October 2023

Sharing Our Best Ideas

From the SNAPP Board

There were a lot of great ideas and conversation at the SNAPP National Meeting in Las Vegas, Nevada, last month.

Licensed operators, doctors and key staff provided each other with encouragement and shared their experiences of what has worked well in their practices.

But some of the most tangible ideas came from the Meet Your Fellow Operators exchanges, where attendees moved from one table to another to discuss key topics such as work/life balance. Here are some of the pearls that came from these discussions.

Achieve better work/life balance

•  Take time off; schedule your personal time.

•  Don’t check emails at home (work will always be there).

•  Trust staff and show associates that they’re valued with small gifts or outings.

•  Create a culture in the office that respects associates’ personal time.

•  Consider a shorter work week or closing on Sundays.

•  Take care to meet your own needs of family time, exercise, nutrition and focus on mental health/self-care activities.

Enhance your leadership

•  Encourage staff members to learn more so that they’re better and more engaged workers.

•  Cross-train staff.

•  Empower the team to solve problems.

•  Delegate, but be available.

•  Share your short- and long-term goals.

•  Be present, even as you’re working “on” the business.

•  Walk the walk. Model the leadership skills you want to see.

Know that selling and service are both essential

•  Pearle Vision locations are both selling organizations and service organizations.

•  The goal of the service organization is to uncover needs, create a plan of care and educate patients.

•  The goal of the selling organization is to provide options, share knowledge and help fulfill the plan of care.

•  Emphasize the “why.”

•  Don’t make assumptions about what patients and customers will or can purchase.

These were just a few of the great discussions we had—in formal sessions and informal conversations over meals, breaks and time we spent together.

Practice-building: Recruiting

Develop a Recruiting Plan

Ken Kopolow, OD, SNAPP board member, has 12 Pearle Vision practice locations to staff. So he and his partner Steve Girisgen, OD, are continually refining their recruiting for ODs to join the practice. A few months ago, they brought on six new graduates (see some of those stories below)—but the process to recruit some of them lasted for more than a year.

“We brought our candidates to Las Vegas and presented them with a strong recruiting deck outlining the core philosophies of the practice, followed by dinner and a great night out enjoying some of what Las Vegas has to offer,” Dr. Kopolow says. The doctors also provided an employment agreement with some financial incentives for signing on. “For students heading into rotations and their final year of school, that can make a difference,” he says. It’s also more effective and less costly than working with a headhunter, he says.

“One of the biggest challenges facing all practitioners and eye care business owners is finding associate doctors. Everyone’s hiring, so we are continually looking for ways to be creative.”

Be Open to Opportunities New Grads Can Bring

Justin Lucido, OD, was no stranger to Kopolow & Girisgen, Pearle Vision operators with 12 locations in Las Vegas, Nevada. In fact, he had started working at the practice as a technician while he was in college in 2015. “I just needed a job that worked with my undergrad studies, but a few months into the work, I realized I loved optometry,” he says. He worked there until he went to optometry school at Southern California College of Optometry (SCCO).

Dr. Lucido

In school, he learned more about the different models of optometry, hearing about corporate-affiliated practices and independent practices. He began to realize that Kopolow & Girisgen, with its size and scale, was a unique model that acted much like an independent practice with the branding power of the corporate affiliation.

During his fourth year at SCCO, he returned to Las Vegas for a rotation at a Veterans Administration site. He reconnected with Ken Kopolow, OD, a SNAPP board member, and Steve Girisgen, OD, to talk about his future. He also attended a Nevada Optometric Association meeting, where he saw how well the two doctors were respected by members and how much they contributed to the profession.

While Dr. Lucido long had the idea that he’d return to this practice as an optometrist, there were criteria that were of primary interest to him.

A well-established location is important. This indicates a steady flow of new patients.

He wanted to pursue his clinical interests. “I’m interested in both pediatric care and specialty contact lenses,” he says. Those two areas certainly overlap, especially in orthokeratology services, a practice area that he is working to foster within the practice. The practice owners knew of his interest in this area and encouraged him to explore where it can go.

