Issues in Optometry

3 Low-Cost Practice Changes Resulting in Extra $60,000+ Annually

Dr. Davison has found that including cleaning kits as part of her practice’s premium eyewear package pleases patients while generating additional revenues. The kits are also available for purchase, at a slightly higher price, to patients who opt for one of the practice’s other two eyewear packages.

By Janelle Davison, OD

Sept. 28, 2022

Your practice offers many opportunities to improve care while building profitability. Some of these opportunities are easier and lower-cost to implement than you may think. Here are a few changes we made that were minimal in cost, yet delivered a significant positive impact.

Extended Warranty for $29.99
Patients want to feel reassured when they make a purchase that, should something happen to their new glasses, they will not be out $300, or much more. We decided to offer an extended warranty for which the patient pays a $29.99 enrollment fee. For that fee, they have a $50 “deductible” for lenses and frames, respectively. So, if they only need a new frame, and their lenses are still good, they would pay $50. If they need both frame and lenses replaced, they would pay $100, regardless of what they paid for their glasses.

Close to 90 percent of our patients who purchase eyewear opt for the extended warranty, as its cost is built into two of the three eyewear packages we sell. It is not built into our lowest-tier package, yet even some of those patients decide to get the warranty. It has given our patients added security in their purchase, and has been a financial winner for the practice.

For every 15 extended warranties sold, there is only one occurrence in which it gets used. This resulted in an additional $14,000 generated in 2021.

Patients will text us that they broke their glasses, and we’ll text back, “You have an extended warranty, so your new glasses will only cost you $100. Please send us a photo of the broken glasses.” Our extended warranty does not cover lost or stolen glasses, so it is important that we receive proof of the broken glasses before we order them a new pair.

We got the idea for an extended warranty from cell phone companies. Most of us pay $15 monthly for a warranty that enables us to replace a phone for around $100 that originally cost us much more. Cell phone companies refer to the money that a person with a warranty would pay for a new phone as a “deductible,” so we adopted the same language, which we know is familiar to most of our patients.

As practitioners, we have to make sure we are keeping up with the consumer buying experience, giving patients in our office options similar to what they are getting from other businesses. We have to keep in mind how the patient is used to shopping and making purchases.

Selling Glasses Accessories & Eyecare Products
We started selling eyecare-related products in quantities that are just enough to get the patient started. They then can come back to us to purchase more (though we ask them to check with us beforehand to make sure we have the products in stock) or they can buy directly from the company that manufacturers the products. We have affiliate relationships with these companies in which we get a percentage of every sale that comes from our recommendation. In some cases, patients are given a code to use when they make their purchase that ensures the sale gets credited back to us, and even provides them with a slight discount.

We sell an eyeglass cleaning kit for around $20, which comes with cleaning solution, cleaning cloth and anti-fog spray. It is sold at a reduced cost to those purchasing our highest-tier eyewear package. We also sell vitamin supplements, artificial tears, a $62 home dry eye care kit from DryEye Rescue and make-up from Twenty/Twenty Beauty. We keep our inventory investment low, ordering, for example, no more than 100-200 cleaning kits at one time for less than $1,000. This is a small enough number that we can keep the products in a drawer in our optical.

Sales of all of these ancillary products generated an additional $45,000 in 2021.

I would recommend these specific products, and patients would tell me that they were having trouble finding them, and some would not even want to try, as having to search for a product means an additional chore in peoples’ lives. Now, when a patient asks where they can get the products, I tell them, “We can go out to the optical and dispense it to you today.”

Medically Necessary Contact Lens Billing Guide
Billing insurance providers to be reimbursed for medically necessary contact lens services is tricky. These are contact lenses for people with -10 or higher or +6 or higher prescriptions, or for people with conditions like keratoconus. Unlike contact lenses for other patients, insurance companies often cover the majority of out-of-pocket expenses for these patients, as they are seen as being medically necessary, rather than something that is a luxury.

The difficulty is every insurance provider has slightly different requirements for the information that needs to be submitted in order for the practice to be reimbursed for the service. In the past, we missed meeting these requirements often enough that sometimes we would miss out on $700-$2,400 in reimbursement, or have payment delayed for months.

To address this problem, I had one of my staff members create a binder with the rules, logistics and regulations for submitting claims for medically necessary contact lenses for each of the vision plans we accept. The binder includes billing codes and diagnosis codes. We also have notes about additional requirements, like when a completed prior authorization form needs to be faxed in. We even have mock claims for each vision plan that we can use as a model to follow when submitting claims to reduce the chances of making a mistake.

In the past, we would sometimes find that the process of resubmitting a rejected claim for medically necessary contact lenses was so time-consuming and difficult that we would accept the loss of reimbursement. Now, I have peace of mind knowing we are able to get reimbursed every time for delivering these important services.

Janelle Davison, OD, is the owner of Brilliant Eyes Vision Center in Smyrna, Ga. To contact her:

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