The SNAPP Insider monthly newsletter recognizes SNAPP members every month. Let’s take a quick look back.

January: Stacy Mazzarella and Carmine Mazzarella reflect on winning the Dr. Stanley Pearle Award.

February: Lisa Hamilton, OD, introduces Tear-based Point-of-Care Quantitative Testing Platform to her practice, and Jared Noble launches Arrellio.

March: Marjan Valenzuela guides patients through visits with a 20/20NOW-affiliated doctor in the Winter Park, Florida, Pearle location she manages.

April: Milissa Stone explains how getting herself out of the office helps bring new patients in with these outreach tips.

May: Ken Kopolow, OD, secretary/treasurer of the Nevada Optometric Association, who won the 2024 State Advocacy Award from the AOA, details the many critical legislative initiatives affecting eye care.

June: Peter Cass, OD, of Practice Compliance Solutions, shares smart tips on how to create compelling social media content while staying in the safe zone.

July: Our friends at HR agency AmCheck walk us through the steps to take when a job candidate says they have a disability. The HELIX team reiterates three steps for preparing for the back-to-school rush, which could be applicable at the busy year-end season, too.

August: New Licensed Operator and SNAPP member Arlandis Word talks about the learning curve that comes with switching from software engineering into the eye care world and the support he got from Pearle Vision and SNAPP.

September: Anthony Perry, OD, and practice manager Courtney Beatty saw an immediate impact when they added a patient financing option through Sunbit. And general manager Terry Murphy, of a three-location practice in Nebraska, developed a process to keep callbacks from falling through the cracks.

October: Lori Feezor-Ribble, OD, and Ben Ribble found a way to relieve some of the strain of a very busy schedule through the 20/20NOW virtual platform.

November: Andrew Ladochi uses inexpensive but high-impact custom products to make sure his patients and customers keep the practice front of mind.

We’re already excited about the range of stories we’ll be able to bring you next year. Feel free to reach out to us to share what’s working well in your practice. We would love to feature more of your stories in 2025.

After graduating from the University of Houston College of Optometry in 2007, Dr. Gorman completed a residency in ocular disease at Omni Eye. From there, she explored various career paths, including private practice and opening a LASIK center. “I spent five years in a high-volume LASIK setting, but by 2015, I wanted to slow down and focus on something more sustainable,” she explains.

Her next move was influenced by her husband, who researched opportunities with optical franchises. “Pearle Vision stood out because they made it easy to get started,” she says. “They had people in place to guide us through the early stages and beyond.”

She particularly credits SNAPP member Nadia Sledge, OD, who has served as a mentor to her.

Opening at COVID onset

Dr. Gorman opened the practice just five months before COVID-19 upended the world. Despite the challenges, they focused on providing exceptional service. “When we first opened, we knew we needed to differentiate ourselves,” Dr. Gorman recalls. “We looked at reviews for other practices and noticed most were middling—patients would say the doctor was good, but nothing stood out. We decided to aim for five-star customer service.”

Her husband’s role as the practice’s greeter helps set the tone. “He connects with patients as soon as they walk in—offering water, asking about their day,” she says. “In the exam room, I make time to talk with patients. They tell me no one has ever given them that kind of attention before.”

That personal connection has paid off in loyal patients and glowing reviews. The practice serves a diverse demographic, ranging from value-driven Walmart shoppers to higher-income residents from the Heights area. “Even patients who don’t spend a lot still value our service and come back every year,” she says. “We focus on educating them about the quality of the products we offer and the value of our expertise.”

Although nearly 90% of the care she provides is primarily focused on refractive services, she is comfortable co-managing medical cases. With limited space for advanced diagnostic technology, expanding into more medical care is a long-term goal, along with potentially opening additional locations.

“Nate is encouraging me to grow,” she says. “I can own up to three practices, and we’re considering adding a CFO to help run things when the time comes to add a second or third. But for now, we’re focusing on making this practice the best it can be.”

Dr. Gorman attended her first SNAPP meeting in Las Vegas, Nevada, in 2024. Talking with vendors, expert speakers and colleagues helped her find reassurance that her practice was on the right track. “Owning a business isn’t easy,” she says. “But with dedication and a focus on service, it’s incredibly rewarding.”

Q: It was revealed that employed doctors can be liable for their own actions. Does that mean if they code for services in a wasteful or fraudulent manner the examining doctor is liable and the practice owner is off the hook?

