Co-Management

Work with MDs to Treat Ocular Conditions with Specialty Contact Lenses

By Amir Khoshnevis, OD


Specialty contact lenses can help to improve vision for patients with eye conditions such as kerataconus, cornea ectasia and post-surgical corneas. Co-managing  these conditions with MDs can take you down new avenues in patient care.

ROB Bottom Line
Specialty Contact Lenses
Cost of Entry
Purchase of custom contact lenses diagnostic kits, which range in price from several hundred dollars to several thousand dollars.Number of Patients
A few referrals for new patients per week.Fees
Medical management fees that range from $500 to $1,500 per specialty contact lenses patient.

As most ODs know, patients with  corneal conditions are often treated by ophthalmologists through surgical procedures but, often, when surgery is not the best option, they can find improved vision through the use of custom contact lenses. You have a chance to partner with MDs to manage these patients with appropriate contact lenses. Doing so will enable you to better the lives of these patients while opening up another growth sector for your practice.

This opportunity has enabled me to grow the medical eyecare services I provide, resulting in a few referrals of new patients each week, with my practice receiving medical management fees that range from $500 to $1,500 per specialty contact lenses patient. Fees vary depending on the complexity of the patient’s condition–the harder the case and more intricately designed the lenses need to be, the higher the fees.

Consider if this Opportunity is Right for Your Practice

There is a cost to providing specialty contact lenses, so you need to consider whether this opportunity is right for your practice. Diagnostic kits are sometimes required to fit specialty contact lenses. While some of these kits are available as “loaner sets” from your preferred vendor, most have to be purchased, ranging from several hundred dollars to several thousand. To be truly capable of handling most complex cases, you’ll need to own several designs, leading to higher cost to the practice.

More importantly, an OD thinking about offering  specialty contact lenses services should consider that these are complex cases that require many office visits from the patient (most doctors would charge one global fee for prescribing and managing these lenses rather than charging per office visit), with hand-holding often required. Patients with difficult corneal issues understandably are already frustrated, so as a doctor, you need to have the patience to work with them until the proper physiological fit is achieved. This experience is far from your typical contact lenses management experience.

You also will need to sharpen your knowledge of surgical and non-surgical cases that will be coming to you, and you will have to fully understand the process of selecting the appropriate contact lens design. Consider the time you will need to spend reading articles about corneal conditions and specialty contact lenses fittings and the time you will need to invest in hands-on training for both you and your staff.

Prepare Practice

If you decide to move forward with this opportunity, the next step is deciding on the types of specialty lenses you will offer, and you will need to establish your budget for purchasing the diagnostic sets  required for medically managing these patients. You also will need to decide how your fee structure will work. Fees usually are derived from the complexity of the case, the number of anticipated follow-up visits and the skill level of the practitioner. Gain an understanding of third-party billing policies, benefit availability, and reimbursement for services and products from EACH plan regarding specialty contact lenses. After you’ve completed that process, create proper patient communication documents and procedures. You’ll need a professional quote sheet in order to explain all services, fees and product pricing. You should also be able to explain to patients warranty information and limitations.
Solicit Referrals

My practice has built relationships with ophthalmologists who perform corneal or refractive surgery. We sent a letter to all corneal or refractive specialists located near our practice. We then followed up with a call and a personal visit, bringing each of these doctors a few samples of specialty lenses that illustrated the newly designed, innovative lenses now available to improve vision for patients with conditions that cause the cornea to lose its proper shape. Typical candidates for custom-made contact lenses are patients with Keratoconus/Keratoglobus, post-surgical ectasia, corneal degenerative diseases, corneal trauma, high myopia and/or astigmatism or irregular astigmatism.

When an MD agrees to refer specialty contact lenses cases to you, commit to sending the doctor regular patient updates and final treatment reports.

Along with ophthalmologists, you should reach out to other ODs in your community. Many are not interested in taking on specialty contact lenses cases, and will be happy to refer this work to you.

Don’t forget to thank each doctor for referrals. You can do this by regularly calling them, taking them out to lunch or dinner or sending a gift basket to the staff or to a key referral coordinator.

Market Specialty Contact Lenses Services

Once you decide which specialty contact lenses vendors you will work with, find out if they have web sites with doctor-locate functions. If they do, ask that your name and contact information be included. Also consider adding a page or section on your practice’s web site that is devoted to specialty contact lenses. You also can advertise these services in your reception area, and you can do search engine optimization of your site so that your practice comes up nearer to the top of the search results for specialty contact lenses in your geographic area.

By providing specialty contact lenses services you can expand your medical eyecare by developing relationships with local MDs leading to more co-management opportunities and, most importantly, you can improve the quality of life of more patients.

Related ROB Articles

Children in Contact Lenses: Introduce and Train Young People to Wear Contact Lenses

Specialty Contact Lenses: Growth Lies in Niches

Ask the Right Questions to Keep Patients in Contact Lenses

Amir Khoshnevis, OD, founded Carolina Family Eye Care in 2003. He is a graduate of the Pennsylvania College of Optometry and is a member of several optometric associations. He is a presenter at AOA and SECO. Dr. Khoshnevis has a strong interest in specialty contact lenses and has built a medical co-management contact lens practice as well as a clinical investigation site for specialty lenses. To contact him: drk@carolinafamilyeyecare.com.

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