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Insights from My Vision Express

Insights from My Vision Express is Insight Software’s inside look into My Vision Express and the ever-changing vision care industry. This is where software meets eye care.

Do You Provide Services For Free?

Do You Provide Services For Free?

Who doesn't like getting something for free? Now, I'm not talking about a buy-one-get-one or BOGO type of deal. I mean something much more substantial, such as your bank skipping your home mortgage payment but credits you with the payment anyway. Does this ever happen in the real world? The answer is most likely a resounding no. Does it happen in your own practice? It just might, and not in a healthy way.

Recently I spoke with a fellow eye care professional about each other's practices. My colleague indicated that his practice struggled with billing. At the root of the struggle was the question if the staff was charging for all services? For example, when special diagnostic testing is ordered and conducted, is it included in the fees charged for that day? I am sure all of us in our vision care careers have looked back a patient's prior encounter only to grumble to ourselves at the discovery of unbilled exams or testing services.

If you are using a practice management and electronic health records (EHR) solution, that solution should enable you to quickly add in fees for specialized testing and procedures, and to easily report on billing. My Vision Express is such a system where your interpretation of testing generates the bill for your staff to process. This means all test fees are sent to billing.

Further, with regard to billing services, instead of hand marking a paper superbill, you or your staff can select exam services from the Assessment tab within the software, making billing as simple as a few clicks of the mouse.

Additionally, your practice manager can easily generate an unbilled audit report, which eliminates staff overlooking a bill.

If you happen to practice in a manpower shortage area and need the diagnostic test split into a technical and professional component, My Vision Express also offers designs that are a one-click resolution.

In short, users of My Vision Express can count on all-inclusive billing fees for services and testing. How does your current practice management or EHR software measure up?

Dr. Joseph Audia, O.D., is a private practicing optometric physician with offices in Harrisville and Salem, West Virginia. He has 30-plus years clinical experience in eye care, practicing in the medical optometric model.

His practices have over a decade charting experience with electronic health records and have been using My Vision Express for medical records for three years. He became their customer in 2006, initially using the practice management module only. He has been assisting on the electronic health records development for five years and is currently a consultant for My Vision Express.

To date, over 20,000 exam encounters have been charted in his offices with My Vision Express.

How to Survive Medical Records Audits

How to Survive Medical Records Audits

Medical records audits are a necessary part of your optometric practice. Auditing helps to ensure that your practice and staff are providing quality vision care, as well as maintaining accurate patient documentation. Medical records audits aren't a "gotcha" scenario — these audits can help to protect your practice against potentially fradulent claims and billing activity, to alert you to problems in medical coding (problemns that can lead to challenges from insurers or the government), to uncover reimbursement opportunities, and much more.

Even with the positives, audits can generate stress. Do you feel under the gun when medical record audits occur? Do you awaken in the middle of the night in a cold sweat, crying like a baby? How about coding special diagnostic testing such as fields or optical coherence tomography (OCTs)?

If you have a certified electronic health records (EHR) system in place, you should be able to rest easy. Your EHR should be able to conform to the needs of your practice and workflow, helping to alleviate any medical records audit anxiety, especially when it comes to diagnostic testing or services.

How can your EHR set your mind at ease? For example, the EHR feature in My Vision Express has a patient testing tab you can add to any template. It allows a single portal of access to any — and all — of your specialized tests.

Have you ordered a visual field, optic nerve OCT, and corneal pachymetry for that new patient glaucoma suspect? How can you be sure and how can you easily document this? With My Vision Express, it's no problem. My Vision Express has predefined tests that are populated with a robust set of anticipated notes. Users can edit on the fly on a per test basis or select customized templates with the appropriate diagnostic tests.

In my practices, my staff and I attempted to make a test type for all possible options but with the ever expanding eye care landscape, it proved a daunting task. That being said, users can add easily a new test type as diagnostic services are introduced or modified.

It was clearly the goal of My Vision Express to have all our current needs covered with a rich library of predefined tests. My Vision Express even has unique procedures built in, such as punctal plug, corneal foreign body removal, epilation, injections, et cetera.

If you have the right EHR for your practice, you don't have to sweat a medical records audit, instead focusing on the benefits an audit can bring, like confirming you are running an efficient, liability-free office. If you don't have an EHR like My Vision Express...you might find yourself in that cold sweat after all.

