Business Tips: Charging Outside the Medicare Schedule for High Tech Instruments.
This is probably the most important business decision you can make for your future.
We have been charging outside the Medicare schedule for more than six years.
I have always been confident that the use of high tech instrumentation could be billed outside the schedule and therefore did so.
All billings have been for diagnostic instrumentation that are used outside of the consultation room and are delegated to our staff to perform. Examples of these are:
- Screening Visual fields
- Threshold Visual fields (there is now a Medicare item for this)
- Digital Imaging of the optic nerve and the posterior pole
- Corneal Topography
- Corneal thickness
- Tomography of the optic nerve and/or macula
To successfully implement the billing of consultation fees outside the umbrella of Medicare one needs to educate the patient in the consultation room on exactly what each test entails and its specific purpose. Personally I believe it is imperative to perform computerised visual field screening and a digital image of the posterior pole of every patient at least every three years. In our practice a fee of $68.75 is charged and individually itemised as not rebatable from Medicare.
Many practitioners have said that it is viable in my practice because I am in the city centre. The reality though is that I have many, many pensioners that travel into the city and they happily pay out of pocket because they perceive value in ruling out eye disease using high tech instruments.
Any patient that is a glaucoma suspect, has diabetes or has the beginning of macula degeneration is immediately scanned using our StratusOCT (yes even our pensioner patients). Our fee for this is $95. Approximately 40% of my patients now pay $200 plus for their consultation. It has nothing to do with my practice being in the city.
My billing outside Medicare started six years ago. By the 4th year it was common for patients to ask for the photo of the back of their eye. They came to expect it.
From tomorrow you need to buy a new instrument and start charging for it. Your only pre-requisite is to believe that it adds value to the testing process. Once you believe it, your patients will believe it and eventually expect it.
From a business perspective the most important piece of equipment that can be used outside the consultation room is the retinal digital imaging camera. A high resolution image of the retina is not only your best protection against medico-legal problems but also is a wow factor for the patient. If I was purchasing a camera today, I would probably go for the Zeiss Visucam. Soon to be networkable, it would link with our OCT and Matrix Visual Field Analyser to form one searchable database. This could be called up through our practice management software, so we could have all scan and test results at a press of a button.
Don't do what I did. I spent 3 months psyching myself up and fearing that my patients would leave me in droves. Some of my consultation only patients did leave, but most of these non-productive patients stayed on. They still did not purchase product from me but at least now I was earning a reasonable remuneration for my time. The patients that did purchase product, also were happy with the extra consultation fees. They are now definitely getting the best possible eye examination and can be sure that if anything was astray it would not be missed.
Register for Business 2005. This seminar in mid-October will concentrate on charging outside the Medicare schedule, nurturing productive, responsible staff and take home business tips that are bound to increase your efficiency and your bottom line.
The Stratus Optical Coherence Tomographer
The Matrix Visual Field Analyser using Frequency Doubling Technology
Carl Zeiss in our opinion carries the most extensive and clinically relevant instrumentation for optometry in the Australian market. From the Matrix Visual Field Analyser to the StratusOCT, if you want to practice high end optometry you cannot go past Carl Zeiss instruments.
Call George Loucas their instrument rep today on:
(02) 9020 1333 and he can help you choose the most appropriate instrument for your current needs.
The GDxVCC Nerve Fibre Layer Analyser