January 2023

Bring Forward Your Best Ideas

From the SNAPP Board

One of the biggest reasons SNAPP members enjoy National Meetings is that they can interact with colleagues and hear how changes in their practice have made a difference. So, we’re bringing some of that “deep dive” into issues of the SNAPP Insider monthly newsletters.

We kick off with a look at how Board President Lisa Hamilton, OD, used the opportunity of a much-needed remodel to go big—literally.

While Dr. Hamilton’s expansion was expensive and time-consuming, we know that small modifications can also create significant change. If you’ve adapted your intake or hand-off process, or if you’ve found a better way to preappoint or verify insurance, your colleagues would love to hear about it. Many of us face common stress points, so if a change has helped you, it may well help another Pearle professional.

If you would like to be interviewed briefly for an upcoming issue, let us know—and one of our editorial team members will reach out to you.

Case Study

A Remodel Doubles Space and Creates Efficiency

When Lisa Hamilton, OD, signed her 10-year Franchise Agreement with Pearle Vision for a practice in Centennial, Colorado, the eye care center opened in full alignment with then-current design guidelines. But in the ensuing 10 years, Dr. Hamilton’s interest and practice grew beyond the space she had.

Dr. Hamilton

When it was time to renew the agreement, it was also time to remodel the office to maintain brand standards. While many of those upgrades were relatively simple—updated signage and new flooring, for example—those types of cosmetic improvements would not address the core issue of office capacity, says Bobby Hamilton, manager, and Dr. Hamilton’s husband.

As it turned out, the space adjacent to the facility was available, and so the couple chose to expand their office by acquiring the additional space, essentially doubling the size of their clinic. “By knocking down that wall, we added 1,300 square feet to our current 1,900-square-foot space. When we built out originally, the recommendation for optimal size was 2,000 square feet,” he says. That gave them space for two exam lanes, a small finishing lab, a small pretest area and a break room. But bottlenecks occurred regularly, especially in the pretest area and at the front desk. “If we had five people in the front, it felt crowded,” Bobby Hamilton says.

In addition, Dr. Hamilton had begun to build a dry eye practice. In mile-high Colorado, three-quarters of the residents are dehydrated, and even patients who are motivated to wear contact lenses sometimes struggle with the dry environment. Bobby Hamilton says that the small space he used for his office was retooled to be the dry eye facility, but those new services contributed to the bottlenecking even more.

After months of working through construction,
the doctors, staff and patients are happy to have more space.

The New Space

The remodel took about five months in early 2022. Because the space next door was empty, the remodel could begin without impacting the current office flow, so the practice remained open throughout the process. It wasn’t easy when main walls had to come down, but doctors and staff made the best of it.

The new space has four exam lanes, double the number of the old space. The fourth exam lane is the dry eye center and has a more spa-like feel—a spa chair instead of a traditional exam chair, different lighting and different music. But it can be used for exams as well if the space is needed.

The pretest room is larger and can accommodate two patients at once, if necessary, and a second, smaller specialty pretest room was added for dark adaptation, dry eye testing and visual fields testing. “Now specialty pretesting doesn’t interrupt the flow,” he says. The finishing lab is twice the size of the old one, and the space allowed for a second bathroom.

The retail floor is also larger so the practice can carry a bigger selection of frames. “It’s a much better experience for people when they walk in. There’s no sense that they’re entering a crowded space and it’s going to take a long time before they’re seen by the doctor,” he says.

With better flow for pretesting and more exam lanes, the office is far more efficient. Technicians can pretest and escort patients to different exam lanes so the doctor can move smoothly from one to the next. As a result, they can schedule three patients comfortably per hour, with room for a fourth contact lens check or follow-up visit. On double-doctor days, the practice schedules up to six patients an hour.

Not only has it become a beautiful space, but it’s also much more comfortable. Patients and staff have room to breathe, and it feels less hurried. Plus, Dr. Hamilton has been able to work on building the dry eye practice, which has also contributed to the overall contact lens component of the practice.

Expert Advice

Is This the Year to Outsource Your Billing?

Revenue cycle management (RCM) is far more than just filing a claim. The RCM process starts with claim evaluation to reduce the chances of denial, continues with correct claim filing and concludes with payment processing. These are the more automated RCM functions. The most important job of an RCM specialist is making sure every claim is paid to the fullest extent possible. Let’s look at the pros and cons of remote billing.


• Expertise. A remote billing service can provide billing agents with years of experience, often compounded by the fact it is what they do day in and day out. That also aids efficiency and stability.

• Rapid payment. A razor focus on getting claims filed accurately and quickly means you get your money quickly.

• Workflow. Good employees are hard to come by, especially these days. Transitioning functions that can be better outsourced can free up existing employees to transition to other practice needs.

• Cost. Due to all the above reasons, outsourcing your insurance billing process usually saves money. Industry standards estimate most practices spend about 8% of collected monies on the RCM process, and the process can be slower than it needs to be.


• Perceived lack of control. With the work being done at the end of an internet stream offsite, it can seem like you lose some control over the process. This is usually resolved by excellent communication between the office and the remote billing agent.

• Change. Outsourcing office functions will definitely create a different workflow. If employees are transitioned from insurance functions to other responsibilities, they may experience some uneasiness with change (they also may be overjoyed!). There may also be some front-end costs to changing to different systems that might be required.

