The Managed Care Conundrum

This month’s article deals with specialty lenses—both contact lens and ophthalmic—and how they can help you increase revenue even within managed care structures.

» MESSAGING MATTERS. Most patients have the mindset that their insurance will pay for everything. My staff and I let them know the insurance is there to help with the charges, but not cover all of them.

A patient is willing to pay for something if they feel it is truly worth the money charged. Therefore, it is our job to explain why these lenses are worth the money charged.

Optical manufacturers have taught us ECPs well about the importance of using the highest quality and the latest designs in ophthalmic lenses, so I won’t spend time on that here. But we as ECPs do need to get better at sending that same message to our patients.

» DAILIES PROVIDE OPTIONS + REVENUE. Today’s contact lens technology is amazing. I feel we have an arsenal of solutions like we have never seen before; an arsenal that allows us to prescribe contact lens products to patients who in the past had to settle for inferior solutions.

Because of the growth of the daily disposables category, I now ask patients who have worn only glasses if they would like to wear contacts part time, maybe for going out or to the gym, or anytime they may want an alternative to glasses.

Showing patients the option of part-time contact lens wear has helped build my practice with extra income. With every “yes” answer, my office will get a contact lens exam charge and revenue from the boxes of contacts. This is above what the insurance pays because the patient is still getting their glasses and computer glasses from me as well.

» EXTRA-PAIR SALES. With the progression of technology (and popularity among patients) in multifocal contacts, I am prescribing more contacts than ever—in both the daily and monthly modalities. But this hasn’t taken away from eyewear revenue.

When I have a new contact lens patient come in, I know I will always make sure they have a back-up pair of glasses as well as plano sunglasses, thereby giving the practice extra income.

» SPECIALTY CONTACTS. The biggest area of specialty contacts growth is with hybrid and scleral lenses for irregular corneas from radial keratotomy, keratoconus, post-surgery wear, and others. They are so much easier to fit now, and patients love the comfort and vision they provide.

They are good revenue producers as well, because they are specialty lenses and you can charge more for them. And, more important, insurance companies pay it.

COMING UP: The next (and last) article in this series will deal with optimizing social media and your practice.

ERIC WHITE, O.D., is the owner of Complete Family Vision Care Optometry in San Diego, as well as a well-known speaker and educator, company advisory board member, and recurring award winner for best practices.