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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

Learning Objectives:

Upon completion of this course, the participant should be able to:

  1. Define the opportunities to connect online for one-source business services.
  2. Understand the importance of online efficiency for ordering and claims submission.
  3. Learn the key tasks needed to develop a plan for full online implementation.

Faculty/Editorial Board:

Mark Mattison-ShupnickMark Mattison-Shupnick, ABOM is currently director of education for Jobson Medical Information LLC, 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.

Credit Statement:

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.

ONLINE MATH

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 optometric practices 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 ordering methods.

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).

CONVENIENCE

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

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.

PRIVACY

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.

NEXT STEPS

List all the tasks that should be part of the plan to increase convenience and efficiency. Once you've done that, identify the online servi\NYSSOExams\clearinghouse 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 steps needed.

CONCLUSION

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.


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