Learn how to integrate DED treatment into a practice and properly bill for it

We have been talking about dry eye disease (DED) in eye care as a separate and identifiable disease process for over 25 years now. This conversation started with the development of products targeting the cause of the problem. We then learned more about DED, as additional products for diagnosis and treatment were developed. Before we knew it, our cabinets were loaded, and our offices filled with related devices.

The discussion around DED management can feel like it is always changing, and sometimes feels like it is becoming more complicated. The danger for many of us with “complicated” is that we are then tempted to avoid it altogether or refer DED patients to someone else.

The good news: Even though there are new treatments for DED, as well as a few new devices, the process for diagnosis and treatment can still be straightforward for our practices and our patients.

DED IN THE GENERAL PRACTICE

Let’s answer the question: How does one get started down this path of creating a straightforward approach for their practice that emphasizes DED diagnosis and treatment? While there are a few approaches, most colleagues I have talked to want to integrate DED as part of a general practice in the same way that glaucoma, AMD, and contact lenses are, to help keep things simple for patients and the clinic team. With that as a goal, I would start with:

1. Create your step strategy for diagnosis. By “create,” I mean write it out and put it in your protocol for your practice’s team.
2. Create your step strategy for treatment and organize it by levels of severity, while also listing the specific products (and pricing) you prescribe in your practice. This is so your team knows where they all fall into each step.
3. Outline how technology plays a part in the treatment and the pricing for the procedures. This should include details for your team on how to discuss these treatments (scripts) and the cost.
4. Set up your process for office visits once diagnosis and treatments are started, and include the tests that will be performed at each visit. This is so you are consistent for better patient outcomes. For billing and coding purposes, this step makes certain you meet the necessary level of complexity for the codes selected.
5. Design handouts for your patients that outline the information important to them. Patients don’t need to know your office’s standard operating procedure, they want to know what their problem is, what to do to get better, what to expect as they improve, as well as what to expect from their next visit with you.
6. Celebrate success at each visit with patients, keeping in mind that the most important part of all of this to the patient will be symptom relief. Be sure to tell patients about signs and how they can affect symptoms, to help improve outcomes.

WHOM TO BILL

Many doctors have asked whether they bill DED visits to insurance or create their own global fee for these visits. The answer: If you are a provider for the patient’s insurance and your office visit fits the insurance rules for billing, then you must bill for what is covered. A global fee can work nicely when you are not a provider for insurance, however you will want to make certain patients are clear on what is covered and not covered within this fee. Transparency in billing is important to provide value to the patient and show the true worth of the service you provide.

The most important thing, though, is to simplify the diagnosis and treatment process you follow in your practice for you and your team, and pass on this organized plan to patients so you can continue to see their lives changed for the better. OM

DR. JASPER practices in West Palm Beach, Fla.. She is an American Academy of Optometry fellow and is chief optometric editor of Optometric Management. Email her at april.jasper@pentavisionmedia.com.