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Thread: in home dispensing

  1. #1
    OptiBoard Professional Dannyboy's Avatar
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    in home dispensing

    We have just added in "home dispensing" modality to our practice and it seems to be picking up. From the people that actually have been doing this, how have you advertise it? Do you charge a dispensing fee for your time? What other adds on do you do? How do you arrrange the schedule between the office and in home dipensing? What commission structure do you give the LDO doing it. Do you arrange eye exams as well? ;)

    Dannyboy

  2. #2
    Sawptician PAkev's Avatar
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    Dannyboy,

    I started my first optical business as a mobile optical service in 1992. Now our doc does his surgery on Thursdays which I close shop and still head for the road once a week. A majority of my on-location accounts have been health care facilities with house calls coming in second.

    Our motto:
    We go the extra mile to help people "SEE" a difference.

    I do not advertise "House Calls" from the office because there are many folks perfectly capable of returning to your shop for their eyewear but will take advantage your time and gas instead of their own. However, if someone exhibits ambulatory problems or indicates transportation logistics influence purchasing somewhere closer to their home I offer to personally dispense the eyewer to their home on a Thursday. Since I commit a specific day for on-location services I only charge extra if I should have to travel beyond my normal distance parameters.

    With experience as my best mentor I will recommend giving strong consideration to a few issues before you begin:

    1. ALWAYS request someone else is in the home when you meet with a patient. This could be family, friend, neighbor etc. Unfortunately, many seniors have been programmed that they are a good target for exploitation which can create a mutually uncomfortable environment. The third person usually helps relieve this problem. I also inform folks purchasing eyewear in our office that the eyewear must be paid in full upon ordering since it is our policy not to take money from people in their homes. Other than that make sure to carry some dog treats in your pocket to get on the good side of their pooch.

    2. Many folks living in HUD assisted housing require any/all service vendors to be licensed and insured. Most business insurance policies only include on premise liability. I therefore had to take out a seperate off premise policy of 3 million before I could walk through the doors of one facility. Although licensing is not required in our state, I must maintain current ABO certification in order to get professional liability insurance.

    3. Maintain the focus of your service. You are providing a service to someone who may have difficulty recieving that service in a conventional manner. You are there to service them because they are paying you for their eyewear and are now receiving the value of which they paid for. My most uncomfortable situations were when I knew it would take me 15-20 min. to service a patient and then ended up spending 45 min. adjusting every family member or neighbors eyewear. I now purposely leave the screws, nosepads, temple tips, etc. in the car and inform the people their request was unexpected but I would be happy to adjust their eyewear at our optical shop during normal business hours. Someone making an effort to come to your shop for service to the flopping temples on their drugstore readers is the first step in recognizing your professional abilities to meet their vision needs rather than getting a polite but insincere "thanks" because they happened to be at the right place at the right time.

    I find on-location services to be very enjoyable but I wouldn't want to do it every day. It gets you out of the office for a little change of scenery but most of all it gives you a firsthand relationship with your patients.

    Hope the info I posted helps

    Kevin

  3. #3
    Snook Fishin' Optician Specs's Avatar
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    We don't advertise it but we'll travel to a home, nursing home or hospital. Usually it comes up when a family member brings in a broken pair of glasses from a relative in the hospital or a nursing home. We charge a $25.00 fee for going somewhere. If its a matter of bringing frames to the patient for selection/measurements, and then coming back to dispense it, there will be only one fee. This is presuming the facilities are reasonably close by. Never had the slightest complaint on the fee. They are always thankful the service is available.

  4. #4
    Master OptiBoarder LENNY's Avatar
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    On my Medicaid billing form there is a place to bill for home delivery.
    Anybody knows the fees and the requirements for this servise.
    Can we bill for it to deliver eyewear?

  5. #5
    Sawptician PAkev's Avatar
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    Lenny,

    I know OD's bill the HCFA for out of office services such as you indicated for a slightly higher fee structure. However, when I tried this for eyewear the claims were rejected. Changed the place of service, resubmitted and was paid as usual. If they did outright pay for it we would anticipate a lot more folks would be providing in home service.

    I am only speaking from personal experience but believe things may be different for licensed states.

    Kevin

  6. #6
    Master OptiBoarder LENNY's Avatar
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    Thanks for your replt Kevin!

    It makes sense what you said about place of service!
    You do dispense at a different place.
    On my billing forms there is no place for place of service!
    I guess it has to be changed in the Medicaid procesing office.
    I guess i have to talk to my biller about it.

    BTW how much more did they pay?
    Dispensing fee only?

  7. #7
    Master OptiBoarder Alan W's Avatar
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    Re: In-Home Dispensing Another Twist

    I managed two "executive dispensing" enterprises over the last 15 years that were etrenely lucrative. None were insurance accomodating and they both were succesful only because they played to the upper end market. They also had to be done very strategically. The rewards were very high. These enterprises also operate under the radar of traditional opticianry, and in order to do it and make it work, it had to be done along certain guidelines:

    1, ONLY high end. Had to be shown from very good looking rolling tray systems.
    2, Only premium eyewear and nothing was sold as an option. Everyone got AR. Everyone got cosmetic tinting.
    3, The dispenser/sales person had to have "The Look". We had woman standing 5'10" in blazers and slacks. Groomed or made up like celebrities.
    4, By appointment only . . . legal offices, executive suites. It took a lot of homework and who's who. A lot of "telemarketing" with a lot of snob effect. Can only be done where there's "clientelle".
    5, Show the product with absolute body language, expensive mirrors with no finger prints, place mats only with designer names on them. No optical trade names. We even made our own with BMW and Jaguar logos.

    Got the idea? OK...it took 3 months to cultivate the market, which was a lot smaller than you think. Pure rumor mill. A showing in an executives office (Irvine, California and Minneapolis) resulted in executive secretaries "trying on" (and, buying) and VP's invited in by "the boss" which made extra sales. Customers wore nothing but the best in eyewear and optics. They paid for it. And, it was in thir own back yard. Perfect! Gross sales year #2 $200,000.00 20% commission plus salary to optician. Made a lot of money . . .
    but, the doctors who took care of them played dirty. "Whatever you see you want, write it down, fax it to me, and I'll order them for you for less. Just stop by and pick them up."

    Duh! Lesson learned . . . . Maybe I can interest you in this digital PD stick. It also doubles as a phone dialer, and removes the shell on lobsters.

  8. #8
    Sawptician PAkev's Avatar
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    Lenny,

    HCFA guidelines require that if you are charging Medicare patients a dispensing fee you must also charge routine patients a dispensing fee. The problem I had with this is that when folks learned they are now paying a fee which they previously didn't pay, they became very cranky. I didn't want to risk any of the stiff fines imposed from the HCFA for this subjective fee. Therefore I just increased my bifocal lens prices by $10.00; no one asks any questions and everyone lives happily ever after.

    Alan,

    My mobile optical service is a seperate entity from my retail shop so that there is no conflict of interest with the OD's who do exams for me in health care facilities which for the most part keep everything ethical. On a few occasions, I had a problem with a particular doc sending patients out to their office under the guise of "further testing" which led to selling patients new eyewear. I learned of this after the health care facility staff members picked up the eyewear at the docs office, brought it to the residents and then called me for adjustments or further service. I sent the facility a bill for my services suggesting that they reclaim the charges from the doctor. I now maintain a great mutual relationship with the health care facility and a new doctor which also services the facility with me.

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