Click Here For Four Weeks' Vacation*
*When online ordering and insurance filing...
By Mark Mattison-Shupnick B.S., ABOM
Release Date: May, 2012
Expiration Date: May 6, 2013
Upon completion of this course, the participant
should be able to:
- Define the opportunities to
connect online for one-source
- Understand the importance of
online efficiency for ordering and
- Learn the key tasks needed to
develop a plan for full online
Mark Mattison-Shupnick, ABOM is
of education for
has more than 40
years of experience
as an optician, was
senior staff mem ber of SOLA International and is a
frequent lecturer and trainer.
This course is supported by an educational grant from VisionWeb.
This course is approved for one (1) hour of CE credit by the American Board of Opticianry (ABO). Course STWJMI303-2
Are you tantalized by a four-week
vacation from work? Sounds too
good to be true, but it's real. In this
case, you can find four weeks just by sitting at
your computer, doing the things that need to
be done... faster. Think of what you can do
by saving four weeks this year.
Here's how: Shorten the time it takes to do
the usual things demanded in your office. If
you place, check or have to locate lab orders,
you can reduce time and errors. Get online
and use a service that allows this instantly
24/7, so it works when
you work. When choosing that online service
be sure it also allows checking a patient's
insurance eligibility, the submission of their
claims and verification of payment. Too many
dollars are lost when the trail of a claim can't
be verified and payment isn't confirmed.
So that's it. Find your one
go-to service online, put
your feet up and leave
the office when you're
supposed to. Spend
more time marketing
the practice, enjoy
more time with patients
or get that training needed
to deliver more digitally optimized lenses.
Get your office to $1 million in revenue. You
get the idea; now here are the details.
You'll agree that the Internet is gradually
transforming both consumer and business-to-business commerce by providing cost-effective and convenient methods to communicate, research and/or purchase products.
Consider the ease at which travel information, hotel room views, flight options, product/buyer opinions and
reservations can be seen
and made online. When
was the last time you
made a restaurant reservation directly from
your smart phone? It's
all done with ease and
convenience. The consumer today is unconstrained by traditional
brick and mortar business hours. This transformation is evident in
with virtually all offices using the Internet
to file insurance claims, many offices using
it to source products and an increasing
number using it to communicate with and
sell products to patients.
But did we mention patients are also seeing that same ease and convenience to
order eyewear and contact lenses online?
Competing with online has many facets;
one is using the same technology for every
practice advantage to improve efficiency,
which improves patient convenience.
Although it's clear that optical offices are
increasing their use of the Internet to communicate with patients and other businesses, and using older technologies less, it's
less clear what impact the shift is having on
practice operations and profitability. In August 2011, Jobson Optical Group's
Practice Advancement Associates conducted a research survey among independent
optometric practices to assess the administrative efficiency of ECP product ordering
and insurance claim filing. In this Vision-Web-supported research, a total of 478
offices replied to questions about current
usage of different product ordering methods as well as the process of medical insurance management.
Compiling the results of the 478 offices
and using an average number of annual
jobs ordered and claims filed suggests that
an office using online systems consistently
can save about one month of time. Figure 1 details the findings.
Over 60 percent of revenue in typical
optometric practices is derived from product sales. As a result, the many administrative steps to order, monitor, receive and dispense products consume a significant
amount of total staff hours. How efficiently
these tasks are executed has a major impact
on staff productivity. The survey revealed
that ECPs use many methods to order
products. But the telephone remains the
most widely used method of ordering spectacle lenses, frames and contact lenses, even
as online ordering has become prevalent as
well. Seventy-two percent of practices order
spectacle lenses on the telephone, 90 percent place frame orders on the phone and
73 percent order contact lenses that way. By
comparison, 75 to 90 percent of offices
never place orders online, depending on
product category. This suggests that many
practices continue to rely primarily on dated
In all cases, the survey found that being
online took less time. The time spent to place
orders and the time to check
or locate orders for spectacle
lenses saved 47 and 13 hours
annually, respectively. The
time spent to verify insurance
eligibility, check reimbursement status and file claims saves 65 hours and 15
hours, respectively. In
fact when added up over
an average number of
jobs per year, the time
saved was four weeks.