Dr. Joseph Audia, O.D., is a private practicing optometric physician with offices in Harrisville and Salem, West Virginia. He has 30-plus years clinical experience in eye care, practicing in the medical optometric model.

His practices have over a decade charting experience with electronic health records and have been using My Vision Express for medical records for three years. He became their customer in 2006, initially using the practice management module only. He has been assisting on the electronic health records development for five years and is currently a consultant for My Vision Express.

To date, over 20,000 exam encounters have been charted in his offices with My Vision Express.

What to Expect from Your Practice Management Software

What to Expect from Your Practice Management Software

Finding the right software for your practice can be a daunting task. Most practices know the core features they need: a scheduler, patient information, electronic health records (EHR), and financials. But what about the expansion of technology in the healthcare sector? It is essential to have a software that can accommodate technology and your practice's workflow simultaneously.

The core features of a practice management software are also the core features of your office. Ask yourself, "What is your practice's first interaction with the patient?" This is an easy one — it's when they schedule an appointment. The calendar should allow you to schedule and record patient information in a timely manner. All that your staff is looking to input is basic information along with a possible insurance carrier. Within the calendar, the patient information recorded should already be integrated with the next core feature, patient information.

Keeping track of patient information is essential to providing excellent customer service. Within a patient's profile you not only want demographic information, you also need easy access to their history within your office. Accessing their orders, insurance claims, and exams from one centralized screen allows for an efficient office workflow. Let's go through a real life scenario: Patient calls in and wants to reorder their contact lenses. Does a member of your staff go to the file room and search for the patient's record? No! All you need to do is search for the patient, look for their previous order, and copy the order. How easy and efficient! In less than a minute you can search for the patient, their previous order, and generate a new order.

Not only does your practice want to be tech-savvy savvy when it comes to the optical side of your business, you also want the examination and documenting of information to be just as seamless. An EHR will reduce medical errors, enhance patient care and provide better communication amongst physicians. Double entry errors will also be reduced with the integration of diagnostic equipment. The crucial part of the puzzle will be to have the EHR system integrate flawlessly with the optical end of your practice management system.

This leads us to the bottom line: financials. With a thriving practice, analyzing its financial health is of utmost importance. Are there any areas that can be improved for the patient to receive a higher level of care, while maintaining a good profit margin? The best way to retrieve this information is with an extensive reporting system that will generate financial information such as costs per job, frame profits, contact lenses sold, insurance reporting, and retention rates. A software that is integrated with each of its components will be able to generate financial information that will ensure your practice's success.

The basics are integral to the health and growth of your business, but what about the expansion of technology into the healthcare sector? With the affordability and availability of mobile devices practices must to be able to communicate with our patients via text and email. While there are some great third party software to accomplish this wouldn't it be great for your practice management software to have this integrated? This is one less feature that you need to worry about coordinating with your software.

These are the essential features needed to make sure that your practice's basic needs are addressed. While comparing software, look for these features as well as some other technology based needs that will allow your practice to flourish. A steadfast practice management software vendor will not only provide these features but evolve with the industry and your practice — and you should expect nothing less!

Marlene Vega, ABOC, NCLEC

Marlene Vega, ABOC, NCLEC is the Enterprise Client Manager for My Vision Express.

Calculating Commissions

Calculating Commissions

How are you calculating commissions in your optical retail?

If you're still doing it the old fashioned way — with a pencil, paper, and a calculator — it might be time to reconsider. Odds are you've made investments into ensuring that your practice has the latest in medical devices and measuring equipment, as well as the latest spectacle frame styles and contact lenses. Make sure that the way in which you are managing your business is just as advanced as the way in which you care for your patients.

Commissions have long been standard in sales environments, and your optical retail is no different. What is different is the way in which you calculate, record, and report on those commissions. Whether you have a commissions program in place or are considering one for your practice, there are ways you can ensure that commissions are tallied correctly. Here are some questions you should ask yourself about your current program or are thinking of implementing.

