Optometry Coding & Billing Alert

Published on Thu Dec 08, 2016 PDF

Make no mistake — your scheduling strategies can make or break your bottom line. (See related article p. 93.) That’s why you occasionally need to step back to make sure your assumptions about scheduling are right for your practice right now.

In the old days, practice management experts used to advise optometry practices to book months in advance. To guard against no-shows, practices would schedule more patients than they could see. If everyone happened to show up — well, someone would just have to wait.

As “the patient experience” becomes one criteria for the new value-based payment systems, it may be time to leave those old scheduling systems behind so that your practice reduces wait times and can even make same-day appointments available.

Expanded practice access (same-day appointments) is included in the Clinical Practice Improvement performance category of MIPS. Providers who start transitioning their practices to accommodate same-day appointments should be well-positioned to earn points in that category in 2017 and beyond.  

Deployed and managed correctly, “open access scheduling” can improve practice operations, boost patient satisfaction, and bring in more revenue, say Drs. Jay Henry and Philip Gross, who presented at SECO 2016 earlier this year.

How it works: Leave 50-65 percent of each day’s schedule open for same-day appointments like walk-ins, new patients, or emergencies. Pre-booked appointments account for the rest, and are usually booked in the morning, leaving afternoons free to accommodate same-day requests.

Drs. Henry and Gross point to four distinct benefits of open access scheduling:

1. Zero days wait time for patients: Eliminating wait times is not only a boon to patient retention; it boosts clinical outcomes as well. When addressing vision problems, there’s usually no value in waiting.
2. Reduced risk of no-shows: Statistics vary, but Drs. Henry and Gross peg no-show rates for open access offices at around 4 percent, versus 6-10 percent for practices using traditional scheduling methods.
3. Increased patient satisfaction: Shorter wait times aren’t the only reason patients love open access. In an increasingly patient-driven industry, open access gives them a measure of control and encourages them to take ownership of their vision health.
4. Increased efficiency: Same-day appointments reduce the amount of staff time spent on confirmation calls, preparing reminder cards, and sending recall notices. Staff also spend less time on the phone scheduling and evaluating the purpose of a visit. This time can be reallocated, or you can reduce your staffing costs.

Open Access Scheduling Makes ‘Emergency’ Visits Easier to Work In

Many ODs express frustration with being frequently interrupted by scheduling staff with requests for “emergency work-ins.” Open access will alleviate much of that stress, but you should still develop and implement an emergency visit policy. It will ensure that you utilize emergency appointment slots for those patients who are truly in need.

What dictates an emergency appointment in your office? Drs. Henry and Gross offer these tips:

• If the patient cannot take an immediate appointment (or one at the time that you offer them), then they are not experiencing a true emergency.
• If a patient declares an emergency, they lose the right to choose their appointment time, and they lose the right to choose their doctor.
• If a patient refuses the appointment that you offer, be sure to document the refusal in the patient’s record, along with any other information given to the patient.