Think about what else
could be done in the
practice or in the less
frenetic and frustrating
operation of orders or
claims filing and tracking
(save up to 32 hours just
checking on claim reimbursement status).
Getting online is convenient and improves
efficiency. For example, convenience is the
driver of online sales. It is also a comparative that consumers and patients alike
make when they changed to online banking and downloaded music and books
instead of visiting the store. Buying shoes
on the Web? The thought that consumers
would not buy online because they could
not touch, feel and try the shoes before
buying has proven wrong. Zappos, a division of Amazon reported sales of $1.2 billion in 2009. Adding convenience in every
form is a requirement. Many offices have
added a contact lens replacement plug-in
to their website for patients' reordering
convenience. Remember, you're competing with convenience, price transparency,
brand visibility and the efficient delivery
of "personalized." In part, that's what
drives the estimated 150,000 pairs sold
each month of Internet-ordered eyewear.
This isn't to scare you—but it's important
to pay attention.
Use the convenience of going online to
make office tasks more efficient—it
speeds the process whether verifying
insurance options or placing the order
when the time clock is ticking and you're
under pressure. Exceed the patient's
expectations and your value increases—
don't let online retailers or other offices
take your business.
After all, the median time to source
eyewear from your lab is six days
(according to the MBA Prescription
Eyewear Survey, March 2012), every
minute lost increases turnaround time.
Reducing the time to deliver that eye-wear ordered increases patient confidence.
Turn that time found (about four weeks,
if not more) to further increase patient
confidence. Turn it into more time with
patients. Understand their wants and
needs better by increasing communication
time and the time to get to more premium
and beneficial products.
ONLINE AS PART
OF THE PROCESS
Online is a path to patient convenience
and office efficiency. It starts at the
appointment and the confirmation of
insurance. This way the office understands
the options and opportunities to go over
with the patient when the patient arrives.
After all, patients with insurance benefits
often think their Rx co-pay will be all they
have to pay. At reception, when the patient
checks in, you'll have already confirmed
their eligibility and can begin the process
to eye health and quality eyewear. Define
their insurance benefits and the goals for
indoor and outdoor eyewear for this visit.
See "Maximizing Managed Vision Care with
Lifestyle Dispensing" at 2020mag.com/CE
for other ideas to maximize benefits.
Efficiency can be measured by speed; it is
also a measure of accuracy. How can we
measure efficiency? Let's count the ways. First, reduce errors. When asked, more
than half of survey respondents agreed that
online ordering reduced redos and errors
are more likely with phone orders. Next,
efficiency is the ability to do as many of the
daily office tasks within the same software
or processing system. Having a software
system online in the background, on
demand for required daily activities allows
instant access and completion of work in
real time. Respondents strongly agreed that
getting online for spectacle lenses and contact lens sourcing had significant advantages. As many as eight of 10 reported the
following advantages when lens sourcing:
24/7 availability, online order status, no
waiting time to reach a representative by
phone, fewer errors and faster order input.
From the patient's view, online ordering and
job tracking facilitate patient communication
and speed up the frame ordered to the correct laboratory to reduce fabrication time.
For the business, claim filing from one
source simplifies the process. It ensures
submissions on time and tracking of the
dollars due to the practice. Also, being able
to identify rejections up front before time
is spent, only to learn that fixes are needed
all aids cash flow through speed of process
and a dismissal of fees. Be sure that the system will de-code codes, i.e., assist in the
coding of services so that all payments
deserved are paid.
Analyze the variety of online services
available from the online companies,
and then choose the one clearinghouse
that provides the most services. One
clearinghouse online can virtually eliminate the need to administer practice
paper and go paperless where all data is
accessible online. In addition, the process is enhanced when an office's practice management system is directly
linked to the online ordering system,
eliminating duplication of input.
Going to multiple sites means learning
multiple systems and keeping up with
the complexities of each. Clearinghouses
give you one place to manage almost everything, and it's pretty easy. Accessing all of
the payer sites you may file to means creating accounts on each one, for each employee in your practice using it. Your staff will
also need to remember how to use each
site's varying functionality, and know how
to train others to use them.
