Managed Care

The Technology Empowering a 59% Per Patient Revenue Increase During COVID

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By Daniel Sjolund, OD

August 11, 2021

The COVID pandemic made it clear that vision plans were an obstacle to practice success. And our practice was proof: We dropped vision plans during the pandemic and increased per patient revenue 59 percent.

Third-party vision plans can put serious constraints on how you practice and on the level of profitability you are able to attain. Tired of these constraints, our practice found an alternative in a technology that made it possible for us to drop all vision plans while remaining financially strong. That technology is Anagram.

Anagram is a cloud-based web application that provides a streamlined experience for managing vision insurance benefits for all kinds of eyecare providers, including optometrists, opticians and ophthalmologists. It’s as easy for our staff as obtaining the patient’s insurance member information, logging onto Anagram, seeing the patient’s benefits information appear on the screen and creating a claim for the services and product purchases. The process takes no more than around one minute per patient.

A Crisis that Opened Our Eyes
We had already discontinued participation from certain vision plans approximately one year before the pandemic started. Once the COVID shutdown began, and before we reopened our doors, we discovered that our chair cost would be higher than the reimbursements from the remaining vision plans. We developed our own COVID procedures to keep patients and staff safe, which significantly increased the amount of time per encounter. The greater time required per patient meant we were not able to see as many patients each day, making it all the more important to maximize the profitability of each patient visit.

Dropping our lowest reimbursing vision plans was the most logical and fastest way to get to that higher level of profitability. Anagram’s technology allowed our company to become sustainable so we could continue serving patients even during a pandemic. Anagram delivered exactly the results we were looking for: It boosted the profitability of patient encounters and increased transparency for patient costs. Our revenue and net have significantly increased, and we are now able to offer our own optical promotions to boost capture rate.

We retained 35 percent of patients after eliminating the low reimbursing vision plans, and those patients’ time in our office is now mutually beneficial. They receive the quality and service they expect while our team enjoys the simplicity and ability to deliver a competitive offer at any price point.

Despite losing some patients, our total revenue didn’t drop. How? We experienced a 59 percent average increase in per-patient revenue after implementing Anagram and offering high-end products and services patients demand.

Good for the Practice & Good for Patients
Dropping vision plans was not just a sound financial decision for us; it was a great win for our patients. Vision plans dictate significant decisions that you as a provider ideally want to make yourself, such as the lens products you use and which lab makes your patients’ glasses.

Eliminating vision plans allowed us to deliver a consistent experience for patients, in terms of service and quality of products (frames, lenses, contact lenses, etc). Especially during COVID, the quality and turnaround time for vision care plan-contracted labs significantly declined and would have reflected poorly on our business.

Anagram has allowed us to grow by focusing on quality of care and delivering the products and services that solve our patients’ problems. The in-network restrictions made it difficult to deliver a consistent experience for patients, whether it was slow turnaround time from insurance-contracted labs, or inferior-quality “covered” lenses that resulted in the need for troubleshooting.

Taking the Pain Out of a Major Practice Change
Some practice owners shy away from dropping all vision plans because they worry about the loss of patients. However, a technology like Anagram that enables your staff to facilitate patient reimbursement for any vision plan insulates you from some of that loss. We are able to offer our patients care with a promise to painlessly process reimbursements for them, so they don’t need to worry about doing it on their own after they get home.

The remaining plans we dropped all at once since we knew we had previously dropped other plans with minimal impact. Having Anagram as a tool to help the transition certainly accelerated the process and allowed us to continue delivering an in-network experience while eliminating the “middleman.”

Create a More Efficient Practice
Among the downsides of accepting vision plans is the drain on your staff’s time. It takes significant time to verify each patient has insurance before their visit, and then to process each patient’s insurance. It now takes a fraction of the time to look up the patient’s insurance and facilitate reimbursement as it took before we had Anagram to verify and process patient insurance.

With the pressure to keep patients and staff safe with the new COVID protocols, we felt it was a poor use of our employees’ time to spend countless hours billing and deciphering low-paying vision plans. The last thing we needed was a high-volume, low-revenue business model where every encounter would put everyone’s health at risk.

Anagram allows our staff to login to a single location to quickly and accurately discover the patient’s vision care benefits and eliminate errors in interpreting often-confusing in-network benefit sheets. It significantly reduces the complexity and billing time for staff. Even new employees can be quickly trained on how to use the software!

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A Practice-Builder that Changes How We Talk to Patients
A key advantage of Anagram is it changes how you and your staff are able to talk to patients. Knowing you can help facilitate reimbursement for any vision plan means you can send a more welcoming message to your community.

Anagram’s software allowed us to accept new patients by changing the mindset of our team to use inclusive language instead of shutting down conversations with potential patients by telling them we are not in-network for them.

We explain to patients that we are an open-access provider, and that we can look up their benefits. We also explain that we submit claims on their behalf and provide them an estimate of how much their insurance plan will reimburse.

Patients know we are able to welcome them to our practice, and are able to provide the highest level of care, regardless of their insurance plan.

Daniel Sjolund, OD, is a partner with Sunshine Optometry in Valencia, Calif. To contact him: 


*Photo credit: Getty Images

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