lives. Patients with conditions like keratoconus often have searched for solutions to their visual challenges at multiple providers before arriving at his practice, says Office Manager Arty Aleksanyan. Having the ability to pay for the fittings and lenses over time, rather than all at once, makes receiving this much-needed care doable. That care means the patient can more fully live their life. “With those conditions, there is no alternative, like buying glasses. Being able to get the specialty contacts, helps them live their lives and do their jobs better,” says Aleksanyan.

Helping patients access specialty contact lens services also creates a stronger revenue stream for the practice. Aleksanyan estimates that around 10 percent of keratoconus patients use CareCredit for their fittings and contact lens purchases.

Myopia management is yet another area of Lancaster Optometry’s contact lens services for which the ability to pay over time makes a huge difference. Myopia management is not covered by insurance. Yet with myopia linked to increased risk of conditions like glaucoma and retina detachments, among others, having access to these services is potentially sight-saving.¹ Myopia management also helps young patients in the short-term in essential ways. “It helps with the child’s early development process,” says Aleksanyan. “If a child can’t see well at school or when doing homework, their primary learning is impacted.”

Aleksanyan estimates that 10 percent of myopia management services are paid for with use of a CareCredit credit card.

Vision therapy is yet another life-changing service for children that patient financing can put within reach for families. Lancaster Optometry just launched these services in 2020, with 10 of the practice’s first 14 vision therapy patients using CareCredit to pay for the therapy sessions.

All told, as much as 30 percent of practice revenues are generated from payments made through a CareCredit card card, says Aleksanyan. The optical team, and other support staff members, are the ones who walk patients through the CareCredit application and payment process, but the doctor in the exam room lets patients know when prescribing an out-of-pocket treatment that there is help: “If for some reason you need financial help, there is financing available through CareCredit.”

Making the Full Treatment Plan Possible
Sometimes the doctor’s full treatment plan requires more than what a patient’s insurance will cover. Such is the case when it comes to dry eye treatments like punctal plugs, says Jessica Betancourt, owner Bronx Optical Center in New York City. In addition to providing much-needed relief to patients, punctal plug procedures generate around $10,000 annually in revenues for the practice. Without a patient financing option, much of that revenue might not be possible. “It’s an elective procedure that would often have to be skipped without patient financing,” says Betancourt.

Medical eyecare emergencies are another area of patient care where a financing option can make a tremendous difference. Betancourt says a patient who comes in with a piece of metal in their eye, requiring foreign body removal, can find themselves with a bill as high as $400 with additional charges for follow-up care. Patient financing through a CareCredit credit card frequently makes it possible for the patient to visit the office for as many follow-up exams as the doctor deems necessary.

With a practice located in the Bronx neighborhood of New York City, Betancourt says that a significant number of patients are senior citizens, at greater risk of conditions like glaucoma. “We have patients over sixty years old without insurance who have need for out-of-pocket testing. They have medical issues that will progress without additional care. We always offer the patient financing option because it is appreciated.”

Betancourt estimates that while 90 percent of patients have insurance, about 20 percent have co-pays for the full treatment plans the doctor has prescribed. “Not everything is covered, so they might not be able to afford the doctor’s total treatment without a financing option,” she says.

References
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6688422/

Margery Weinstein is editor-in-chief of Review of Optometric Business. To contact her: mweinstein@jobson.com