He wanted a place where he could grow. “I feel like there’s always opportunity to grow and improve. These doctors have shown me that the sky is the limit, so I feel like I have those opportunities here.”

No Practice Model Young OD Saw During Optometry School Captured the Same Opportunities Her Father Offered

Kara Kopolow, OD, grew up in Kopolow & Girisgen, the practice co-owned by her father, Ken Kopolow, OD. She remembers as a little girl “answering the phone” in the front office as a technician in the back would call in and pretend to be a patient. She worked there as a technician herself between undergraduate and optometry school, and she had made the decision early on to be an optometrist. “I saw how much my father loved going to work and how much he enjoyed working with patients and staff,” she says.

Dr. Kopolow

Once she was in optometry school at Western University of Health Sciences College of Optometry, she became even more drawn to return to this practice. “Working with my father made the most sense,” she says, and that decision was reinforced as she completed her rotations in optometry school. “I introduced three classmates to come learn more about this practice. I wanted them to see the practice, the level of support that optometrists get and how progressive we are with technology,” she says.

To new graduates, that’s important because a practice that has made the investments in technology means a greater likelihood that the young OD can practice to the fullest extent of his or her scope, while also being able to focus on providing a high level of patient care. As a former tech herself, Dr. Kara Kopolow knows how well-trained these associates are. “I hear about young doctors starting cold, and maybe they’re pretesting their own patients or they’re waiting to be able to afford some equipment purchase,” she says.

While she admires their entrepreneurial spirit, for her, being able to dive right into her interests in ocular disease and dry eye treatments was another huge draw. “We have optical coherence tomography and Optos equipment. People who have certain expectations for what they’ll find in a corporate-affiliated practice are definitely surprised by how much technology we utilize,” she says.

Just a few months out of school, she’s already deeply involved in dry eye treatments, and she’s gaining the experience and confidence in managing disease. She works primarily in one practice, although she does spend some time in the others. Dr. Kopolow says that she particularly appreciates the occasional two-doctor days in some locations because that setup provides her with a mentor within easy reach. However, she knows her father will always take her calls, too.

Revenue Cycle Management

Outsourced Billing: Is It for You?

By Joe DeLoach, OD, President and CEO of Practice Compliance Solutions

There is a lot to consider with the decision to outsource billing. Revenue cycle management (RCM) is far more than just filing a claim. The process starts with claim evaluation to reduce the chances of denial, continues with correct claim filing, and concludes with payment processing. 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—consider them all!

The advantages

•  Expertise: Remote billing agents should have years of experience—in eye care.

•  Efficiency and focus: Remote billing agents manage the RCM process. They are not distracted by the other office operations, patients or other employees.

•  Rapid payment: Claims filed accurately and quickly mean you get your money fast.

•  Stability: There’s no “downtime” for insurance processing.

•  Cost: Outsourcing your RCM should save you money.

Potential detours

•  Perceived lack of control: What’s going on? With the right communication protocols, this should never be an issue.

•  Change in systems: RCM companies should require secure communication processes, unrestricted access to high-speed computers in your office, a robust electronic health records system and use of a proven clearinghouse. Extensive HIPAA compliance is essential. These changes may have some front-end costs.

•  Staff sabotage: This is the most common cause of failure in outsourcing. Staff members may feel their jobs are in jeopardy, don’t like change, feel they need to protect the doctor from “these strangers” or simply do not like the decision.

Thinking about outsourcing? Here’s what to look for in a RCM company.

•  Experience: Find someone experienced in eye care billing.

•  Access: Ensure that a company assigns you to one individual to handle your account, not a team of people pointing fingers.

•  Size: If the company is one person or has few billing specialists, you may experience the same issues with instability you have with an in-house biller.

•  Fees: Determine that the RCM company charges based on monies received; you don’t pay them unless money is going into the bank.

•  Claim control: Do they 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 the doctor.