A good clearinghouse is affordable and
offers a great deal of value. They aren't
free, but are worth the money because of
all they have to offer. A clearinghouse provides thousands of payers in one location,
patient eligibility verification, claim submission and tracking, secondary claim processing, detailed reporting and analytics,
claim uploading from practice management systems, electronic remittance advice
(ERA) and ERA Auto-Posting in compatible practice management systems. In addition, a seven-year history of ERAs required
by providers is available from some systems. Be sure to confirm this.
Lastly, to increase access, add high-speed
connectivity from an Internet provider in
your area. The best connectivity ensures
that all in the office can be online simultaneously.
ANOTHER KIND OF INSURANCE
What would happen to your practice if you
lost your biller and couldn't fill the position for a month or two? That may sound
dramatic and unlikely, but could the practice sustain operating costs without claim
reimbursements coming in? Plus, if the
practice gets audited, guess who's under
the microscope? Not the biller. It's the provider who has to answer the tough questions. Could you answer them?
Claim filing is a crucial part of a practice's
success, so providers have an insurance
policy of sort, with an online clearinghouse
processing system. This ensures the biller's
needs are understood and the staff has the
tools they need to get the job done. Pushing online to the max allows increased concentration on patients.
Clearinghouses have the same compliance
responsibilities as the payers. The information that is entered and processed is secure.
Customize account settings within a clearinghouse so your staff only has access to
the information they need. The same goes
for the Internet access in your practice. Set
your browsers so that only certain sites are
accessible. Take advantage of the benefits
of electronic claim filing but at the same
time control Internet use in your practice.
THE MILLION DOLLAR PRACTICE
Convenience, efficiency and immediate
access to information lead to the ability
to concentrate on products and services
that build the practice. Metrics in a practice provides focus: "If you don't measure it, you can't fix it." For managing
insurance billing, knowledge is money.
Higher revenue practices are typically on
top of their claims, and follow their
progress every step of the way. If claim
filing is consolidated in one location with
built-in reporting, the process is efficient. Clearinghouses like VisionWeb
offer a solution equipped with extremely
detailed reporting and analytics features
that allow the following of claims
through every step of the process. By
logging in, the claims paid, rejected and
delayed are visible. From the reporting
screens, a list can be assembled that
allows focus for staff and doctor alike.
Claims managers in the practice can have
visibility to compare actual payment and its
timing with submissions. Payers won't
guarantee either. Reports can be generated
that show turnaround times and payment
amounts. Know if it took three rejections
to get a claim accepted and paid. If the
payment had been adjusted to a lower
amount incorrectly, be able to respond
quickly. Then someone in the office can
follow up to get the remaining amounts
due. Reports provide claim clarity. In addition, a claim not paid may be indicative of
other claims not paid, especially where a
coding error has occurred. Reports that are
regularly run immediately allow the identification of those claims with errors.
POSITIVES AND NEGATIVES
So are you online? There are opportunities
for office convenience and efficiency, faster
turnaround time on orders and if claim filing, shorter reimbursement cycles. The
next step is to look for those companies
that have the most in one place. Look for
the largest network of connected suppliers
and connected payers. The results will be
easy to use.
Are there negatives? Sure, it will take a
small amount of time to create and implement a process, as any change does. There
will be some staff or doctors averse to
change and even those who will say, "This
probably won't work anyhow." However,
those words have been heard before, and
they've come along for the new, though
some kicking and screaming. Many will
have built a loyalty to a variety of individual sites but the goal here is to get to the suggested four-week advantage.
List all the tasks that should be part of the
plan to increase convenience and efficiency. Once you've done that, identify the
online serviclearinghouse that meets all
demands. To do that, review your own
practice management software and other
PM software, and each of the clearinghouses available. Put a plan in place to: 1.
Discuss your needs with a representative
from that clearinghouse/online order service. 2. Confirm your first choice. 3. Connect with them (do all the necessary steps
to open an account, get online), and 4.
Develop an implementation plan that considers office capabilities and discuss it with
the service's implementation team. They
will work with you to create a plan that
adds services in a logical order to meet
your needs, help with a monthly check-off
list, then together clearly define any next
If you were enticed by the thought of saving as much as four weeks of time and
effort, getting online will save you time and
effort while helping the practice. Online
has become the norm. Patients are also
online so make the opportunities that connecting a practice add to the convenience
and efficiency demanded today by the consumer. Your ability to improve order and
claims traffic while having more time to
work for the patient helps improve everything else in the office.