“Many practitioners don’tthink of documentinganterior segment disease

as often as they do posterior segmentdisease,” says Brian Berliner,O.D., Huntington Station, NY.Why not? he wonders. “Ante-rior segment disease can comeup just as often. And the pho-tographs of the anterior seg-ment are most often coveredby insurance as well,” he says.

Dr. Berliner takes clinicalphotos of conjunctivitis, ul-cers, foreign bodies, giant pap-illary conjunctivitis and even sties. “Pa-tients are almost as impressed by a pic-ture of the front section of the eye asthey are by posterior segment photos.They recognize the structure more, so

it’s more familiar to them,” he says. As long as practitioners ensure

there is medical necessity for taking thephoto, they can bill a patient’s medical

insurance provider using CPTcode 92285. “Make sure youinclude your impression andyour treatment plan on thechart,” he says.

Dr. Berliner uses his cur-rent retinal camera to shootanterior segment images. “Byplacing the patient so his orher chin is at the very frontedge of the chin rest, and by

experimenting with the illumination,and then adjusting the focal lens,we’re able to take photos of the ante-rior segment,” he says. Switch the

A L LD O C S

ASSOCIATION OFLEASEHOLDINGLENSCRAFTERSDOCTORS

ALLDocsALLDocsThe

NewsletterRx Therapeutics for Practice Growth

First Quarter 2007

When Anna Hopkins, O.D.,Lancaster, OH, began billingpatients’ medical insurance

carriers for medical services she wasproviding, her outlook changed. Notonly was she being compensated forher efforts, but also she found she wasenjoying the practice managementchallenge. Most importantly, that in-cluded properly scheduling patientswith medical needs.

“So often I was spending time withpatients and not getting paid for it. Iwanted to give as much care as possi-ble, but it was stressful when I knewthere were other patients waiting to seeme,” she says.

Medical Billing Turns Practice AroundNearly 40 percent of practice revenue comes through medical model

Dr. Hopkins creditsher ALLDocs colleaguesand the ALLDocs an-nual meetings for pro-viding her the encour-agement to move intomedical model optom-etry. She returned toher practice followingthe 2005 meeting inMiami and began theprocess of incorporat-ing medical codingand billing. After the2006 meeting in Mexi-co, she was eager to make morechanges necessary to embrace full-scope

optometry. The results have

been impressive. Be-fore the 2005 ALLDocsannual meeting, Dr.Hopkins was not be-ing paid for medicalservices. Now, med-ical care patients ac-count for about 25percent of her pa-tients, and even moreimpressively, nearly40 percent of her rev-enue. She adds that

the revenue generated through med-ical billing is an entirely new incomestream. She is able to charge for herrefractive services separately from themedical services. “It’s working betterthan I thought it would—and ourrevenue per patient has increasedsubstantially,” she says.

Picture-Perfect Addition to PracticeAnterior segment photography

aids documentation, profitabilityContinued on page 2

Continued on page 2

Dr. Hopkins

Dr. Berliner

ALLDocs AnnualMeeting PreviewOctober 14-18, 2007

Scottsdale, AZsee page 3

Photo courtesy Scottsdale Convention &

Visitors Bureau

ALLDocsALLDocsThe

Newsletter2

FROM THE PRESIDENT’S DESK

What’s in Your Future?

At our 2007 annual meeting, we’llbe building on the themes of the

past years to help you understand thevariety of technology that can improveyour practice and clinical management. The themefor the 2007 meeting is “The Office of the Future.”We’ll learn about the latest computer technology,paperless office systems and billing systems.

I often hear from colleagues who attend our an-nual meetings that these are the most relevant

meetings. In this issue, Dr. Anna Hopkins shares how these past twomeetings have revolutionized the way she practices. The impact, sheand others say, is immediate.

This next meeting can do the same. Our goal is to help LensCraftersleaseholding O.D.s do the best for their patients while increasing revenue.It’s a cycle: a healthier financial practice can allow you to increase cover-age by hiring associates, which in turn increases the number of refrac-tive patients who can fill their eyeglass prescriptions at LensCrafters.

Please make your meeting plans now. The first step is to sendyour annual dues. You can download the dues form from our website: alldocsod.com. Then let us know if you’ll be coming. Our atten-dance goal is 95 O.D.s—10 more than our 2006 meeting. ■

Kerry Gelb, O.D.drkmg@comcast.net

Dr. Gelb

A L LD O C S

ASSOCIATION OFLEASEHOLDINGLENSCRAFTERSDOCTORS

Medical BillingContinued from page 1

Picture-PerfectContinued from page 1

Dr. Hopkins counsels patiencewhen it comes to training staff. Eachtime Dr. Hopkins attends a seminaron medical billing, she summarizes itfor her staff. “I’ll type the protocoland review it with the staff. I alsocreated laminated sheets with proce-dure codes to match the diagnosiscodes on the patient’s chart. In thebeginning, we used those so the staffwould have a reference to know howto charge,” she says. She tries tomake it easy by regularly updatingthe allowable charges as well as calcu-lating the 20 percent for which thepatient is responsible for each com-monly used procedure.