  • Will you specify different employee commission types? Your practice doesn't sell one product — so your commissions will differ. What will you base your commission structure on? Orders, product types, or specific items like a certain line of frames?
  • How will commissions be assigned? Not every member of your staff will be on the sales floor and not every item in your inventory will be under your commission program. Make sure that you have a system in place that will help you easily manage this part of your business.
  • Is your commission structure based on a set amount or gross?
  • How can you tell what the percentage or the margin percentage is, including Sales Performance Incentive Funding Formulas (more commonly known as "spiffs")?
  • Will you be able to change commission types on the fly? How flexible is your program? Is it reflected in your practice management system?
  • Are you and your staff able to see commission amounts on the orders as they're generated?
  • How will you report on commissions?

The way you manage your business — which is exactly what your practice is — should accommodate for your sales and reporting needs. Commissions should be able to be set up at the inventory type, individual product, and employee levels of the software program for automatic calculation, and you should have the ability to create commonly used commission criteria, and also be able to associate that criteria with an employee's record, a product type, or specific products in your inventory. You should also be able to easily change the commission rates for items that are linked to your practice's commission structure.

Most importantly, the reporting should be accurate and simply obtained via end-of-day (EOD) reporting or on-demand reporting. Check your practice management system to see if you are able to establish a customized commission program and can report on that program with as much (or as little) detail as you need, whenever you need it.

If you find that your practice management system isn't where you need it to be to support your optical retail, or if you want to make the switch from the manual way of calculating commissions to the automated way, call My Vision Express toll-free at 1-877-882-7455 or email us at sales@myvisionexpress.com to learn more about our Commissions module and how our practice management software can help optimize your practice.

The Chief Complaint Questionnaire Your Practice Needs

The Chief Complaint Questionnaire Your Practice Needs

A common management pitfall (regardless of industry) is the concept of, “If I wanted it done right then I would do it myself!”

Typically, the author of such a philosophy struggles in having the confidence of knowing a member or members of their team can get the task at hand done right. With regard to any of the medical professions, a trained staff is essential to quality care. In the case of technician history taking capability, it often varies with experience and the memory of the staff member.

With that in mind, which questions do I ask for this type of patient encounter? I have seen a best practices method of scripting questions on flashcards (something which should be familiar to anyone who has studied for a course). When creating physical flashcards, two-sided flashcards are ideal. As a test for yourself and your staff, consider making a flashcard for a contact lens encounter, and a different one for a post-operative examination, and another for a glaucoma visit. You'll find that the questions for each are unique. You'll also notice that the questions vary from doctor to doctor based on practice style and professional preference.

My Vision Express has designed a questionnaire section in the History of Present Illness (HPI) area that addresses this need wonderfully. It truly is as easy as 1-2-3!

First, users can create a category of questions (glasses, compliance, diabetes, contacts, et cetera). Second, you can easily script specific questions for each category that you've created. Third, you can decide which questions will automatically appear on the exam by designating a template.

This process is nicely done and easily customizable. You simply ask what you want, when you want. Or — better yet — your technician can ask exactly what you want. Which, to come back to our management pitfall, is ultimately like “doing it yourself”, only efficiently.

Dr. Joseph Audia, O.D., is a private practicing optometric physician with offices in Harrisville and Salem, West Virginia. He has 30-plus years clinical experience in eye care, practicing in the medical optometric model.

His practices have over a decade charting experience with electronic health records and have been using My Vision Express for medical records for three years. He became their customer in 2006, initially using the practice management module only. He has been assisting on the electronic health records development for five years and is currently a consultant for My Vision Express.

To date, over 20,000 exam encounters have been charted in his offices with My Vision Express.

What Your Practice Needs To Know About EMV Cards

What Your Practice Needs To Know About EMV Cards

Given the push toward ICD-10, as well as the hope (now fulfilled) that the Centers for Medicare and Medicaid Services (CMS) would postpone Stage 3 of Meaningful Use, it was easy to overlook another important deadline: the liability shift for retailers who accept credit card payments.

What is the liability shift? Effective October 1, 2015, the four major card issuers implemented their liability shifts for point-of-sale (POS) terminals.

American Express®, Discover®, MasterCard®, and Visa® have migrated their cards from the previous swipe-and-sign card to EMV (which stands for Europay, MasterCard, and Visa).

EMV is a global standard for credit cards that are equipped with computer chips. These cards are called smart cards, chip cards, smart-chip cards, chip-enabled smart cards, chip-and-choice card (PIN or signature), EMV smart card, or simply EMV card. Regardless of what the market and consumers call these cards, retailers are now facing the reality of being able to handle the new card technology when it comes time for payment.

