February 2023

The Ideas Keep Coming

From the SNAPP Board

In January’s issue of the SNAPP Insider, we looked closely at the office remodel done by Lisa Hamilton, OD. The “before and after” images were very impactful.

It’s important to realize there’s not always a strong correlation between the potential positive impact of an idea and its cost. Think of some minor modifications you’ve made in the past that resulted in immediate increases in top- or bottom-line revenues and cost very little to implement. For 2023’s Case Study segments within SNAPP Insider, we’ll be asking our members and readers to provide the great ideas! While we understand some projects will take more financial planning than others, the series will highlight the small, medium and larger changes that have provided success at any level.

If you have something to share, email Dr. Hamilton and someone from our editorial team will reach out to you so that other SNAPP members can determine if your great idea could be their next great idea.

Case Study

SNAPP and SnappGroupMasterminds Have Been Key to Many Recent Successes

Milissa Stone, Licensed Operator (LO), at Pearle Vision in Grand Junction, Colorado, says she’s gained so much confidence in her business decisions since becoming a SNAPP member. In fact, she’s also active on the SNAPP Board, and she loves where SNAPP has been and where it may be going.

Milissa Stone

“I’ve changed so much as a result of my involvement in SNAPP,” she says. “I’ve gone from working 9-5 on the retail floor or covering the front desk to almost entirely pulling myself away from that and working on the business.”

And…it was due to encouragement from SNAPP members that she moved her Pearle Vision Eye Care Center out of a rental space, bought a building—half of which she leases to a dermatologist—and reaped the benefits of having moved from renting 1,500 square feet to owning a building with 7,000 square feet.


As helpful as SNAPP National Meetings have been, Stone says that she recently has gained even more benefits by becoming part of the SnappGroupMasterminds. Group participants enroll, pay an annual fee and meet four times a year—at least one or two of those in person. The advantage is that the group dives deep into both tangible and intangible aspects of their businesses.

For example, the first group held a Shark Tank-like event during which people presented their best business ideas in a creative format modeled after the popular TV show of the same name. “The idea exchange was amazing, and these LOs and doctors were sharing an enormous amount of experience about how to operate a business and what drives revenue in their locations,” she says.

A key takeaway for Stone was to shift an employee’s role each day to focus exclusively on customer care. “Now that I’m not working on the floor each day but can view the practice, I could see that when we have five people on the floor, about four of them are regularly busy. So I thought I would start rotating one person a day out of his/her regular retail floor duties and move them into this customer care role, which involves greeting patients, explaining any expected wait times, answering questions and making sure they leave without unanswered questions.”

This move has already proven to increase patient satisfaction, flow and even revenues. Patients feel seen and heard and make a personal connection with someone immediately.

The staff members have also enjoyed the change in routine. Hearing more directly from patients about what’s confusing in the process or what they don’t understand also encourages the employees to take greater ownership of the patient experience.

Proof in the metrics

While Stone is happy to share the ideas that work for her, she’s also competitive about her own performance. Some of the participants in the SnappGroupMasterminds typically rank higher than she does in the company’s high-performing operators listing. “My eye care center had seemingly plateaued at #19 for quite some time. It was like I couldn’t get out of my own way to push it higher,” she says. But listening to the other SnappGroupMasterminds participants and analyzing their data has helped her identify opportunities in her pricing strategy. In fact, changing her fees and system for collecting co-pays has catapulted her practice to #5 on the company’s list.

“We are not in competition with each other locally, so SnappGroupMasterminds members are open to sharing the details. We can learn so much from how other people do this, and with the year-long SnappGroupMasterminds program, we have the time to really get to share these best ideas,” she says.

Stone remembers becoming a new LO and how intimidated she felt. She took over the franchise in 2005; she had been working in that location as an optician since 1992. “I’m not a doctor-owner. I have one store. I thought I was limited. But once I began to surround myself with people who perform better than I did, my performance improved,” she says. Plus, the more she dared try new strategies in her office, the more she had to share with others in the network.

The next SNAPP Mastermind group will be forming soon. To learn more about becoming a member of an intimate group dedicated to improving the business, contact Dr. Lisa Hamilton.

Billing Tip of the Month from VisionWeb

Modifiers… Why Do We Need Them?