“The more medical billing andcoding you do, the more comfortableyou become,” she says. She focusedinitially on procedures she did often,

such as nevi, conjunctivitis and glau-coma. Her primary sources for billingand coding information—along withALLDocs seminars—were her localMedicare and other insurance carriers.

Dr. Hopkins has created an officepolicy to have patients pay for the

medical charges, even if they havesecondary insurance. “We help thembill the secondary carrier, and whenthe check comes in, we issue a refundto the patient. It’s easier to issue a re-fund check than to try to collectfrom the patient.” ■

Caring for Glaucoma Patients

There’s a learning curve for properly coding carefor glaucoma patients. While Dr. Anna Hopkins

was crafting her protocol for billing, she alreadyhad her preferred therapy—TRAVATAN®. “The once-a-day dosing is so much easier for patients. Andthey achieve better control with TRAVATAN thanthey do with other medications,” she says.

Dr. Hopkins says as a result of the information learned at last year’s an-nual meeting, she anticipates prescribing more TRAVATAN® Z for her glauco-ma patients. “It will provide the same efficacy without BAK, which could beespecially important for glaucoma patients who also suffer from dry eye.” ■

camera and insert the auxiliary high-plus lens and then back out the cam-era, he says. “Have some staff mem-bers sit for you while you experimentand get your settings just right. Thenyou can teach the technique to thetechnicians so they can take the pho-tos,” he says.

While he prefers the retinal cam-era, another method he sometimesuses is to use a hand-held digitalcamera in conjunction with his slitlamp biomicroscope. “I’m able totake reasonably good quality photosand download them on the computerright in the exam room,” he says. Hesuggests some similar experimenta-tion with staff. “Play with the digitalcamera speed and work on the align-ment of the camera with the eyepieceof the slit lamp,” he says. Have atechnician stand by and aim a hand-held light source, such as a transillu-minator, near the eye that you areimaging, he suggests. That can helpbrighten the image.

Dr. Berliner estimates he submitsclaims for an average of five to 10 an-terior segment photos per month. ■

3ALLDocsALLDocsThe

Newsletter

By Harvard Sylvan, O.D., Director, Professional Development at CooperVision

As contact lenses have continued to be viewed by theconsumer as a low-priced commodity item, it is es-

sential to the growth and success of a contact lens practicethat products be utilized that enhance both the profession-alism of the doctor and the profitability of the office.

The huge numbers of patients thatare becoming presbyopic give contact lensfitters the best opportunity for practicegrowth and a way to differentiate them-selves. It is estimated that 2.4 million con-tact lens wearers are becoming presby-opic each year. This is a group that ishighly active, wants to maintain a youth-ful appearance and is resistant to wear-ing reading glasses over their contacts.

In order to better serve the needs of this popula-tion, CooperVision has released the Biomedics® EP. Thisunique lens has been designed to address the visualdemands of the Emerging Presbyope (hence the nameEP). The center of the lens has a spherical distance zonesurrounded by a progressive aspheric zone that pro-vides excellent intermediate and near vision.

Maintaining crisp distance vision is of paramountimportance to the emerging presbyope. The sharpbinocular distance vision, coupled with the ability tosee at both intermediate and near, is what makes thislens a far superior choice over monovision.

In fact, after a recent pilot studyby 68 doctors, 84 percent of thosedoctors who fit monovision as theirdesign of choice for emerging pres-byopes indicated that they wouldnow utilize Biomedics EP instead.That is an outstanding endorsement.*

Although it performs like a multifocal, the Biomedics EP isas easy to fit as any spherical lens and re-quires very little chair time. There is no needto be concerned with eye dominance or se-lecting an add. The add is built in and willwork with patients who need up to a+1.25D. As the Biomedics EP is comparablypriced with two-week spheres and is lessexpensive than traditional multifocals, it willassist in transitioning patients from sphericalcorrection to higher add multifocals as their

presbyopia increases. In addition, it will serve as an easyentry into multifocal fitting for those doctors who are unfa-miliar or uncomfortable with fitting these types of lenses.

Many doctors also are using it to fit their youngerpatients with either accommodative insufficiency orconvergence excess. Simple parameters and a small fit-ting set allow you to keep all Biomedics EP powers instock and ready for same-day dispensing.

