OptoMap

[Suburban Gal]

Our practice just started using it. We charge $39 for it.

Doc initially started doing OptoMap on everyone and just charging those patients who were interested in knowing the results of the scan. However, doc stopped doing that because he quickly learned he was losing out on way too much money. Now, we make patients sign an OptoMap form prior to testing and we only scan those patients who want to be scanned by the machine.

Out of curiosity, does your practice use OptoMap and, if so, how much do you charge for it? Is there a better way to sell it to the patients so more patients will say yes to it? We hear a lot of patients tell us they'd be more than willing to do it if insurance actually covered it.

One of our OD technicians is tossing around the idea of billing OptoMap to insurances to see if we can actually get any of them to cover it for our patients.

[fjpod]

I don't like the idea of making parts of the eye health exam "optional", but that's me...either do it because you think it is in the best interest of the patient or don't do it. That being said, this technology can at times uncover otherwise undetected pathology...but it is the doctors responsibility to detect it by whatever means is necessary.

As far as billing it to insurance...you need to have a pathology situation that requires monitoring in order to bill for it. And, in theory, if you are billing patients $39 for the test, then you should bill insurance companies the same. You might be shortchanging yourself this way.

Optomap...it is a conundrum. Not so much because the technology is questionable...but because of the business model the company espouses.

[Slim]

we charge 29 for it...
I sell the hell out of it out front when I end up with outside Rx's.

[DanLiv]

First, you should Optomap everyone. Call your rep or Optos and have them set up the system that way, and you will only be billed if the doc opens the results in the viewer. That way you don't need a form and techs don't need patients to make any decisions during pre-testing. We opto everyone, and last thing in the pre-testing techs explain the doc will want to review their opto results for which there is an additional fee. Optos has an exam room info card to explain exactly this, and patients can mull it over while waiting for the doc. In the exam the doc asks to review their optos with them, if they decline simply dilate. We run 90% Optomap, only dilate a couple times a week. Much more efficient.

As far as billing vision insurance, good luck. A very few VSP plans are popping up that cover it, but they are rare. I just had one that covered it with a $20 copay. I'll be interested in seeing if they pay anything on it (they should, their normal fee to VSP patients for Opto is $39).

However, there is "Optomap Plus" option, which as fjpod said can be used for pathology monitoring and can be billed to medical insurance, which we do often. Has to be medical ins though, vision won't care. Optos does offer billing and coding training for this.

[Suburban Gal]

First, you should Optomap everyone. Call your rep or Optos and have them set up the system that way, and you will only be billed if the doc opens the results in the viewer. That way you don't need a form and techs don't need patients to make any decisions during pre-testing. We opto everyone, and last thing in the pre-testing techs explain the doc will want to review their opto results for which there is an additional fee. Optos has an exam room info card to explain exactly this, and patients can mull it over while waiting for the doc. In the exam the doc asks to review their optos with them, if they decline simply dilate. We run 90% Optomap, only dilate a couple times a week. Much more efficient.

I don't like the idea of making parts of the eye health exam "optional", but that's me...either do it because you think it is in the best interest of the patient or don't do it.

We already tried this. They tried it just before I was hired 3 months ago and were continuing to do this a few weeks after I was hired.

Doc was OptoMapping everyone because he's a really good doc who cares about his patients and felt it was necessary to do on everyone all the time.

However, we found that, despite the fact we're in a very well-to-do area, MOST patients were declining to pay to learn the results of their OptoMap scans. When he does the OptoMap on patents and they don't pay, he loses money on it. He doesn't want to continue losing money on OptoMap.

Most people only want what insurance covers. They really don't want to pay anything extra. Times have gotten really tough since the onset of the Great Recession in the summer of 2007. It's even impacted more well-off families and individuals.

[Suburban Gal]

Our problem is trying to sell OptoMap to where patients will pay the extra money for it in the area we're currently in.

[Slim]

Sounds like you might need to rethink a selling speech maybe... When I tell people about it they cant wait to get it done.

[Suburban Gal]

We run 90% Optomap, only dilate a couple times a week. Much more efficient.

Doc says he wants to know how you're able to do it at 90%. Prior to the forms, when we were OptopMapping every patient and only charging them for it if they wanted to know the results of the scan, we were at 60% in terms of patients paying for it.

We dropped to 30% since making it optional and handing patients the form.

[DanLiv]

The only challenge he to opto everyone is that the doc has to sell it to the patient. My doc loves optomaps and thinks everyone should have them, and he tells the patient that. If they resist, he explains he really wants to be able to review their eye health with them and keep and permanent visual record of the findings. The doc has to believe in it and make the patients trust his advice on the benefit of the technology. Of doc thinks dilation is just as good, he'll have a hard time convincing patients it's worth the money. I would never design a lens without AR before explaining why it's a mistake, and my doc would never dilate without explaining why not optomapping is a mistake. It's always worth the money, even just not to be dilated.

