By Melissa Richard, OD, MS
July 1, 2020
With offices up and running again, it’s time to think about how to get financially back on track. Here are a few ideas for better serving patients and recouping lost revenues that my practice is implementing.
Assessing the Damage to Practice Finances
We were closed for exactly two months. I went to the office for a few hours a day to return phone calls, dispense glasses, contacts, and low vision equipment, catch up on medical billing and billing issues, and placed some contact lens orders (mostly for patients for whom we had to postpone annual exams). I have a small practice (focused heavily on medical eyecare) and do my own billing, so having this time to catch up was beneficial. It kept some money coming in and took a lot of stress away.
We reopened May 18 for urgent exams and medical visits, seeing patients four days a week from 9 a.m. to 4 p.m. (no extended hours). They were mostly spaced an hour apart to allow time for cleaning and optical selection. We are now back to our original schedule and normal hours.
I was expecting a loss in revenue of about $35,000 per month when this started. However, I was able to defer my practice finance loan and several other loans for two months. I had no payroll costs.
My lab bills were low since we had minimal orders. It also helped that I was able to get grant money from an Economic Injury Disaster Loan and Health and Human Services as part of the CARES Act. With all of that factored in, plus the fact that I was able to catch up on medical billing and nearly clear out my accounts receivable, I didn’t lose much at all.
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I thought we would be slow to start back up, because I limited my hours in the office seeing patients and spread out the appointment slots. However, even the first weeks after reopening were very successful, and my receipts per exam metric were–and still are–almost double what they used to be. This is mainly because most of my visits have been medically billed, and the few vision plan/routine exams I have seen have been “urgent” in that they needed to buy new glasses or order new contacts.
I took several free webinars on myopia control during the shut-down, and decided to add this to my practice. I had been wanting to do this since attending a CE dinner six months ago on it, but didn’t have time to re-learn about Ortho-K. During this downtime, I evaluated several Ortho-K systems, and got certified in fitting two of them.
The Ortho-K systems I chose to get certified in (Euclid and the new MoonLens) do not require the doctor to purchase a fitting set. The only cost to implement is the topographer. I needed a topographer anyway, and found one that could also do the dry-eye testing I wanted. I was able to get a fantastic deal with Marco because I am a Vision Source member.
I could make my payment on the topographer with less than one Ortho-K fitting a month. The dry-eye testing will also allow me to bring back more patients for medical dry eye follow-ups.
My head tech is great at helping me implement new technology and protocols. We are proud of all the technology we have in the office. I think it will be easier to implement new protocols (for dry-eye screening/follow-ups and for myopia control consults/Ortho-K fitting) at this time because we have spaced out the appointments and have more time for patient education or additional testing.
Expanded Dry-Eye Services
I have also been wanting to do more with the dry-eye section of my practice. I was interested in adding testing, including meibography, and had planned to explore my options at Vision Expo East before it was cancelled. I took this time to call/e-mail/meet virtually with several dry-eye vendor reps, and found a piece of equipment that does both topography for Ortho-K fitting and a meibography/dry eye report for objective dry-eye testing.
I have a contact lens specialist, who started with me a couple weeks before the shutdown. She is thrilled to have this new technology to enhance her evaluations, and will be able to bill more for her services.
Opportunity to Prescribe & Sell More Computer Glasses
We’ve had a lot of patients calling because they’re having trouble with their eyes from the extended amount of time they spent in front of a screen during the shutdown.
Many patients are working from home, kids are doing school work online, meetings and extracurricular activities are done online, and people are spending their spare time on social media or playing video games. I’m hearing a lot of complaints of eyestrain and headaches.
We offer neurolenses in our office, and I anticipate prescribing a lot more of these lenses, which ease convergence demand with contoured prism while blocking blue light. The prescribing process will be easier because I have more time with each patient to thoroughly educate them and answer their questions.
Marketing New Services to Patients
I think we need to take advantage of the extra time we now have with patients to discuss specialty services, like neurolenses and Ortho-K. If we do that, we’ll find ourselves building better relationships with patients and bringing in more revenue per exam at the same time. I will have to continue to schedule a higher ratio of medical or self-pay patients to vision plan patients as we get back to “normal.” The reimbursements from vision plans are not going to cover the extra time we need to take with each patient and the masks, cleaning supplies and other safety investments.
I became more active on my practice’s social media pages during the shutdown. I am doing announcements about our new services through social media. We already have a good referral network with local MD offices because of the specialties we currently offer: low vision, neuro-optometric rehab and specialty contact lenses, so it has been easy to let them know we now offer myopia control. Word-of-mouth from current patients will also be important in getting new dry eye and Ortho-K appointments.