Exam Fees

[Joann Raytar]

What criteria do you use for establishing exam fees other than what other offices in the area are charging?

We are at a point where we are charging less than half of what other area professional offices are charging because "it has been that way for 15 years" with very few increases in fees. My concern isn't so much regarding the exam but the contact lens evaluation.

The profit margin on contact lenses seems to get narrower each month. The patients don't understand that if they went to an office supplying $13 contacts they are usually paying twice as much for an exam and CL evaluation. They are getting a discount upfront because we charge so little for a contact evaluation. We are starting to approach that line where we cannot match competitor pricing because on certain brands because we will be dispensing contacts for less than what we pay for them.

I believe if we raised our fitting fees, we wouldn't have to worry about contact pricing at all. Contact lens supplies are no longer an intergral part of our business. If patients desire to walk out of the office with a supply they can. I am just tired of feeling like I am bidding on the cost of supplying every other patient. I feel like I don't care where they get their lenses anymore. (As long as the source is legit. and ethical.)

[hcjilson]

Find out if the fee schedule is the reason they came to your practice......I'm betting even money that it isn't.

Tell me who is going down on prices.Certainly not our wholesalers-certainly not our oil companies! etc.

The other thing to do is to bring your fee's into line with everyone else. Try it for a month or two. Track business.....if it falls off markedly you can always restructure your fees. If it doesn't......you will have increased your margin and will be a hero to your employer....who might find a way to reward you financially.

hj

[Homer]

that optometry needs to think and position itself as a stand-alone health care profession.

The only reason why exams are artificially low is that optometrist have be operating as thinly disguised merchants. They need to separate these functions in their minds and their books and in their offices in order to understand what is really going on.

Perhaps they have been just pumping out reasons to get new glasses instead of practicing medicine as optometric physicians.

[EyeManFla]

One major factor is with the Eyeglassworlds and Optimarts et al offering "Free Exams" with purchase, most consumers get upset when you charge $20.00 for an eye exam.

Our exams are $59.00. That puts us about $10.00 more than Walmart. But or contact lens exams are the same at $89.00.

One OD in town bases his fees on Medicare. He'll tell a patient that if you have medicare you won't pay out of pocket...but then he bangs medicare for $124.00.

[paw]

Homer said, "The only reason why exams are artificially low is that optometrist have be operating as thinly disguised merchants."

That is true and so unfortunate for ODs.

Optometry is a unique profession in that it provides health care services (the professional side of optometry) and it allso sells glasses and other optical products (the commercial side of optometry).

The commercial side has been taken over by chains, who provide eye exams just so an Rx can be generated so that glasses can be sold. The chains' primary purpose in life is to sell glasses. They set the exam fee cheap, so people can afford to get that Rx and spend the real money on glasses.

Private practice ODs, like it or not, have to compete with these insulting exam fees set by the chains. That segment of the public who is ignorant about what a qualilty exam by a private practice OD entails, thinks that a chain exam is the same as a private practice exam, so paying $29 at the chain is the way to go.

That leaves the commercial side (selling glasses and other optical products) as the only way to make money. The private practice ODs who charge what they're worth must educate, educate, educate the public that they are getting their money's worth. That's what we do, and the patients know an exam in our office is worth what they're paying. We are told all the time how thorough the Dr's exam is, and how he takes the time to explain things.

And please, don't respond by telling stories about how great some chain eye exams are, or how awful some private practice exams are. Those are the minority.

Jo, to answer your question, I think you have to experiment. Raise prices slowly, until you hear some complaints or notice a dropoff in business, then back down a little and you have your mark.

[Joann Raytar]

Thank you folks. I appreciate any and all thoughts on this subject. Originally, an LO owned the dispensary and the Doc owned his end. The LO decided to leave for warmer pastures down in West Virginia and the Doc bought him out. So the boss has been trying to learn about running a dispensary and I am trying to learn as much as possible about the Optometric practice.

There has to be a comfort zone that will enable me to stop pouring through three or four vendors/distributors for every patient's contact lens supply.

How many lines of contacts do most of you stock in-house? Right now we have three or four brands on hand.

[Stopper]

Jo,
only you know what your services are worth. If you are good you need to charge patients for it. Don't be afraid to raise your fees. You mentioned on a previous post some of the fees you charge and they seemed very low to me. Don't give yourself away. Make your money on the professional service not the material. It's the only way to survive.

[Traci]

Contact lens supplies are no longer an intergral part of our business. If patients desire to walk out of the office with a supply they can. I am just tired of feeling like I am bidding on the cost of supplying every other patient. I feel like I don't care where they get their lenses anymore. (As long as the source is legit. and ethical.

Ok, shouldn't exam fees be exam fees and CL's and glasses be separate? Comprehensive Exam, CL Exam w/Comprehensive Exam, and all the other reasons why a patient needs to see a doctor. I am thinking the service fees for a service provided vs. a product fee for the product provided. We are a "unique business" providing services AND product.

Also, shouldn't the decision of WHERE to purchase the glasses or CL's be decided by the patient? After all, it is their money.

to compete with these insulting exam fees.

People will only be willing to pay for what THEY think the service or product is worth. You know, those who want in and out quick, and others who know the difference. You get what you pay for and thus the REASON to do something different to set yourself apart from the competition - no matter if it is service or product.

[Chris Ryser]

Jo said:
What criteria do you use for establishing exam fees other than what other offices in the area are charging?

We are at a point where we are charging less than half of what other area professional offices are charging because "it has been that way for 15 years" with very few increases in fees. My concern isn't so much regarding the exam but the contact lens evaluation.

I recently had to use the plumber to fix some problems.

Cost:

charge to come to my house $ 45.00

Full time charge 1.15 H which included travelling at $ 80.00 plus parts $ 36.00

Total cost $ 181.00 plus tax.


Why has it always been that in the optical business the original prices in the retail end have been on the high side and then for any follow up the charges have been peanuts.

When is the optical trade going to learn that the time spent for a job is worth the rate it should be.

Maybe the system should be revamped. Charge the real and actual cost of the material and labour as separat. Then the better quailfied one will be the winner!

[Joann Raytar]

Traci said:

Also, shouldn't the decision of WHERE to purchase the glasses or CL's be decided by the patient? After all, it is their money.

Traci,

I don't mean where the patient purchases their contacts; they can go where they wish. I mean what vendor or distributor I use to purchase contacts. If we are matching $X.00 contact lens prices, I can't buy our supply for the same amount of more.