The United States is the last major market to make the shift from the swipe-and-sign card to EMV cards, a move that was brought to greater focus with the large-scale theft of credit card data from Target, Neiman Marcus, and other retailers.

So what does your practice do to ensure that your payment strategy is able to accommodate all forms of card payment, including the new EMV technology?

If you're using My Vision Express, the answer is simple. The My Vision Express practice management and certified electronic health records (EHR) software solution has done the hard work for you. Our integration with OpenEdge™, one of the largest worldwide providers of payment solutions, means that the move to EMV doesn't have to be frightening, time-consuming, or expensive.

The integration of OpenEdge EMV technology with our point-of-sale software means that your optometry, ophthalmology, or optical retail practice can easily accept both swipe-and-sign and EMV cards from your patients. In fact, the first round of EMV cards will carry both the smart chip and the traditional magnetic stripe, so you can continue with business as usual while you're ordering the new terminal technology from OpenEdge.

Bottom line, what does this change mean for your practice? More safeguards and a level of comfort for your patients as they can be assured their personally identifiable information (PII) and financial data is secure with your practice. The partnership of My Vision Express and OpenEdge means that all practice-critical data (PII and protected patient information, or PPI) is in good hands.

Patient Interactions and Medical Records

Patient Interactions and Medical Records

In a paper medical record, charting the patient interaction was easy. You wrote in the medical record documentation necessary that occurred outside of the actual exam. This could be a phone discussion with a patient or a call back from a pharmacy. We all learned the importance of sound medical record keeping from quality of care and insurance audits as well as medical-legal ramifications.

My Vision Express has developed a powerful system for documenting such things. My Vision Express allows users to create scripted interactions (pharmacy call backs, patient care-related, among others). You can create interaction types needed by your practice. You can even have common things placed in a pick list. Here is where it gets very nice. You can designate if you want to be notified about specific interactions.

Let me repeat that. You can designate if you want to be notified about specific interactions.

My Vision Express strongly respects user practitioner individuality. You could select that you are automatically notified about every interaction created (if that is your management style). You could select no notifications or you can be somewhere in between. We created appointment interactions (missed, rescheduled, cancelled); financial interactions (collection, non-sufficient funds); pharmacy (refill requests; denials) and many more. We then looked over each and set up which ones our attending physician would always want to know had happened. These types, when created, will sent a message to the physician. A red indicator shows in the EHR to alert the doctor that a message exists. It even keeps a running number of how many unresolved messages remain.

My Vision Express has created a great system to allow our users to keep in touch with the pulse of the interactions created for their patient's medical records. Can you say if your current EHR software does the same?

Dr. Joseph Audia, O.D.

Dr. Joseph Audia, O.D., is a private practicing optometric physician with offices in Harrisville and Salem, West Virginia. He has 30-plus years clinical experience in eye care, practicing in the medical optometric model.

His practices have over a decade charting experience with electronic health records and have been using My Vision Express for medical records for three years. He became their customer in 2006, initially using the practice management module only. He has been assisting on the electronic health records development for five years and is currently a consultant for My Vision Express.

To date, over 20,000 exam encounters have been charted in his offices with My Vision Express.

Last Minute Preparations for ICD-10

Last Minute Preparations for ICD-10

ICD-10 has finally arrived and will be enacted tomorrow, whether practitioners are ready for it or not. There is still time to prepare for the transition from ICD-9 to ICD-10, even as the deadline draws near.

Following we have listed a few of the last minute preparations your optometric, ophthalmic, or opticianry practice can take to be ready for the October 1 deadline.

  • Do you have a practice management or electronic health records (EHR) system in place? Make sure that you are able to access ICD-10 codes through that system, particularly the codes that you know you will be using for diagnosis and billing.
  • Educate your staff, focusing on clinical documentation, new clinical concepts, and the ICD-10 fundamentals for coding and administration. The Centers for Medicare and Medicaid Services (CMS) has a wealth of resources available, all online.
  • Are you still using paper to make claims? Then make sure you have CMS-1500 (2012) forms and on your superbills, replace the ICD-9 codes with ICD-10 codes.
  • If you use software systems, health plans, billing services, contact those vendors to verify that those systems are ready for the October 1st switch.
  • Test your systems and processes, including workflows, either with your business partners or in your existing software to verify that you can generate insurance claims.

