Nicole Lovato (right), who is the practice manager in her office, with optician Taylor Lundegreen. Lovato says that a practice manager, who can guide the work of opticians, can go a long way toward enhancing the patient experience and increasing profitability.
By Nicole Lovato
Feb. 9, 2022
Practice investments can change how you care for patients, the experience you provide in your office and the level of profitability you are able to attain. Here are a few investments that had a significant benefit to both our patients and practice.
Use of Wet Amniotic Membranes for Treatment of Dry Eye & Ocular Emergencies
Our practice uses wet amniotic membranes, Prokera from Biotissue. Our doctors have been pleased with the resulting effectiveness in patient treatment. We did not see such success with the dry membranes. Dry membranes are less costly for a practice to invest in, but the results were not what our doctors felt was best for our patients.
We began using the membranes after several months of hesitation. Our ODs were initially concerned about the impact of the membranes on how they manage patients. They were particularly concerned about the use of membranes on patients with ocular ulcers, as the membrane covers the part of the eye where the ulcer is, which can make monitoring the patient’s progress difficult. It can be hard to monitor the eye through the resulting cloudiness.
After discussing this concern with our Biotissue rep, the rep offered to cover the use of another membrane to allow the doctor to remove it after 24 hours to see the effectiveness of the treatment without incurring the additional expense of placing another membrane if the affected area was not fully healed. This solution calmed our doctors’ concerns.
The cost to the practice is roughly $700 per membrane. We try to purchase several at one time to receive discounts. As our doctors have gotten more comfortable using membranes, and have seen the success it has brought to our patients and our practice, the investment has grown. We use about eight membranes per month, which costs about $5,600. We keep no more than several membranes on hand at any one time. The membranes need to be delivered on dry ice, so keeping many in stock isn’t necessary, as they will be delivered within 24 hours.
As long as you accurately code your exams, you should have little-to-no problem seeing reimbursement for use of membranes within six weeks of billing. We have found reimbursement for use of membranes to be around $1,300 per procedure. We use CPT code 65778 when coding placement of an ambiotic membrane.
I have run into the occasional road block with reimbursement, but these difficulties are few and far between. I have been able to get all of these procedures paid easily with the exception of one, for which Biotissue was generous enough to replace the membrane at no change after assisting me in appealing the insurance company’s decision with no success.
Results: Our practice was able to quickly profit from this investment. We saw the reimbursements coming in within six weeks, and the incredible positive impact on patient care has continued to increase with usage. This investment helped our practice to better serve and care for patients while increasing gross revenue by $110,000 in one year.
Hiring a Practice Manager
When I came to work for this practice, I was brought on as an optician under a different owner with a dedicated practice administrator who worked at another location and an in-office manager who had little experience managing, and whose only other experience was being an optician at another practice. The practice owner did not practice at our location and the owner and administrator seldom visited our office. Management was virtually non-existent, and what management did exist was given by an under-qualified individual whom the staff did not respect. This combination led to poor practice performance, poor customer service, poor patient care and the practice failing to meet its potential.
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Staff needs to be managed, procedures need to be managed, your schedule needs to be managed and the person doing so needs to be invested in the practice being successful. Doctors taking on the management role while also seeing patients can be highly challenging. You cannot watch from an exam room what is happening in the office, how employees communicate with patients and how they interact with one another.
If you elect to hire a manager, you need to provide them with expectations, so they can feel successful and accomplished when they have met or exceeded the expectations. Most people are not the take-it-and-run-with-it sort. So, follow-up care with a newly hired practice manager is as essential as it is with patients.
Select a manager who does not have a problem being assertive and bossing people around. Employees thrive with direction. Keeping employees busy and on-task is not something that comes easy for most people. If you have a manager who is failing to do this, your manager may have the wrong priorities. Management cannot be worried about upsetting staff or making friends. With the right manager, your staff can be the best of friends, love and respect their manager and do their jobs efficiently.
A good manager should be making double what your lowest paid employee makes. If they are not, then you either do not have a good manager, or you are not showing management their value. If management does not understand their value, then how can you expect them to value your practice?
If you cannot afford a good manager, then you likely have dead weight on your payroll. Let go of the staff who are under-performing. Delegate more tasks to the staff you have. Set higher expectations. Ask yourself, or your manager: Do you allow your staff to use their cell phones at work? Does your staff spend a large portion of their time talking to fellow employees instead of working? If you are answering yes, then there you go! Cut that out and your staff will be more productive resulting in more revenue and you can pay for a manager who is a great investment for the practice!
Results: Since our office changed management seven years ago, with myself assuming the role as practice manager, we grew by 55 percent in revenue in the first three years. When ownership changed, which led to more autonomy for management, as well as better communication between ODs and manager, revenue doubled.
Utilizing a GOOD Billing Company to Handle Your Claims
We had been billing all claims in-house for years, but after the employee who had been doing it decided to take another job, we decided it was best to outsource this aspect of our office due to the difficulty of training someone to replace her and the importance of accuracy in the position. We decided to outsource this part of our practice to VisionWeb.
We have a high volume of claims, so our practice pays approximately $3,000 a month for this service. We pay a percentage of what is paid by the insurance companies.
We budget the costs of this claims service into our staff expenses. The increase in paid claims and the efficiency we gain by using such a great outsource partner makes the additional expense pay for itself. And now we are not reliant on one individual to ensure our claims are paid. We have an entire team dedicated to working our claims and getting them paid.
Results: We began reaping the rewards of this decision within six weeks of signing on with VisionWeb. The transition was seamless, and we were able to immediately see claims being paid quicker and with little-to-no denials. This service was able to help clean up a lot of problems that we didn’t even realize existed.
Nicole Lovato is the practice manager of Azle Vision Source. During her 20 years in the optical industry, she has worked alongside several doctors and acquired a variety of tools and business skills. To contact her: Visionsource17@gmail.com