CooperVision has “no risk” evaluation programsand introductory offers for this exciting new lens.Contact your area sales manager, Bob Scott or GarthBradley, at 800.538.7850 for additional information. ■*Data on file

Biomedics® EP Offers OutstandingOpportunity for Practice Growth

GUEST COLUMN FROM COOPERVISION

Dr. Sylvan

ALLDocs Annual Meeting to Examine Office of the Future

The 2007 annual meeting will beheld at the Fairmont ScottsdalePrincess from October 14 through

October 18. A tentative agenda follows. Updates

will be available on the alldocsod.comweb site and in the next issue of ALLDocs.

Sunday, October 14th◆ 12:30 p.m. Golf outing at the fabu-lous Scottsdale TPC course, home of theFBR Open (formerly the Phoenix Open)◆ 5:30-9:30 p.m. Welcome receptionwith hors d’oeuvres.

Monday, October 15th◆ John McGreal, O.D., onmedical optometry update◆ LensCrafters update◆ Vendor presentations◆ Vendor fair◆ Special evening event

Tuesday, October 16th◆ Vendor presentations◆ Craig Thomas, O.D., onbenefits of medical optometry◆ Bill Fox, O.D., on practice management

Wednesday, October 17th◆ Legal issue overview◆ Vendor presentations◆ Vendor fair◆ Special evening event

Thursday, October 18th◆ Morning business sessionand departures ■

Photos courtesy Scottsdale Convention & Visitors Bureau

Biomedics® EP Design

4 ALLDocsALLDocsThe

Newsletter

Supported by an unrestricted educational grant from Alcon Laboratories

By John Rumpakis, O.D., M.B.A.

Most O.D.s focus on providing clinical excellenceand reason that financial success will naturally

follow. That certainly can and does happen. For agreat many O.D.s, however, a different perspective onclinical care and billing and coding for medical insur-ance reimbursement may deliver better results to boththeir patients and their practice’s bottom line.

If you feel that you missed opportunities in deliveringthe care you’re capable of delivering as well as the eco-nomic benefits that result from understanding how tocode patient encounters properly, consider what I call theABCs of CPT coding. It’s a way to organize your outlookon providing care and put your practice in a position torealize appropriate reimbursement for your services.

Demonstrate that you are an ACTIVE par-ticipant in your patients’ total eye care.Don’t limit your service to refractive care.And don’t limit your services to dispens-ing samples of OTC and Rx agents. In-

stead, take a proactive role.

Be BETTER at what you are trained to do.Strive to practice to the fullest scope ofyour license on a daily basis. Reach outto friends, colleagues and peers to learnmore, to take the initiative and create op-

portunities within your practice.

Take CONTROL. Define what you do andhow you do it. Be passionate about thecare that you deliver. Don’t stress aboutthings you can’t control, but take full re-sponsibility for the things that you can.

These ABCs will help you deliver the best care topatients. They also will help you achieve more effec-tive results with medical billing and coding. How?Very simply. Understanding the basics of the CPT sys-tem is not only critical for survival in practice, but alsothe only way that you can define to third-party pay-ors the care that you provide.

To illustrate, let’s consider anterior segment care—especially ocular allergies and dry eyes—which domi-nate the therapeutic landscape in many optometricpractices. Prime season for allergies is just around the

corner, and the potential impact toyour practice can be huge. If the al-lergic population potential was real-ized within the typical optometricpractice, it could add nearly$140,000 of pure net income to the bottom line.

◆ Nearly 124,500,000 people in the U.S.—about42 percent of your existing patient base—have ocularallergies.

◆ Nearly eight times more people buy OTC ocularallergy medications than Rx preparations.

◆ Most patients pay more out-of-pocket by self-medicating with OTC remedies than with Rx products.

◆ Alcon has launched PATADAY™—a once-a-day,24-hour solution for your patients’ ocular allergies. Now apply the ABCs of CPT coding to these patients.Remember: present an ACTIVE recommendation for theBETTER alternatives and take CONTROL.

Allergies are clinically easy to diagnose, easy to treatand even easier to code. Both the one-week and six-month follow-up visits after prescribing PATADAY on theday of your general examination would typically becoded with a 99212, 99213 or 92012 code, along withan appropriate corresponding ocular allergy diagnosiscode. It’s just that simple.

If you aren’t gettingyour share of the allergymarketplace, vow that2007 will be different—bepro-ACTIVE with your pa-tients by mentioning thatyou have a state-of-the-artsolution for their allergiesrather than waiting for themto ask. Don’t sample; beBETTER in how you ap-proach your patients’ clinicalprofile by prescribing andsolving their problem. Bystriving to be the best clini-cian, you can change pa-tients’ perception of whatyou do. Take CONTROL of your patients’ total eye careneeds by embracing both refractive and medical eye care.

The bottom line: be the doctor. After all, that iswhy patients come to see you, and it’s the basis uponwhich medical insurance carriers reimburse you. ■

The ABCs of CPT CodingA simplified approach to providing the best care

THE MEDICAL MODEL

Dr. Rumpakis

Alcon’s new PATADAY™ isa once-a-day allergymedication.