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Last edited by Refractingoptician.com; 02-23-2007 at 11:02 PM.
Let's not play their game!
Let's post a sign that says there will be a service charge for all doctor's prescription changes within 45 days of the Rx date. This charge will be a percentage of the original price of the lens. The lens will be free of charge but additional handling and fitting and lab charges reqire us to access a minimal service charge.
(such as $10 for SV, $20 for BI/TRI, $40.00 PAL)
Try getting the same arrangement at a pharmacy!
Amen..........
The Pharmicist does not offer a no charge refill !
But to keep the customer happy I do a 1 time Dr's change at no charge within 60 days............
Its the muliple changes that really bother me and they seem to always come from the same Doctors....go figure
Just my 2 cents
Mikol
While this is consistant with our office policy and I have seen a few Rx's with similar inscriptions. This is someone else demanding your generousisty. I once had a great great physician tell me when I expressed the desire to have my business do one prosthetic eye in ten free of charge, tell me that I would end up with Doctors sending me the freebees and the deadbeats and doing the prosperous jobs in house. Don't go for it.
We used to have what was called a CTD (charge to doctor) we usually ate these but such a term existed. Have also found that there are some doctors that will intentionally write incorrect Rx's for people taking the Rx out of thier office. We don't eat these.
Never let anyone dictate what your charities should be, pick your own.
Chip
How about this
There will be a $20 charge for consultation conserning the glasses that are made ouside our practice
I got this rx from an OD in Jacksonville , FL
It is going to be my pleasure to send him a bill!!!!
Is this practice in Pasadena California? Looks familiar
Seems to me that the easiest way to figure out who is supposed to pay for a remake would be whomever makes the mistake makes the remake (and eats the cost). If the lab uses the specified materials, and everything is made within standards, all special instructions followed, etc., and the patient cannot wear the glasses, then it seems the doctor did a poor refraction and should shoulder the cost of the remake, if it's a mistake in fabrication then the lab should eat it. Maybe one Dr remake per pair as previously mentioned would eliminate a good deal of headaches, but it seems pretty simple to me. I realize that getting people to admit mistakes isn't nearly that easy though.
SCO2004, The problem with "at fault" paying the cost is that the costs are quite a lot of money, and the first thing the pt. says when they give you the remake RX, is that "the doctor says that if the glasses had been made and fit properly, I wouldn't have had to come back for a recheck, but since we found in the recheck a bit different RX than the first time, and they have to be made over anyway....." then they rotate that 2.00 cyl axis back to what they used to wear, instead of the 15 degree change they gave them. We do a 'doctor error' remake one time, period, then we charge the patient 'lab cost' after that. I saved a lot of these problems when we quit referring to MD practices that have 'techs' doing the refracting and writing the Rx's; give me a good OD rx. and we rarely have any sort of problem.
Indeed, I agree with you more than 100%.Originally posted by SCO2004
Seems to me that the easiest way to figure out who is supposed to pay for a remake would be whomever makes the mistake makes the remake (and eats the cost). If the lab uses the specified materials, and everything is made within standards, all special instructions followed, etc., and the patient cannot wear the glasses, then it seems the doctor did a poor refraction and should shoulder the cost of the remake, if it's a mistake in fabrication then the lab should eat it. Maybe one Dr remake per pair as previously mentioned would eliminate a good deal of headaches, but it seems pretty simple to me. I realize that getting people to admit mistakes isn't nearly that easy though.
There used to be the Great Late Dr. Madangopal at my place, who had ultimate wisdom of WRITING a chit and sending WITH the Patient saying" Sandeep, I have committed a mistake, now,please prepare the lenses with the Correct description and send the Bill to me" .
We were overhelmed by the honesty, and could never even think of compensation from him. Now a days, the Opthalms write "Sandeep, please change and donn't charge to the Patient ."
Is honesty in ones Genes or is an exception or is omnipresent and being killed by general deterrioration of morals ?
:hammer:
Sandeep, it's like for decades the American Academy of Ophthalmology considered filling ones own prescription to be most unethical, but when enough of that sort put in enough dispensaries, they all 'voted' on the ethics' of dispensing, and decided that it was now OK.
I had a patient come back in with a Dr. Redo Rx for their new 7x28 Thin and Darks with A/R. The script had "Dr's. Re-make" written on it. The patient said he asked the M.D. what that term meant. The M.D. told him it meant nobody had to pay for the re-make and not to worry.:o
I have a tiny problem with this one. My lab allows me 3 mos to order a Doctors Change or a PAL Non-Adapt at 100% discount on a standard lens. If it is a lens they have to order they will only cover the base lens. So on a Transitions PAL with AR they will only cover the cost of the PAL; they won't discount the cost of the AR or the Transitions. I have no problem eating the non-discounted price on a patients lenses once, especially since we don't have a ton of Doctor's changes. If more than one change is made or the change is made outside of those 30-Days, it has happened, that is alot of lens cost to eat.1. SPECTACLE PRESCRIPTIONS MAY REQUIRE CHANGES IN LENS TYPE OR POWER TO MAXIMIZE PATIENT ACCEPTANCE. PLEASE DO NOT FILL THIS PRESCRIPTION UNLESS IT IS AGREED
THAT DOCTOR'S CHANGES WILL BE MADE AT NO CHARGE TO THE PATIENT.
