Making vision plans work for you

Atlanta-Katie Gilbert Spear, OD, MPH, and April Jasper, OD, FAAO, have found a way to succed in the face of managed vision care challenges and shared some tips at a presentation during SECO.

Vision care contracts

The first step to success with vision care plans is understanding the plans.

They estimate that more than 80 percent of the doctors who have attended their lectures across the country have admitted that they didn’t read their vision plan contracts.

Related: The vision care plan industry’s vertical monopoly

“We can’t improve and we can’t do better if we don’t even know what the details of these contracts are,” says Dr. Jasper.

When you read the contracts:

• Look for rules and regulations that vary from plan to plan

• Find plan polices on contact lens follow-up visits

• Understand when prior authorization is required

It’s not unusual for a company to update these contracts, so it’s smart to refresh yourself. This information can be found on the insurance company’s website.

Understanding this information can help protect you and your practice.

“Print your contracts for all of your plans,” says Dr. Jasper. “The reason you need to have those-not just to benefit from knowing what’s in them-but if you go through an audit for a vision plan or medical plan five years from now auditing you for the patients you’re seeing today, and you don’t have a contract and your legal agreement with the company for that period of time that you’re being audited, then you have nothing with which to defend yourself. You’ll be working according to current contract, which may have changes.”

Next: Effectively managing frames

Effectively managing frames

Once you understand the plans-what they cover, how much your patients will owe, how much the plans will pay, etc.-you then have to understand the types of frames that will give you the most profit.

“Sometimes those brands that you think are profitable for your practice aren’t necessarily so,” says Dr. Jasper. So, do the math. 

Related: Simple strategies for successful frame board management

While you must carry a certain number of lower-priced frames, Dr. Jasper says that luxury brands are going to be the best thing for your practice.

“Be smart about your frame buying so it’s easier to help your team understand what to sell,” she says.

Dr. Spear says that if you stock brands that no one looks for and aren’t selling well, it’s time to reevaluate and move into more profitable brands.

Some tips for frame buying include:

• Watch out for low-wholesale frames

• Educate yourself and your staff on frame board reordering-figure out which brands work better for different plans

• Luxury, designer, and high-profit brands are always the best

“If you don’t manager your frame board-you think your practice is too small or too big or that you don’t have the time-start now,” says Dr. Jasper.

Next: The importance of staff training

The importance of staff training

In general, your staff members are the ones out on the optical floor selling the products, so it is vital that they understand the plans, which options are the most profitable, and the best-quality options for the patient. 

“I’m so passionate about staff training in my own practice because most of the problems we’ve had in our practices have been because a lack of training-and that was my fault because I’m responsible for that,” says Dr. Spear. “If your staff is not trained, it can be significant in terms of the cost factor for your practice.”

Related: Maximize profits with managed vision care

For example, if a staff member is purchasing frames for your practice but buying a lot of cheaper wholesale brands, she likely thinks she is doing you a favor by keeping your cost of goods low. However, because she hasn't  crunched the numbers, she doesn't know that those are the brands which are often the least profitable with vision care plans. 

Train all of the staff on the basics, even if they don’t normally work in a certain area. Dr. Spear recommends a regular staff meeting to review new products and reinforce their training.

“We try to cross-train our office staff. When we have new technology come out, whether it’s a drop, a new lens, or a new frame brand, I make everyone attend that meeting-front desk, technicians, opticians,” says Dr. Spear. “It’s really important because one day a patient is going to ask, and that staffer needs to know how to answer a question about a specific product.”