Contact Lens Fittings for Non-Stock Lenses

[DylanDavis]

We just had a patient in our office who had a heavy cylinder prescription on top of a small amount of hyperopia. The doctor did not have the appropriate lens of the brand that the patient wanted in stock, so she said she would have to order the lenses for them. This patient seemed kind of perturbed by this. She said she would order the lenses for them, and it would take around a week, but that we would have to collect the fitting fee up front before ordering the trials. The patient was very offended by this, and stormily left the practice. They then called around seeing if anyone else had the trial in stock (which they didn't) and then called us back and tried again to get us to order it without collecting the fee. We didn't back down. The patient said that 'we were discriminatory to their sight' because we did not carry his complex contact lens in stock.

Were we okay in refusing to order the contact lens without the fitting fee upfront? I'm kind of at a loss as to the circumstance.

What are your policies revolving around this?

[newguyaroundhere]

Sounds like you were trying to fit the patient into a XR Toric lens (Frequency, Vertex, etc) or a speciality RGP lens. In the case of the XR lenses, they are usually never in stock and have to be manufactured to the Rx given by the office. I dunno what the turnaround time and cost is for other places but my office uses ABB Concise/ODG and we are charged a fee for each trial lens and it usually takes a couple of weeks at least.

As far as collecting a fee upfront, I would probably do the same thing. You are probably incurring a cost for the lenses plus this patient is likely going to need multiple follow up visits before the Rx is finalized.

[rbaker]

I, personally, commend you on your decision. Show her some real discrimination and throw here out of your office.

[Johns]

This is a case of where it is helpful to have a policy manual, that can be easily accessed and shown to the patient. When they see it in black and white, they sometimes don't take as much offense, as they realize you are applying the policy across the board, and not singling them out.

[obxeyeguy]

CL patients, most non compliant, most demanding, most chair time, set them free!

[Jubilee]

"It is our policy to collect the corneal evaluation fee upfront. Regardless if we have your personal diagnostic lens in stock, the doctor still took extra time to take measurements and do tests that are not part of a regular eye health exam. While I can understand your frustration not to be walking out with diagnostic lenses at this time, this is a specialty product that is made on demand. This means we actually have to pay for the lens to be made and shipped to us before we can even see if it fits. The extra fees help offset these costs, and rest assured, we will call them as soon as we have them in."

[Jubilee]

I don't know why.. but when I read "Set them free!" I started to have Sting singing in my head with that song, "If You Love Someone Set Them Free"

Free Free.. set them free..

[Dirk]

We don't ask a fitting fee before ordering. I guess you did expain to her all the reasons for asking this fee and why the lenses are not in stock?
Most likely she was offended because she thinks that you do not trust her to collect her lenses.
Whatever the reason, these are your rules, the customer can accept them or not.

[EyeSore]

Of course you made the right decision. Keep us posted if she chooses to to see things your way.

[mervinek]

I agree... Right decision. I wear a hearing aid. I am a very difficult fit due to all the surgeries and scars I have. I had to pay $600 up front before ordering. I did it with a smile because I know my audiologist will get me the best aid I can wear and will make sure it is a good fit. What is wrong with people???

[ziggy]

What are your policies revolving around this?

If there was chair time involved in determining what lens to order then yes collect the fee up front, that is exactly what I would do. Now if I know that the patient has only a couple of options that are not a MTO lens, then I would just have ordered the lens as trials lens (non MTO Lens) don’t cost anything. A lot of the decision for me would depend on if this was a long term patient. I assume it wasn’t. I support your decision.

[CCGREEN]

For some I think that they feel they have such a close knit relation with their Dr's office, the office should carry the expense of ordering the the trials. The pt does not understand that ALL trials are NOT "free".
Our office has the expense of the fitting fee that the pt pays at the time of service. If the special trials are going to cost us money I collect at least half the retail price of the lenses up front. That way the pt has put forth some good faith money and we know they are serious at doing this.
If they have a problem with that I tell them that when the big box stores stop asking for good faith money we will also. Now if they are a long term patient and have ordered from us before then I can do otherwise to help accommodate them if needed.
How many times have you spent time and money with the patient and they ask for the Rx and walk. "I want to shop around, maybe order on line. I live so far away they can mail them to me."
We all know there is no money to speak of in contact lenses. If you didn't get your good faith money up front you not going to get it on the back side and now you are stuck with the cost of the lenses.
Oh by the way did I tell you people I HATE CONTACTS! At times so much effort and so little return. Other times little effort little return.

[drk]

I don't know why.. but when I read "Set them free!" I started to have Sting singing in my head with that song, "If You Love Someone Set Them Free"

Free Free.. set them free..

Me too! (That song rocks.)

[CGalloway]

We charge the fitting fee up front...the fitting initially occurred during the exam. The lenses are dispensed from stock or ordered. When the contact lens check is done a week later that visit is included. Our time and knowledge is worth money not free.

Also for the new contact lens patient requiring an I&R. If you come back for your follow-up and don't have your lenses on, lost them etc. You were supposed to call me if you tore it, I told you during the I&R...grrr. IF, when I give you a replacement pair or even just a pair to wear for the check...and you can't get it in your eye, I AM charging you for the I&R all over again...again my time and knowledge is not free.

[DylanDavis]

"It is our policy to collect the corneal evaluation fee upfront. Regardless if we have your personal diagnostic lens in stock, the doctor still took extra time to take measurements and do tests that are not part of a regular eye health exam. While I can understand your frustration not to be walking out with diagnostic lenses at this time, this is a specialty product that is made on demand. This means we actually have to pay for the lens to be made and shipped to us before we can even see if it fits. The extra fees help offset these costs, and rest assured, we will call them as soon as we have them in."

This is generally the way that I placed it to the patient. The patient had a scale reaction to the fitting fee. At first, it was about "What if the lenses do not work", which I reassured them by saying that the fitting fee covers all of that, which means we will do everything we can to get it right for them. Then the next complaint was the "Discrimination against their eyes" thing, which me and my doctor sort scratched our heads at. Needless to say, this patient has not and hopefully will not return to our practice.

[Paul Smith LDO]

Perhaps I'm the odd man out but I have always deferred the contact lens fitting fee until the Rx has been finalized. I prefer Mr Ray Charles, Hit The Road Jack. I find it's meaning more poignant.

[EyeCare Rich]

It needs to be explained that the fee is for the evaluation, not the contact itself. It is the professional service that the patient has recieved that they are paying for, not the product they will recieve based off of this professional evaluation.