For years, I have said that the profession of optometry is a sleeping giant—if we ever woke up and realized our collective potential, we would be a very formidable force.
Yet our profession, like most, suffers from both macro and micro issues. On the macro side, we are dealing with such issues as national health care reform, board certification and new rules regulating continuing education, scope-of-practice and Medicare.
For most of the profession, though, these big issues go on in the background—we don’t really feel their impact because we’re caught up in the day-to-day problems of our own little world.
Consternation and Angst
But our “little” world of optometry isn’t so little. According to the AOA’s “Caring For The Eyes of America,” optometrists provide the majority of first-time eye care encounters in the U.S., and continue to provide eye care to these patients on an ongoing basis. This evolution has also brought certain issues to bear, such as increasing frequency of audits by both medical and refractive carriers. I hear from many of you that these macro rules concerning coding and compliance, which once seemed so much in the background, are now right in our offices—and causing great consternation and angst.
I travel a great deal, speaking on medical coding and compliance issues all across the country. I’ve had the privilege and pleasure of meeting many of you at one conference or another. With increasing frequency, people introduce themselves to me and thank me for “saving their practice” or for motivating them to incorporate the “medical model” into their practice, saying that it has significantly increased their revenues.
Just yesterday, one doctor said that if it weren’t for me, he would have suffered significantly in last year’s financial downturn. But, because he had incorporated medical eye care into his practice and had learned medical coding, he was able to actually grow his practice, rather than see it decline.
No Substitutes
Our AOA and state associations have done a phenomenal job in not only fighting for us to be primary eye care providers, but also preserving all that we have achieved over the years. But, with these benefits also comes significant responsibility. Keeping the proper perspective is essential: Providing medical eye care is not about making more money. Medical coding is not about making more money. What we do is about one thing and one thing only: Providing the best patient care we are capable of, irrespective of practice modality. Learning how to code properly and getting paid for our intellectual property are simply part of the process and the result of this hard work.
There is never a substitute for taking the time to learn properly and do things correctly. Many audit defenses that I’ve been involved with are the result of practitioners following what they heard in a lecture without getting documentation before putting the process into effect. So, challenge your lecturers, and get references before you follow what they say! There have been many instances where a lecturer may have said something that is false, outdated or simply not applicable where you practice. To make matters worse, rules, regulations and policies change very frequently.
When writing a monthly column, one never knows just how many of you are reading it, let alone implementing the principles discussed. As I am pleasantly discovering, not only are many of you reading—you are doing. So, while the macro issues continue to go on in the background, these micro issues of patient care and medical insurance are what we deal with—but never forget that they are forever and intractably interconnected.
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