A: Not so fast. The attending physician is always liable for their actions as an employee related to compliance and definitely is responsible for every insurance claim submission with their name as the attending physician. The practice owner can and will be held liable if they are not in compliance with the applicable health care compliance laws, which would include holding their employed doctors to legal standards.

Q: You talked about using nonsense statements as passwords. What if a software program protocol still follows the old “eight characters, upper and lower case with a special character and number” protocol and will only use passwords generated by that protocol?

A: You should make every attempt to use a complex password system–the best being randomly generated, nonsense statements. If you are forced to use outdated protocols to make software work, you really have no choice. The software vendor mandate would likely be your defense in the event of a breach, but there are no guarantees the court will agree.

Q: You talked about remote workers. Explain again what the “employer of record” means.

A: If you personally employ an individual (employee or contract labor) in a country outside the U.S., you are liable as an employer to abide by the employee's HR laws in their country. That is a dangerous decision in our opinion. It is better to work with a company where the remote worker works directly for that company. As the “employer of record,” the company is responsible for all legal issues related to the individual’s employment. You are essentially “leasing” the employee from the employer of record.

Q: Our employee manual says employees cannot talk about what we pay them with other employees. We recently fired an employee for doing this, and it is causing a great deal of trouble for the practice. How is it legal for them to openly talk about their pay?

A: It is legal because that is what the law allows. The law, under the Equal Employment Opportunity Commission, has been in place for decades. Firing an employee over this issue would be an indefensible wrongful termination.

Q: You said I cannot use my current router provided to me at no charge by my internet provider? Did HIPAA change the law here?

A: The Office of Civil Rights has not enacted exact wording in the law to change what it considers “reasonable attempts” to protect patient information. Recent court cases have been based on the court considering business class routers and computer company built-in firewalls and the like to be “not reasonable.” The courts concluded the expense for high-level security systems was not an unreasonable expense for health care operators.

Q: Explain the minimum salary in the decision to pay an employee on a salaried basis.

A: To be classified as a salaried employee, you must pass both the Salaries Test and the Duties Test. The minimum salary for consideration was recently increased to just under $59K a year (about $28.50 an hour). That standard must be met before attempting to qualify for the Duties exemption.

Q: Is the Corporate Transparency Act still in effect?

A: At the meeting, we said it was. Compliance laws change quickly. On December 4, 2024, a federal court in Texas overturned the law. So it is currently NOT in effect.

Q: You said we should attempt to accommodate service animals. How can I know for sure the patient has a real service animal?

A: Essentially you cannot. The service vest can be purchased online with no documentation that it is for a real service animal. You cannot demand documentation that the animal is a certified service animal. You can ask the patient what particular service the animal provides to them. Beyond that, it is fairly easy for someone to scam you.

Q: You stated that everyone should consider boosting the medical care aspects of their practice because vision care reimbursement is going down. Don’t you think the American Optometric Association and other pressures will make them start reimbursing us in a reasonable way for exams and eyeglasses?

A: No—next question.

With that, you’ll have to wait until the next installment to read more billing and compliance questions and answers. Visit PCS here.

Q: An employee called out a few days ago by leaving a message with some vague information about being ill and hasn’t followed up since. Can we consider this a voluntary resignation and start the termination process?

A: Most likely not. There are many reasons why your employee might not have been in contact since leaving the original message, and since they mentioned illness, there’s a good chance their absence is protected by law. Potential protections come from the federal Family and Medical Leave Act (FMLA) and Americans with Disabilities Act (ADA), state-level family and medical leaves and disability protections, state or local sick leave laws and state-paid leave programs that come with job protections.

Even if you have a job abandonment policy that says an employee will be treated as having voluntarily resigned after a certain number of days, this is not the time to use it. Since you know the absence started with a reason that may have protections and you did receive a call on the first day, it will be safest to hold off until you have more information.

We recommend trying a variety of ways to contact the employee to find out more about why they haven’t been at work and when they expect to return. Try calling, texting and emailing, and if all that fails, send a certified letter. Document all attempts to reach the employee. If after an extended absence with no successful contact you decide to proceed with termination, detail your efforts to reach them in that communication. Be aware that if they finally do respond with an explanation that appears to be protected by law, you may ultimately need to restore them to their position.

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

Photo credits—Getty images: look back at 2024: Debalina Ghosh; spotlight: bankrx; questions: akinbostanci; out sick: Zinkevych; news 1: MF3d; news 2: STANDRETT; news 3: Memorystockphoto