It also helps to use the rule if threw: people need to hear about something three times before they pay attention to it. Our receptionist mentions optomap when they make their appointment, our techs discuss the advantages when taking the image, and our doc asks to review the images with them the third time.

As with any new tech (optomap, digital lenses, visioffice, etc) one has to embrace it as a practice to convince patients if the benefit. It does NOT sell itself. If you all love it and tell your patients, they will love it too. But the key is to get the doc on board and have him do the heavy lifting. If he's not into that, it won't work.

[Suburban Gal]

The doc has to believe in it and make the patients trust his advice on the benefit of the technology.

It also helps to use the rule if threw: people need to hear about something three times before they pay attention to it. Our receptionist mentions optomap when they make their appointment, our techs discuss the advantages when taking the image, and our doc asks to review the images with them the third time.

That's how it was though. It'd start with me at check in. I'd mention the doc's new toy and have them read a laminated sheet, front and back, along with a brochure. Then off they'd go to pre-test would mention OptoMap and do it on the patients. Finally, the doc would bring it up during his time with them. He'd tell them it'd be an extra charge and he'd only charge them if they wanted him to review the result. The minute the patient would say okay, he'd open the result, discuss and charge them at check out.

And believe me, the doc really DOES believe in it and speaks passionately of it to patients. I've seen him discuss this directly with his patients.

We had a misunderstanding with a patient at one point, which is why we went to the forms and it being optional. Doc ended up having to do a $39 refund on it when he really didn't want to. We wanted to avoid that same incident in the future.

That said, even though we're in a more well-to-do area where patients really should be paying and have no trouble paying, we see patients from all over the county and even outside Lake. Doc has built up a pretty good reputation and practice.

We find that:

-patients who come from Mundelein, the Round Lake area, North Chicago, Waukegan, Beach Park, Zion, Winthrop Harbor, etc..., the more low income neighborhoods, are a lot less likely to pay for OptoMap. It really is more of a cost issue with them and most patients from those areas tend to cite insurance not covering as the reason not to do it.

-patients who are of middle eastern and asian decent are way more likely to have OptoMap done and pay for it because they feel if it truly is necessary and doc recommends it then there's no getting around it. This is especially true when children are involved because, when it comes to their children, they'll do whatever is necessary to help them succeed in life. So if OptoMap helps them succeed in life because it helps maintain their vision and keeps it from getting worse, then they're all for doing and paying for it.

-patients who come to see doc on their lunch time are less likely to do it because they need to get back to work as quickly as possible. (We do get an awful lot of these people because we're around a lot of corporate business and industrial parks and near a lot of company headquarters like Walgreens, Medline, Allstate, ACCO Brands, Rust-Oleum, Pactiv, Grainger, Solo Cup, Klein Tools, CDW, American Hotel Registry, Quill, United Stationers, Hospira, Abbott Labs, Baxter to name a few.

[optical24/7]

-patients who come to see doc on their lunch time are less likely to do it because they need to get back to work as quickly as possible. (We do get an awful lot of these people because we're around a lot of corporate business and industrial parks and near a lot of company headquarters like Walgreens, Medline, Allstate, ACCO Brands, Rust-Oleum, Pactiv, Grainger, Solo Cup, Klein Tools, CDW, American Hotel Registry, Quill, United Stationers, Hospira, Abbott Labs, Baxter to name a few.

And how's that rushing back to work dilated working for them? That alone is a big sales feature...Not having to be dilated.

[Suburban Gal]

And how's that rushing back to work dilated working for them? That alone is a big sales feature...Not having to be dilated.

The patients that are in a hurry like that because they're at the office at lunch time usually don't do the regular eye dilation because of the time extreme crunch.

[Suburban Gal]

Doc's decided to ditch the form and go back to the old method.

That said, if your office has a 70% or greater rate of patient payment on OptoMap from always scanning during pre-testing, please tell me how long you've been getting that and you're able to achieve that because doc would like to increase OptoMap payments from the patients.

[optical24/7]

Tell your patients that a complete eye health check can not be done without dilation or OMing. Let them pick which one.

[DanLiv]

We are not in a particularly affluent area and have no difficulties. We have had Optomap for 10 years, been optoing everyone for 5, and are pretty well acquainted with the routine of it. The problem must be in the presentation. But if you have difficulties shifting patients out of the "only what my insurance covers" mentality for eyewear as well, then it's a issue endemic to your practice and Optomap is just one of the things that suffers.

Tell your patients that a complete eye health check can not be done without dilation or OMing. Let them pick which one.