• Staff sabotage. This is definitely one of the most common causes of failure in outsourcing RCM management. Staff members may feel their jobs are in jeopardy, feel they need to protect the doctor from these strangers or simply not like the decision. Management must make sure the employees understand the benefits and the fact it does not impact their job security.

So, you’re thinking about outsourcing your RCM. What should you look for in an RCM company?

• Experience. Who heads the company? Are the billing agents experienced in eye care billing or spend most of their day billing cardiovascular surgery?

• Access. Whom do you contact for questions? Consider a company that assigns you to one individual to handle your account, not a team of people.

• Size. If the company is one or only a few individuals, you may experience the same issues with stability you have with an individual in-house agent.

• Fees. How are you charged? Is it per claim? Per hour? Look for a company that charges you based on monies received—you don’t pay the company unless money is going into the bank.

• Claim control. Is the RCM company allowed to adjust or change procedures, diagnoses or medical records without approval from the attending physician? All of these liberties should not be granted to anyone except at the direction of the doctor.

• Services. What services are included? The RCM process should be start to finish—claim filed to ALL the money in the bank. Some companies may offer additional services such as credentialing or patient billing, but these processes that are handled easily in-house typically come with a higher fee.

• Offshore outsourcing. With the high demand for RCM management services, some companies are outsourcing business to offshore agents. Consider expertise, access and communication problems that may be associated with this process.

Learn more at www.practicecompliancesolutions.com.

HR Update from Amcheck

Four Things Employers Should Know About Pay Transparency

There’s a pretty good chance that employees discuss their pay with their colleagues. People on the lookout for a new opportunity want to see pay ranges on job postings, and some of them make it a practice not to apply if that information isn’t immediately available. Employees want more clarity about their own pay and how it stacks up relative to their peers, and in a tight labor market, they may hit the road or expend less effort at work if they don’t feel they’re paid fairly. In some areas, pay transparency is becoming the law. Here are four things you should understand.

1. Pay transparency is the next frontier of pay equity. The federal Equal Pay Act went into effect in 1963, but the laws weren’t strong enough, and they didn’t account for all the causes of unequal pay. For example, it’s not that employers have deliberately chosen to pay women less than men for the same jobs. In many cases, the basis for pay differentials has seemed sensible, such as salary history. But it turns out that basing pay on salary history perpetuates discrimination over an employee’s career. Mindful of these facts, cities and states across the country have instituted salary history bans and implemented other legal measures to strengthen pay equality. Pay transparency laws are part of this trend.

2. Pay transparency laws and practices encourage employees to talk about their pay. Once pay ranges are visible on job postings, everyone from job hunters to competitors to current employees can see how their own pay compares to the range offered. That information is useful to job seekers considering whether to apply and how much that type of job pays in the current market. It’s useful to competitors who may try to poach talent. And it’s useful to employees who may wonder whether they’re paid equitably for their work.

3. Employees have a legal right to discuss their pay. That’s right. You may have heard about companies telling their employees not to share how much they make. Or you may have done that yourself. However, under federal law, employers may not prohibit nonsupervisory employees from discussing their wages with one another. Likewise, employers may not in any way discipline or retaliate against an employee for discussing their wages or other terms and conditions of employment. We strongly recommend that employers immediately eliminate any written or unwritten policy telling employees that discussion of wages is discouraged or prohibited or that wages are confidential. Also, discontinue any written or unwritten policy of disciplining or terminating employees for this behavior.

4. Pay transparency can be good for business. Being open about pay is ultimately a boon for employers and employees alike. First, it saves everyone time and the company money. By disclosing compensation up front, employers discourage some people from ever applying. Second, pay transparency on job postings has been shown to increase the number of applicants significantly. Many job seekers are unwilling to apply for positions that don’t indicate a range, and others will value the transparency for what it says about your organization. In a tight labor market like we’re experiencing now, employers should take any leg up they can get. Third, it encourages, and makes it easier for, organizations to comply with equal pay laws. You can’t as easily put pay equity on the back burner when pay ranges are front and center.

News of Interest

A Clearer Prediction of the Market

The inaugural Market inSights 2022 Report estimates that the overall size of the U.S. optical retail industry was $76.5 billion as compared to $76.09 billion for 2021, according to an announcement from The Vision Council. Both the 2021 and 2022 figures use the new methodology associated with The Vision Council’s Market inSights Report. The inSights report utilizes new data sources, advanced analytics and rigorous methodology to present a summary of the vision care industry from 2019 to 2022, as well as a forecast for 2023. Detailed demographic data is also available in a special Market inSights+ edition. Read the whole story here.

Progressive Lenses Take a Lead

The worldwide progressive lenses industry is expected to reach $38.6 billion by 2027. The demand for eye care products in the global progressive lenses market is continually increasing with the growing prevalence of visual dysfunctions in developed and developing countries.

The study cites computer vision syndrome, technological advancements, the rise of e-commerce as a preferred distribution channel, the revolution of 3D printed progressive lenses and an aging population as factors. Read more here.

Get Up and Move

Breaking up sedentary time behind a desk by taking a five-minute stroll every half hour was the optimal break from being seated to improve cardiometabolic and mental health, results of a small cross-over study show.

“We set out to figure out what’s the bare minimum someone has to do in terms of movement” to counteract the harmful effects of sitting too much, according to senior author Keith M. Diaz, PhD. Read the report from Medscape Medical News here.

Getty Images photo credits—billing: shapecharge; ideas: chaiyapruek2520; lenses: peshkov; transparency: mgkaya; and walking: Sunchai_Borahem_EyeEm

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