•  Services: What services are included? The RCM process should cover start to finish. Some companies may offer additional services such as credentialing or patient billing but these processes are handled easily in-house and typically come with a significantly higher fee.

•  Outsourcing: RCM management services are in high demand so many companies are outsourcing business to offshore agents. Consider expertise, access and communication problems that may be associated with this outsourcing.

Outsourcing can be an excellent decision for many practices. A good rule to follow: “Concentrate on your expertise and outsource the rest.”

Learn more at www.practicecompliancesolutions.com  or call 844.626.6579.

HR Update From AmCheck

The Importance of Documenting Performance Problems Immediately

While many businesses schedule performance reviews at a particular time of year, it’s important that some level of performance review and feedback is ongoing. When it comes to documenting performance problems, the need to document those issues cannot be overstated—even in at-will employment states. Although this requires meeting with the employee and discussing the issue, which will almost certainly be uncomfortable, it’s your best defense to a wrongful termination claim should the employee feel litigious after termination.

Addressing performance and behavioral issues as they arise will improve performance and behavior. There are a few basic principles working in your favor when you commit to the mantra of “don’t delay, manage today.” Here are just a few.

1. If they don’t know they’re doing something wrong, they can’t fix it. A huge number of employees don’t realize their performance or behavior is a problem—or that it’s as bad as it is—until they are being handed their pink slip. Talking to them about it will likely lead to you having a better employee and reducing hefty turnover costs

2. No one likes being in trouble. If you talk to an employee about an issue and they understand that failure to improve will result in another talking to, they are likely to shape up. If they are impervious to discipline, then addressing issues early and often will help you shepherd them out the door more quickly, so you can replace them with someone better.

3. Documentation makes it real for the employee. It’s easy to brush off a quick, oral scolding.

4. Other employees will catch on. Consistency is key. If you only haul in employees sporadically for failing to meet expectations, you won’t reap the benefits of a culture of accountability.

Ultimately, talking to employees and making a paper trail will serve you both during employment—by encouraging better performance and reducing turnover costs—and after, should they threaten to sue.

News of Interest

Exploring the Connection Between Vision and Mental Health

“Loss of vision—whether it happens suddenly or over time—can have a major impact on one’s mental and emotional health given its significant role in interpersonal connection and relationships, engaging in hobbies or interests, employment status, independently managing one’s daily activities, maintaining independence and remaining physically active,” said Julie Grutzmacher, MSW, MPH, director of patient advocacy and population health initiatives at Prevent Blindness.

Prevent Blindness created a mental health taskforce last year to explore this topic. Read more here.

November Is American Diabetes Month

November is American Diabetes Month. According to the Centers for Disease Control and Prevention (CDC), almost 29 million Americans have been diagnosed with diabetes, with an estimated additional 8.5 million people who have diabetes and have not yet been diagnosed.

With the increased risk of eye complications in diabetic patients, here are some resources for your patients:

• The American Diabetes Association: Tools & Resources
• The CDC: Take Charge of Your Diabetes
• The National Institute of Diabetes and Digestive and Kidney Diseases, which has graphics that you can download

New Strategy for Wet AMD Could Replace Injections With Eye Drops

The University of Illinois-Chicago (UIC) has developed a compound that could replace injections with eye drops for those affected with wet age-related macular degeneration (AMD). A paper in Cell Reports Medicine led by UIC researcher Yulia Komarova found that small-molecule inhibitors can reverse AMD damage and promote healing. Read more here.

Vision Expo East Moves to Florida in 2025

After 38 years in New York City, Vision Expo East will permanently relocate to Orlando, Florida, for the February 19–22, 2025 show, The Vision Council and RX, co-owners of Vision Expo, announced.

Vision Expo East’s final show in New York is scheduled for March 14–17, 2024. Read more here.

Getty Images photo credits—billing: AndreyPopov; diabetes: sabelskaya; eyedrop: BananaStock; ideas: DrAfter123; mental health: Juanmonino; performance: Rawf8; and recruiting: wildpixel

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Visit snappgroup.org to learn more about SNAPP.