By Amanda Whitener,
Revenue Cycle Management Team at VisionWeb

Modifiers. What are they, and why do we need them? Well, in short, we need them to get paid correctly. Appropriately placed modifiers can mean the difference between a large payment or a little payment or even a payment at all. Insurance carriers use modifiers to determine elements like these:

• Which eye procedure/testing was performed on or if it was performed on both

• If a certain procedure is included or separate and distinct from another

• If multiple procedures were performed on the same day

• If the provider recognizes the procedure as one for which Medicare doesn’t allow payment

All the indicators above financially impact a practice. For example, if a procedure was performed bilaterally but is typically unilateral in nature, then not using a modifier to indicate it was performed bilaterally can result in a reduction in payment. Additionally, even if the payer does submit payment, an audit could take it back later.

Below are some frequently used modifiers as well as their description.

RT/LT—Right side or left side

GY—Provider is aware the service is excluded by Medicare

24—When a patient has an office visit that is separate from another service but is within the global period of that service; used to unbundle a separate and distinct service from a service within a global period

25—When a patient has an office visit that is separate from a procedure performed on the same day; the intention is to unbundle the codes; however, the decision to do so depends on the payer and diagnosis

50—Bilateral procedure; used when a procedure is performed on both eyes

52—Reduced services; primarily used when reporting a screening only for Fundus photography to vision payers

54—Indicates surgery portion only; used on the surgery portion of co-managed claims

55—Indicates post-op care only; used on the post-op portion of co-managed claims

79—Identifies procedures with their own global period being rendered during another procedure’s global period; used to unbundle payment for two separate and distinct procedures with their own global periods

Keep in mind that it is important to only use modifiers that indicate what truly took place. Using modifiers to simply increase reimbursement is illegal, and that sort of audit could be devastating to a practice.

In addition to those above, there are several other modifiers that are pertinent to the optometric space. Familiarizing yourself can definitely help decrease denials and increase reimbursement.

Reach out to the VisionWeb team with any billing questions you have at this link; we might have the solution for you.

HR Update from Amcheck

Promoting From Within

We recently had an open position that two employees were interested in. We’ve made our selection, and our chosen employee accepted the role. How do we tell the other employee they were not selected?

We recommend having a face-to-face conversation with the employee who wasn’t selected to let them know that someone else was selected for the role.

If you elaborate on your decision not to select this employee for the position, keep the feedback honest and factual. For example, you could let them know that you went with the candidate whose skills more closely match what you were looking for, specifying what those skills are so that the candidate knows what to work on in the future. Factual, job-related feedback like this helps set up the candidate for future success and encourages them to accept, rather than dispute, the decision. Overall, it creates a better experience for everyone.

Assuming you want to keep this employee, you may want to prepare to have a short conversation about their career trajectory, what they could apply for in the future, or how they can grow their skills. They will be understandably frustrated. The feedback will help to foster a more positive and productive conversation about their next career step with the organization.

This Q&A does not constitute legal advice and does not address state or local laws.

News of Interest

Pseudomonas Alert in EzriCare Artificial Tears; Company Advises Discontinuing Use

The Centers for Disease Control and Prevention issued a Health Alert Network advisory on Feb. 1, after 55 people in 12 states reported developing Pseudomonas aeruginosa from using artificial tears.

On the same day, EzriCare issued a statement recommending that patients discontinue the use of EzriCare Artificial Tears until more information is available. Read more here.

Chill Out… Seriously

A November 2022 study found that in mouse eyes, stress, such as intraocular pressure elevation in the eye, causes retinal tissue to undergo epigenetic and transcriptional changes similar to natural aging.

And in young retinal tissue, repetitive stress induces features of accelerated aging including the accelerated epigenetic age, found the researchers at University of California, Irvine. Read more here.

Prevent Blindness Provides Free Resources for AMD Low Vision Awareness Month

February is Age-related Macular Degeneration (AMD) and Low Vision Awareness Month, and Prevent Blindness, the nation’s leading eye health and safety nonprofit organization, is offering free resources to the public to help educate and empower individuals, and their care partners, to make informed decisions about their vision and eye health.

According to recent data, more than 19 million Americans ages 40 and older were estimated to be living with AMD in 2019. Prevalence of AMD increases with age. Among persons ages 80 and older, approximately 3-in-10 have early AMD, and approximately 1-in-10 have the vision-threatening late form. Learn more here.

Getty Images photo credits—eye: PeopleImages; eyedrop: Jrgen_Hopf_EyeEm; modifiers: bagotaj; and promotion: fizkes

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