What is the standard charge for office visits? ie foreign body removal, mild cong, corneal ulcer, etc etc
What is the standard charge for office visits? ie foreign body removal, mild cong, corneal ulcer, etc etc
Unless you are an O.D. or an M.D. I wouldn't charge for any of the above. You git in trouble in a big hurry. If you don't charge (as in a simple foreign body, like an eyelash or obvious non-imbeded trash) you ain't practiceing medicine (or "Optometric Medicine"). But you have a very apprecitive patient/customer for the future.
Chip
I finally talked our doctor into charging something. I kid you not, they never used to charge if it was a current patient. We finally settled on about 3/4 of the regular exam fee(which is also to low).
This applies to Drs and anyone else who might be performing these services.
Just because you don't charge, doesn't prevent you from being sued. These type services are high-risk, and these patients need to pay for the liability insurance that is required. When considering your fees, consider the patient's point of view.
1. Go to ER and wait 5 hrs.
2. Untrained but licensed MD attempts to remove the object in the eye without spud, slit-lamp or alger brush. (ie scratches cornea w/ a swab)
3. Patient recieves bill for $300 - still has object in eye but now is embedded and cornea is scratched
4. Makes a trip to OD. 20 minutes later, offending object is removed, rust is removed, CL patch is instilled, and leaves feeling much better w/ an Rx in hand
5. Patient receives bill from OD for $65 and wonders if you are a real doctor. (step 4 described 5 procedure codes if after-hours)
Remember that people are taught that if something is too good to be true, it probably is. Charge what this service is worth - to the patient.
When setting these fees. I suggest you call the OMDs in your area, and ask what they charge, and don't forget that they charge an after-hours fee too. OMDs are much better than ODs at charging what these procedures are worth.
If you increase your collected fees because of the above advice, please remit 10% of any increase to my paypal account marce@optiboard.com. We will use the honor system:bbg:
MarcE is TOTALLY 100% accurate on this, and these reasons are why I generally tell people with eye problems to stay away from the ER or family docs.Originally Posted by MarcE
When first got out of school, I had a hard time charging people for certain services. I thought people would complain about me ordering a test (like an OCT, fundus photos, VF or MRI). After a while, I figured out that most people really don't care, and that they just want me to give them the best possible care of their eyes.
I'm sure people loved it when we didn't charge for all services rendered, but I'm sure those people would also not think twice about suing me if I made a mistake in diagnosis or treatment.
-Steve
Our Drs. only charge $45 for red eyes, foreign bodies, etc...
I tell them that they are way to low, as these are the people that will take up the most amount of time, expose you to the highest liablities, and they are most in need of your services...right now.
On top of that, many are one-time visits that you'll never see again.
Ophthalmic Optician, Society to Advance Opticianry
Our OD charges around 40 for the average office visit.
Great post!
Hey, I just tried your e-mail and it didn't work. Is this some kind of JOKE? ;)
So far I have been unable to convience our OD to charge more than $50 for any service forementioned. If they have insurance - that's a different story. However, I would like to point out that I found it true what MarcE and Steve were talking about. There is a whole topic on this that could be followed and that is the liability issue. OD's do put themselves at risk (low risk at that, but a risk) should something go wrong. So, why are they not setting fee's that are appropriate to the risk involved - their malpractice insurance company doesn't care how much is charged, just as long as the premiums are paid and there are no suits! I firmly believe that OD's are too affraid to charge accordingly in fear that they may lose a patient or a person may not pay. Those who don't pay, go to the ER, If it is an excisting patient, they trust you and they will pay, if it is a walk-in new patient, well simply explain the process that MarcE detailed.
:cheers:
Cowboy
This is wrong. You charge two different amounts for insurance and no insurance? I've heard that it's acceptable to give nothing more than 20% discount for people with no insurance, but you can't charge a big disparity between somebody with or without insurance. Medicare could come in and audit you (even on non-Medicare patients) and cause some serious problems for you.
Trust me, the corneal foreign body patient will be happy to pay more to have a piece of rusty metal dug/burred out of their eye (once topically anesthetized, of course).
-Steve
The way I read the origional post was an optician asking if we could charge for office visits. I would say no unless it were for some optical service such as fixing glasses, contacts, etc. If you remove a lash or some such, or slit-lamp a cornea and find nothing scratched nothing foriegn, I sure wouldn't charge. But then I am an independent (meaning not owned, operated, or otherwise connected to a prescriber other than filling Rx's and fitting contacts, prosthetic eyes and spectacles) you might get away with charging if you are a doctor employed tech.
Chip
And what's worse - It's ALWAYS workmen's comp according to the patient. Yea right. Now I have to fight with the company over $45. Of course the company always denies. They can't afford to admit liability - they might get sued.
You should call up company X or Y and tell them that you would be happy to do workman's comp FB removals, but only if the company sends over a paper as a referral to see you/your doc. If a patient comes in without the paper, you can bill their health insurance or they can pay out of pocket. The company might be willing to send you a lot of business if you'll give them a discount (which means you should charge more).
-Steve
Anyone doing medical procedures should be reading up on medicare's coding guidelines, ICDp, E/M codes (99xxx), opthalmologic codes (92xxx), and any guidelines for the medical plans they participate on. If you are on medicare, you are subjected to their rules in regards to coding and billing even non-medicare patients. Its great to read on here that so many opticians (even those who own stores and may employ or subcontract ODs) think ODs are worth something to take out a foreign body, or anything else excluding routine exams.
There is a problem with too many ODs not understanding what their services are worth. A quick look at medicare allowables should make those ODs sick, and realizing its a heavily, heavily discounted program in comparison to many medical insurances will make them sick again. Often times these fees quoted above are barely more than a patient's copay.
I also liked this thought: A patient who doesn't have insurance gets a discount in that they don't pay a premium each month, they don't necessarily need a separate discount when something does happen to them.
Bottom line, if you are billing any medical plans, they will have their own rules on what discounts you can get. Often times they are shrouded in mystery and deep inside their website somewhere.
Society as a whole greatly values urgent care ahead of routine eye care. Those individuals not charging appropriately are in effect undermining their whole profession. How does that make you feel?
Chip may be right. If it is an optician or staff member, there are some special rules as to what needs to be done for each code (to get paid and keep the money!). Almost everything requires a doctor present.
I think the biggest problem with billing effectively is apathy and the (unjustified, imo) worry of losing patients
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