Day-to-DAy Operations

A snapshot of the daily tasks of operating an optometry practice

From fees to recordkeeping, the day-in, day-out responsibilities of running an optometric practice can be demanding, rewarding and possibly challenging without some assistance from the AOA and other resources.

Young doctors of optometry can benefit from a reference guide to the undertakings, possible issues and in some cases, some ideas for efficiently running an optometric practice. Below is a breakdown of these duties.

Your glossary to day-to-day optometry office operations

Professional fees—Deciding how much to charge for your professional services is a sensitive issue, and no one formula for determining professional fees suits every practice. Remember, too, that fees charged to patients covered by medical insurance must be the same as those charged to patients without insurance.

Figuring chair cost—Chair cost is solid, baseline information about the actual cost of running the business side of a practice and is essential to determining whether to sign up with a vision or managed care plan. Then determine whether the plan will result in additional income or loss per patient. Chair cost establishes how many patients you must see per hour in order for the plan to be profitable.

Methods of figuring chair cost—To do a rough approximation, total your annual costs and divide that figure by the number of complete vision analyses and consultations you expect to do each year. Calculate the total hours you expect to spend in your office annually, then determine the average cost per hour of running your office by dividing your total annual costs, including your salary, by the hours you work per year.

Presenting your fees to patients—Successful practitioners know that the secret to effective fee presentation is open communication. Health-care-management consultants recommend that you present your patient with an itemized superbill that lists each professional service rendered. You also should explain which of your fees are covered by medical insurance and which portion is the patient’s responsibility.

Raising your fees—Management consultants recommend that you review your costs and fees at least once a year to see if a fee increase or decrease is necessary—though you may realize some overhead expenses can be cut.

Professional courtesy—Draft your professional courtesy discount policies regarding your family, your employees, your employees’ families, other doctors and their families, clergy, health professionals and others.

Scheduling—Communicate your scheduling preferences to assistants for an efficient, well-managed appointment system. Approaches include the stream method (appointments are spaced equally throughout the day), the wave method (scheduling patients in groups to account for late arrival) and the modified wave method (identify the time necessary to perform different types of appointments, then assign each type of visit to a specific time of the day).

Taking charge of your appointment book—An essential tool to your practice’s operations, a well-managed appointment book can maximize efficiency and help you minimize disruptions.

No-shows—Arrange your schedule with this contingency in mind so you won’t waste valuable chair-time during no-show gaps.

Office hours—Doctors can increase patient volume by offering evening, early-morning and weekend office hours.

Billing—Good billing systems have clear communication of information. Every bill should include the patient’s balance prior to the current visit, a record of services currently provided to the patient, a record of the fees incurred for those services and date and time of the patient’s next visit.

Superbills—These are pre-printed forms you can use to itemize services provided during the patient’s visit.

Payment at time of visit—This policy eliminates the expense and inefficiencies associated with billing and rebilling patients by mail. And collecting in the office increases the chance of receiving prompt payment from high-risk patients

Accepting credit cards—A credit card arrangement will cost you a small fee, but that fee may be quickly offset by your savings on postage, stationery and hours spent by your staff on the mechanics of billing.

Preventing collection problems—Gathering the right information (who is responsible for payment, current home and work addresses) throughout the appointment process and office visit is an effective way to prevent collection problems.

Formulating a financial policy—Your written financial policy should include when payment is due, types of payment accepted, policy on accepting assignment of payment from insurance companies, credit policy, miscellaneous charges for checks returned for insufficient funds, completion of special forms and other paperwork and whom to contact with questions.

Recordkeeping—Records are the collective memory of your practice and help with any legal issues and third-party payors such as insurance companies.

Clinical records—Patient records include basic information: clinical data, your assistant’s findings, your recommendations, instructions and prescriptions and basic administrative information.

Analyzing the flow of records—Examine how records are created and how they move through your office. Consider which system you’ll use to file (alphabetic, numeric or computerized database), update, weed out for additional space and protect records, as well as how to control record storage.

Managing office supplies—Efficient inventory control can lower your costs of doing business and help you avoid raising your fees. Tips include buying in bulk, and delegating one person to select, purchase and stock office supplies.

Developing an office-procedures manual—This manual acts as a reference to handling routine matters, thus reducing errors and inconsistencies. An office manual also serves as an instructional device for new employees and provides a standard of comparison for new procedures.

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