I personally know of an optician who was sued because in the dispensing conversation the patient complained that this was the second remake and still he could not see. The optician told him as it customery to go back to his doctor. Well, the patient went back to his doctor and the doctor simply changed the Rx. The patient went back to the optician for the redo. When the patient got his new Rx, he still could not see. The optician refunded the money and ate the cost. Well it would have been nice if the story ended there. It turns out that the patient had a delayed retinal tear. The Optometrist was sued, the optical store and the optician also were sued. The lawyers saw that the licensed optician was better prey because he had a larger malpractice insurance than the Optometrist. Scary but it did happen. The attorneys alledge that the optician should have refer the patient back to the doctor after refunding his money and also that at the very least use a pinhole to see if the vision would improve.
In view of the above, I will redo the rx once and maybe twice before giving up. I always document to return to the doctor if his vision is not as expected. (obviously giving time for the usual adaptation time) In the second remake, I have them sign the following:
We take great pride in the accuracy of the prescriptions that we fill. Your doctor has requested that we do not charge you for prescription changes. Several disease may cause vision changes. Some of them are: diabetes, ocular tumors, multiple sclerosis, cataracts, macular degeneration, retinal detachments, failed surgeries and many others that if left untreated may cause permanent vision loss and possible death. In us agreeing to remake your prescription at no charge, you are absolving us and any of our agents from any wrong doing. We also urge you to seek a second opinion at the earliest.
Pink Copy: Doctor
White Copy; Patient
Original file.
Dannyboy
That is a pretty heavy reminder that we are not just retail; we are still Allied Health.
Was this in Florida, a licensed state? I wonder how this would have gone down in an unlicensed state. In today's world, I guess we do pay the price when become officially recognized as trained and educated in optics and the physiology of sight. It is of course a price worth paying.
Specs13, I suppose that the "nobody" the dr. was talking about was himself? and his patient? A remake on that type of job costs plenty. It is frustrating that the dr. really thinks that, and when the pt comes in and at the beginning states that the doc. says "we're going to "try" this and if it doesn't work, then we'll take a different approach. Basically there are "no fault' situations, then there are normal expected rx changes due to any number of things, like a developing cataract, or post IOL, etc. those situations should be considered as part of the normal care of the pt. not "errors". God, there is so much waste in our industry, and people wonder why things cost so much, and most of it is caused by drs. trying to see how many pts. they can see in 5-7 exam rooms at the same time, having OJT techs doing the refracting, and c the conflict of interest of dispensing. IMHO.
Ever since I was a "cub" I've seen this shift of indeminification. It goes back to the days when opticians had to lick the boots of ophthalmologists in order to get the optical rx patients.
There is no such thing as such a shift of indemnification on a drug prescription.
There is one optician here in Houston who does something I am amazed over and he gets away with it.
After he completes the initial sale he offers a refundable Rx change warranty for $20.00. If the doctor changes the Rx once over the first 4 month period, the change will cost only $20.00. If there is no change by the end of the 4 month period . . . they get their money back or the can apply it with an additional $20.00 discount for a second pair.
He told me that some patients ask "Why would the doctor change the Rx so soon?" He answers them by saying "I have no idea. But, if your eyes change or the doctor needs to revisit the prescription, it cant cost you more than $20.00 no matter what."
Works for him!
That's a great example Alan. This optician was able to turn a potentially negative experience into something positive. Not many people are able to do something like that!
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Sandee:
The other side of the ethics coin, is I have a good friend who is an opthalmologist. He has been a patient of mine since he was in high school. He insists on paying for his and all his family's glasses/contact lenses. He tells me: "Chip you took care of us when we were in school and didn't have any money. Now we have money and I insist on paying." He won't even take a discount off retail.
Now this is not the norm, every other opthalmologist that I have preformed some opthalmic service for didn't pay and a lot of them don't even say thank you. Of course, I don't pay for my/my families opthalmic exams/or Rx's either.
Chip
how can I get more information on this case? It is very interesting, since it holds opticians responsible for basic vision screening techniques. I could see this becoming not only a precident for visison screening / testing in the optician's office but even over-refraction - - - which, by-the-way, if the optician had done and been confident in his/her skill, WOULD have referred this patient back the prescribing or to another doctor.
Thanks for sharing the idea. I think it could be developed into a service contract like one purchases on just about everything except underware these days.
What if we designed a service contract that covered one doctor's change of Rx, or one replacement of warrented lenses or coatings. In addition, it would cover the warranty replacement of a frame or frame part and would include one year's worth of service, adjustments and pad replacemnts. Say this would be worth about 10% to 15% of the original cost of the eyewear.
It would thus ancicipate and stipulate the limits of possible service and put a value on all of the "free stuff" we sometimes dol.
BTW, I alread charge for adjustment on eyewear that is not mine and routinely charge for replacing nose pads since they are "kinda like tires that need replacing because they wear out".
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Last edited by Refractingoptician.com; 02-23-2007 at 11:03 PM.
I think that's a wondeful idea.
Why dont you draft one up and lets all look at it.
I wouldn't hesitate to use it. If nothing else, its an income stream if unused.
You just gave me a flashback. I am not going to try to be very accurate about this, it's been a while, but seems to me that the revenue from the patient was invested in a national fund that was either interest bearing or was invested. It was all "on the books" and when the revenue from the patient was to be used to pay for whatever it was, the retained earnings stayed in the fund. Sort of an anti inflation fund / insurance for the provider or something like that.
When you think of so many providers collecting these fees and seeing them materialize into quite a reserve, it's amost like generating a "no fault" support system for optical providers.
I hesitate to use the word insurance, cause opens a heck of a can of worms.
Gee . . . you guys are awsome.
Since the case was settle out of court by the insurance company and never went to trial, there is no public record. I know of the case because I worked at the place 17 years ago. It was in Mass.
Hope this helps you.
Dannyboy
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Last edited by Refractingoptician.com; 02-23-2007 at 11:03 PM.
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