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INSURANCE ISSUES

HOW TO BE LESS DEPENDENT ON MANAGED CARE

ALAN GLAZIER, O.D., F.A.A.O.

AS YOU might surmise, “ODs on Facebook” covers a lot of ground related to insurance, from the kind doctors carry for personal or business protection to the types we accept as payment for goods and services. The latter is what often garners venting posts, yet you can also find practical tips to effectively manage managed care plans.

Here, I provide two posts that gleaned helpful tips.

UNMOVABLE INVENTORY

One member of “ODs on Facebook” lamented that he has $60,000 in inventory on his frame boards, but much of it won’t move because “99%” of his patients belong to vision care plans. He hopes to lower his exposure and strategize his frame mix to compete: “I’m thinking 30% high-end frames and the rest consignment . . . Anybody know of any good consignment frames?”

This post received four likes and more than 60 replies. Examples of replies:

• “Start doing vision therapy…”

• “Your problem is you’re 99% vision care plans. Start doing medical, convert, coordinate benefits. That way you’re not so dependent on material sales!”

• “Closeout frames are by far the best way to save money. They have a high wholesale, but you get them for cheap.”

DROPPING OUT

One of my favorite related posts: A young doctor says she is looking to connect with fellow private practitioners who have “successfully transitioned from taking vision plans to dropping vision plans and operating OON [out-of-network] on them. . . and would be willing to discuss the strategy and success or failure of it?”

This post received five likes and 13 comments. Examples of comments:

• “Evaluate your net for your lowest three reimbursed plans. Drop the lowest one or two. We evaluate and drop one per year . . . We accepted a lot of insurance 11 years ago when we opened cold. It helped us grow, but now it is holding us back.”

• “Limit the number of well visit insured exams you do each day. You’ll fill up with medical, self-pay. Convert to medical as appropriate. When a plan isn’t too big to lose, 15% of volume, you can then afford to lose it.”

• “I didn’t drop all my vision plans, but over 25 years ago I transformed my practice to a ‘concierge-style’ practice — focusing on quality vs. quantity, primarily in the areas of dry eye and contact lens services. I see patients three days week and see about 1,000 patients per year. It’s a win-win situation — patients receive the time and care they deserve — I have loyal patients and after 39 years of practice I still have a passion and love for optometry! Feel free to PM me.”

I, myself, have been successful in dropping many vision plans by evaluating my net for my lowest three reimbursed plans, dropping the lowest one or two and following suit annually. OM

DR. GLAZIER is founder of Shady Grove Eye and Vision Care, a five-doctor medical-model practice in the Rockville, Md. suburbs of Washington DC. He is an author, inventor, industry consultant and frequent lecturer on ocular disease and Internet marketing. He can be reached at aglazier@youreyesite.com. Be sure to follow him on Twitter @EyeInfo or PM him on Facebook.