At the 2025 Optometric Management Symposium in a session titled, "Eye Got This: Essential Tips for Optometry Practices," William H. Stephen, OD, outlined evidence-based strategies for identifying practice bottlenecks, optimizing patient communication, and enhancing capture rates to close the financial performance gap among average and top-performing practices. Execution—rather than clinical skill—explains much of the difference, he said.

Here's an overview of what Dr. Stephen cites as common bottlenecks throughout one's practice and his top tips to alleviate them.

Blockage 1: The “Good Exam, Bad Handoff” 

To help increase optical capture rates and reduce bottlenecks at handoffs, Dr. Stephen suggested this formula:

1. Why + what + how in 1 sentence

2. Patient and doctor meet optician together

3. Optician greets the patient by name and fills the doctor’s prescription

In a practice example he gave, Dr. Stephen showed that the optical capture rate from using this formula increased from 58% to about 65% and beyond over 90 days in his practice.

He added that frame board curation should align with patient demographics and feature Good–Better–Best lens packages.

Further, Dr. Stephen suggested monitoring inventory turns rather than just volume.

“Curation builds value and protects margins, [while] competing on price alone is a race to the bottom,” he said.

Blockage 2: No-Shows and Other Scheduling Bottlenecks

Pre-visit eligibility verification and proactive appointment reminders can reduce same-day surprises and cancellations, pointed out Dr. Stephen. More specifically, he suggested automated reminders at 48, 24, and 2 hours, followed by a same-day text message confirming appointment times and offering easy rescheduling options, such as a self-serve system.

Dr. Stephen also said that new patients and those with a history of late cancellations benefit from personal phone outreach via a “friendly script and easy rescheduling.” 

Finally, he suggested monitoring the weekly no-show rate and the rate at which patients rebook in 7 days. 

Blockage 3: The "Contact Lens Plateau" 

To raise average contact lens capture rates, Dr. Stephen advised prescribing—rather than recommending—an annual contact lens supply in the exam room to help strengthen patient compliance and highlight patient convenience.

Plus, he noted, contact lens ordering before the patient leaves the practice prevents the midyear, new-box emergency scramble when their supply runs out. 

Blockage 4: Lack of Consistent Training

Dr. Stephen recommended weekly 20-minute sessions focused on a single micro-skill, such as warm handoffs or chairside scribing.

“Consistency beats intensity,” he said, “and structured training drives staff retention and performance.”

Several tools, such as role playing patient interactions to determine what can be tweaked... can help staff get it right, he noted.

Blockage 5: Claim Denials 

Because most claim denials are never reworked, said Dr. Stephen, they represent significant lost revenue. As a result, he outlined a plan to prevent denials:

1. Verify patient insurance 48 hours before the visit.

2. Use electronic health record templates that have prebuilt fields and images.

3. Close all encounters by day’s end.

4. Apply claim-scrubber rules for modifiers and frequency edits.

5. Provide clear cost estimates and payment options to patients before checkout.

Further, he advised keeping up to date on new or revised codes, and incorporating learning them into the aforementioned 20-minute weekly training.

In addition, he said, the following important key performance indicator metrics can help:  

1. First-pass acceptance rate, with a target of at least 92%

2. Categorizing denial rates

3. Monitoring days in accounts receivable and the percentage of those greater than 90 days

4. Percentages of point-of-service collections

5. Resubmission yields

Dr. Stephen concluded with a 90-day action plan that incorporated his tips from the presentation.

"Pick 1 constraint to fix in 30 days, hold those weekly 20-minute team training and key performance indictor huddles, and establish 1 workflow standard per month." OM