...for medical problem oriented visits...How do you handle patient requests for a spectacle Rx when it is specifically excluded by insurance? Do you charge a refraction fee or do you just take it on the chin?
...for medical problem oriented visits...How do you handle patient requests for a spectacle Rx when it is specifically excluded by insurance? Do you charge a refraction fee or do you just take it on the chin?
Absolutely! Just like medicare. Refraction is NEVER covered by medicare, so the patient ALWAYS has to pay for it when insurance excludes it.Originally Posted by fjpod
Agree.
Ditto and make sure you charge enough for your effort.
:cheers: Life is too short to drink cheap beer.
You definitely need to charge for refraction caused u know damn well that they will not reimburse for that.
Thanks for all the responses. I feel the same way. We should charge...but I'm wondering why I hear complaints from so many of my patients when I try to charge for the refraction. They say things like, "my last doctor never charged me" So, I have to believe that most Drs. are NOT charging for refraction even though all of you responded that you did.
Heck, I even get patient complaints about having to pay extra for contact lens evaluation or fitting. Just had a 21 year old female, whose dad called me on her $400 cell phone, 5 minutes after her exam, demanding to speak to me about why I wouldn't accept his medical plan to examine his daughter and write her an Rx for CLs. It didn't matter that we told her that when she checked in, or that we handled the billing for her CL visit the same way for the past two years. The dad told me his family was never coming back. Go figure.
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Last edited by Refractingoptician.com; 02-28-2007 at 05:49 PM.
It's very common for some docs not to charge for refraction or for CL eval, mostly out of ignorance and maybe inertia. I have learned that the best way to handle this is to tell them in advance, esp. when I think they might expect a freebie. So if a patient asks about contacts during a regular eye exam, I gently ask them if they also want a contact lens evaluation today. That usually gets their attention, and sets the stage for an explanation that the regular eye exam fee covers no contact lens services.
Similarly, when a Medicare patient says she wants to get new glasses, I say, right then, that refraction will be needed for that, and refraction is not a medicare benefit. No problema. If they balk at that point, fine, I don't do the refraction (and the medicare patient gets no spectacle Rx) or I don't do the CL eval (and the CL patient certainly gets no CL Rx).
I also gently remind them that times have changed since we "threw in" the refraction with a pair of glasses or a CL eval with a pair of CLs. If they still are indignant, I ask why they came to me instead of to their old, free doc?
Most times, they then ask if I take checks or credit cards. The few times they walk, I'm just happy that I didn't have to do gratis work.
I hope that was a tongue in cheek reply. Surely you're joking. Well, maybe my practice is special. At least 80% of my patients have insurance. If I accepted no plans, I'd last 1, maybe 2 months trying to live off the rest. BTW I don't accept ALL plans, and I sure spend a lot of time explaining to those people what they can do. If I had to do that with everyone, I probably wouldn't have enough time left to see the 20%. Oh, I forgot, they'd be going over to costco or walmart anyway...
You must be joking.
In the area I am practicing, I just take it on the chin and pretty much for the reason you stated. "But no other doctors have ever charged me for that." People in my area of the country are simple (not necessarily stupid, just simple). In my last practice I definately charged a refraction fee and it was no problem. I encourage the fee in most cases and I think that in the next few years I will be making a change, but I do think that you have to do what is right for yourself financially and though I doubt you (in NY) are in the same situation I am (in MS) there are some situations in which patient satisfaction comes in a one size fits all mentality.
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Last edited by Refractingoptician.com; 02-28-2007 at 05:49 PM.
Ahh, but what YOUR missing is that it is a "tradition" to undercut the competition in the optical field. Never would all optical providers get together and collaborate with each other in a manner helpful to us. So, your "solution" would not work. From another point of view, it would probably be illegal to collaborate to boycott the insurance industry. It would be OK to do it individually, but not together.
I am trying, but I can't think of one reason why this would be true. Why do you believe this way? I only ask because I could honestly see things coming down to an outright boycott one day.
Anti-trust laws. It's been discussed, ad nauseum, with legal counsel in my state association. It's legal for labor unions, the government and insurance companies to "violate" anti-trust laws. It's not for the rest of us.:finger:
Bummer, but I am sure there is a loop-hole.;)
No, and you really can't discuss fees with a colleague without violating anti-trust laws. I suggest doing a complete body search of your colleague...
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Last edited by Refractingoptician.com; 02-28-2007 at 05:51 PM.
You probably should have started a new thread with that question. It's a big one. My biggest one is my high priced rent. It has produced a significant volume of upscale patients, but I hate working a week or 2 every month for the landlord. My lease is up next year so I'm starting to plan for a serious downsize...
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