Absolutely. One or the other is a necessary part of any comprehensive exam. In fact, your doc's insurance contracts require it as part of a comprehensive. And Opto is way faster than dilation, and way less unpleasant. BTW, if you are having those that decline opto and dilation come BACK at another time to be dilated, your doc is wasting his and the offices time and services.

[Suburban Gal]

But if you have difficulties shifting patients out of the "only what my insurance covers" mentality for eyewear as well, then it's a issue endemic to your practice and Optomap is just one of the things that suffers.

Part of the problem is we have patients who really like doc and are pleased with the quality of the exam he gives them, but they just don't understand why he charges so much for his frames (our frames start @ $220) when they can go to For Eyes, Pearle, LensCrafters, Visionworks, Wal-Mart Optical, Target Optical, K-Mart Optical, Sears Optical, JCP Optical, etc... and pay a lot less or get great deals like 2 for $99. So, they typically just come for the exam and then request their Rx to go elsewhere for frames. We also have patients who come and see him just for the exam and then request their Rx to go to Sam's Club or Costco because they claim they get a better deal on frames and contacts. We try very hard to get them to purchase here by telling them they get better quality frames and a 1 year warranty, which they'd pay for at For Eyes or where have you, but many patients still feel a frame shouldn't be costing that much money.

We also have some patients that take issues with what we charge for an eye exam (we charge $215) (I believe the average cost at a private practice is $114) when they can go to For Eyes, Pearle, LensCrafters, Visionworks, Wal-Mart Optical, Target Optical, K-Mart Optical, Sears Optical, JCP Optical, etc... and pay around $45, $50 or $55 for one.

[OHPNTZ]

We run 90% Optomap, only dilate a couple times a week. Much more efficient.

The above statement is a little scary. So few dilations a week...isn't good. The Optomap has major limitations. Just 3 months ago, my wife (also an O.D.) and I were in a colleague's office who had one and was talking it up. (By the way, I used the original platform 8 yrs ago, so I am familiar with it.) I had my wife sit down to prove a point. She has extensive lattice degeneration with atrophic holes with fluid cuffs, almost 360 degrees in both eyes. She has had extensive retinopexy numerous times. The optomap only caught one area of the retinopexy (scarring) and nothing else. This was with the newer software (not the Daytona). Enough said...

Second point...to bill a "comprehensive" medical eye exam, dilation is required UNLESS contraindicated. So your office would have to down code all of your medical visits to "intermediate" by not dilating. This would include "medical" comprehensive visits that may even include the anterior segment issues (ie annual check of corneal dystrophies, dry eyes, etc...)

[DanLiv]

The above statement is a little scary. So few dilations a week...isn't good. The Optomap has major limitations. Just 3 months ago, my wife (also an O.D.) and I were in a colleague's office who had one and was talking it up. (By the way, I used the original platform 8 yrs ago, so I am familiar with it.) I had my wife sit down to prove a point. She has extensive lattice degeneration with atrophic holes with fluid cuffs, almost 360 degrees in both eyes. She has had extensive retinopexy numerous times. The optomap only caught one area of the retinopexy (scarring) and nothing else. This was with the newer software (not the Daytona). Enough said...

Huh, I wouldn't know I'm just an optician :)

I have worked for 5 ODs in three practices over 14 years, all of whom had Optomap and none of whom dilated except in lieu of Optomap or some special cases. I'm sure there's plenty of professional debate among ODs about the pros and cons of Optomap (especially since a single company controls it and the pricing, which always creates a lot of naysayers), but I just trust my docs to make that prudent decision.

I do know at least one doc who used a simple retinal camera as a cheap Optomap substitute and in lieu of dilation as well. It's not my area, but I know those cameras have narrow image fields. That sounds scarier to me.

[OHPNTZ]

Huh, I wouldn't know I'm just an optician :)

I have worked for 5 ODs in three practices over 14 years, all of whom had Optomap and none of whom dilated except in lieu of Optomap or some special cases. I'm sure there's plenty of professional debate among ODs about the pros and cons of Optomap (especially since a single company controls it and the pricing, which always creates a lot of naysayers), but I just trust my docs to make that prudent decision.

I do know at least one doc who used a simple retinal camera as a cheap Optomap substitute and in lieu of dilation as well. It's not my area, but I know those cameras have narrow image fields. That sounds scarier to me.

It wasn't a dig at you. Just want to enlighten those who are around the device. It should never replace dilated exam. That's all...

[DanLiv]

It wasn't a dig at you. Just want to enlighten those who are around the device. It should never replace dilated exam. That's all...

Thanks, I didn't take it as such. I was being tongue in cheek, but also admit that I don't know enough about that debate. I hope my docs do. Thanks for the info!