Practice Management

Specialized Care + Patient Financing = Thriving Despite a Pandemic

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By Miki Lyn Zilnicki, OD, FCOVD,
and Jessica Licausi, OD, FAAO, FCOVD

This article is part of the six-part series, “Insights to Impact.” Articles in this series detail the insights that 2020 taught optometry and how those insights translate to actions that are having a positive impact on the profession.

Oct. 27, 2021

Surviving a pandemic while remaining financially strong takes many things. Offering services patients can’t find at most other nearby practices, such as vision therapy, helps, and so does offering patient financing. Here is how our vision therapy-focused practice provides care that serves as a practice differentiator while making our services more accessible to our patients by offering patient financing with CareCredit.

Set Your Practice Apart & Build Strength to Survive the Hard Times
Having a niche like vision therapy gives you the chance to build financial strength by providing patients with in-demand services that are not available on every corner. That competitive advantage will hold you in good stead when hard times, like the pandemic we continue to live through, arrive.

The traditional approach to practice management was to accept as many insurances as possible so your patient pool would grow as large as possible. Adopting a non-traditional model of a specialized, limited-insurance practice can feel intimidating. However, we knew the value of the vision therapy that we were bringing to our area, and knew if we conveyed our belief in our services to our patients, that we could conquer this barrier.

Being a specialized care practice gives us a huge advantage in the current optometric climate. So many other optometric services are impacted by decreasing reimbursements or the ease of obtaining materials online. We have found a way to eliminate both of these factors from our practice. Our patients cannot obtain the services that we provide online or from neighboring practices/opticals.

5 Insights to Impact

Differentiate Your Practice. Specialized services give you the chance to build financial strength by providing patients with in-demand services that are not available on every corner. That competitive advantage will sustain you when crises, like a pandemic, hit. 

Grow Doctor Referrals. Communities come together when hard times arrive. A specialized service gives you a chance to build a network with other healthcare practices for mutual referrals of patients for care.

Provide In-Demand Care in a Crisis. Specialized care can become within reach of patients with financing options that help patients balance payment of your services with other financial commitments.

Show Patients You Are On Their Side. It can feel in a difficult time like the pandemic that everything is against you. When a practice offers a manageable way to receive care, by offering financing of payment, patients see that you want to help them.

Become More Resilient By Adding Patient-Pay Services. A practice that is not reliant on the often low reimbursements from insurance providers is a practice that is able to build financial strength to withstand challenging times.

Build Referrals from Other Healthcare Practices
By creating this niche, we have built a profitable and sustainable practice model within our heavily saturated optometric community on Long Island, N.Y. Additionally, our services have caught the eye (pun intended!) of our medical community; specifically our local neurology group, pediatricians, a neuro-ophthalmologist and a concussion group. Having them as our primary referral sources gives patients a vote of confidence in our skill level and the services we provide. We foresee this more unique model of practicing becoming the sustainable future of optometry.

Bring Much-Needed Services to Patients During a Challenging Time
Vision therapy is not a well-covered service. Most commercial insurance companies do not recognize the associated CPT codes within their plans. The few insurances that will pay for vision therapy appear to be lowering reimbursement rates or placing restrictions on the length of treatment.

Following our vision therapy evaluation, we write a comprehensive report and send a payment program breakdown to the patient, which details all of their payment options. Patients can opt to pay for vision therapy sessions, re-evaluations and maintenance equipment separately as they progress through their therapy program. We also offer a bundled service option in which patients can either pay for the whole program or half of their program upfront and receive a discount off the total cost.

The CareCredit credit card is part of the financial conversation with every private pay vision therapy case. We present the option of financing the whole vision therapy program in both our conversation with the patient and in our program fee explanation. We go over the ease of using the CareCredit website and application process and try to encourage patients to use CareCredit, as we offer no interest if paid in full within 6 or 12 months to our patients with qualifying purchases of $200 or more. Over the years, CareCredit utilization in our practice has varied from 5-15 percent.

Show Patients You’re On Their Side in a Crisis While Growing Revenues
In other medical fields, patients pay out-of-pocket for specialty services, and optometry can be no different! You must become comfortable navigating conversations with patients about cost when the insurance option is taken out of the equation. This can be especially challenging during a public crisis like the pandemic.

Offering the CareCredit credit card allows us to frame patient perception. If we don’t accept their insurance, we at least can show patients we are on their side when we offer options for them to make our services as affordable as possible.

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Using the higher end of our past CareCredit utilization of 15 percent of vision therapy patient population, and our average vision therapy program cost, offering CareCredit accounts for approximately $27,000 per year in vision therapy revenue.

Freedom from Insurance Reimbursements Creates a More Resilient Practice
Practices that are more traditional that accept every insurance may be high volume, but are likely low profit or the doctor may be at risk for burning out quickly under the pressure of a high-volume practice. We feel strongly that having specialty services is the only way for independent optometry to survive. It doesn’t have to be vision therapy. It could be myopia management, dry eye or even aesthetic optometry, but it has to be something that creates a niche within your community.

These services are often not covered by insurances, so financing with the CareCredit credit card gives patients a viable way to pay for this much-needed care.

Left to right: Jessica Licausi, OD, FAAO, FCOVD, and Miki Lyn Zilnicki, OD, FCOVD

Miki Lyn Zilnicki, OD, FCOVD, and Jessica Licausi, OD, FAAO, FCOVD, are co-owners of Twin Forks Optometry and Vision Therapy in Riverhead, NY.

To contact Dr. Zilnicki:
To contact Dr. Licausi:


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This content is subject to change without notice and offered for informational use only. You are urged to consult with your individual business, financial, legal, tax and/or other advisors and/or medical providers with respect to any information presented. Synchrony and any of its affiliates, including CareCredit, (collectively, “Synchrony”) makes no representations or warranties regarding this content and accept no liability for any loss or harm arising from the use of the information provided. All statements and opinions in this article are the sole opinions of the author. Your receipt of this material constitutes your acceptance of these terms and conditions.

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