If your practice management or EHR software isn't testing or performing the way you expected for ICD-10, or if it isn't even ready for ICD-10, there's no need to panic. There are software solutions available (such as My Vision Express) that are not only ICD-10 ready, but are specifically made for eye care professionals. My Vision Express even comes equipped with a built-in Injury Builder tool, an industry first, making diagnosis, coding (especially for IPAE — Injury, Place of Occurrence, Activity, External Cause Codes), and billing as simple as a few clicks of the mouse.

The bottom line? Don't panic. Keep calm and stick to your plan. If you run into business-critical issues, contact Dr. Bill Rogers, the ICD-10 Ombudsman via email at ICD10_ombudsman@cms.hhs.gov or email the ICD-10 Coordination Center at ICD10@cms.hhs.gov. You can also call My Vision Express toll-free at 1-877-882-7455 or email us at sales@myvisionexpress.com to learn more about our Injury Builder and how we're ready for ICD-10.

ICD-9 vs. ICD-10

Does Your EHR Support Your Practice Workflow?

Does Your EHR Support Your Practice Workflow?

Does anyone like being told how to do things? Whether as a child being instructed by a parent or a teacher, or as an adult making your way in the business world, there aren't many of us who enjoy being dictated to. So why should your practice be beholden to an inflexible, non-customizable software system?

A few years ago I wrote a treatise entitled, “Do You Control Your EHR Or Does Your EHR Control You?” At the time I was seeking a new medical records program and was frustrated at what was available on the market. So many solutions were inflexible; however, today I'll focus on refractions in My Vision Express as an example of an adaptable electronic health records (EHR) solution.

Understanding that all refractions attain the same end result but have differing approaches, My Vision Express is strong with the way in which they've developed their EHR software. Users can define specific steps in their refractive process and designate which step is next, including a pull forward of the data.

For instance, if you are accustomed to listing the presenting prescription, you can have it listed. You can list variations on retinoscopy (auto-refractor, manual, cycloplegic, mohindra, et cetera). In short, you have can simply create what you want. You can even make a refractive workflow that pulls forward data.

In one such scenario, you can make the retinoscopy populate a monocular refraction if you desire; make a monocular refraction pull forward to the binocular, and so on. The refractive tab is extremely user friendly and easy to develop. Physicians and optometrists and ophthalmologists should like making a workflow that matches their tastes and how they conduct their examinations and practice. When comparing against other EHR software solutions, I can say from years of hands-on experience that My Vision Express certainly does not attempt to control how users refract their patients.

Dr. Joseph Audia, O.D., is a private practicing optometric physician with offices in Harrisville and Salem, West Virginia. He has 30-plus years clinical experience in eye care, practicing in the medical optometric model.

His practices have over a decade charting experience with electronic health records and have been using My Vision Express for medical records for three years. He became their customer in 2006, initially using the practice management module only. He has been assisting on the electronic health records development for five years and is currently a consultant for My Vision Express.

To date, over 20,000 exam encounters have been charted in his offices with My Vision Express.

The Overtime Rule and You

The Overtime Rule and You

Eye care professionals face unique problems as small business owners. You need an awareness of changes in your industry (changes to diagnoses and procedures as an optometrist, electronic health records and adoption of new coding as an ophthalmologist, trends in frames, lenses, and contact lenses as an optician). You also need an awareness of how to run your practice or retail location as a business while maintaining the highest level of patient care.

A recent proposal from President Obama may change the way your small business operates. The newly proposed overtime rules are posed to create an eligible workforce of nearly five million workers. These workers are in white-collar positions, such as office administrators and other office professionals, and would place them in an employment category that would pay them time-and-a-half for overtime hours worked.

The litmus test for who is an exempt worker and who is a non-exempt worker has traditionally been this: they are paid a fixed salary (not hourly); their salary is above a set threshold; and they perform duties that would be characterized as "bona fide executive, administrative, or professional role."

So what does this mean exactly for an optometric or ophthalmic practice? Or an optical retailer?

Is Your Practice Affected By The Overtime Rule?

Should the rule take effect, the overtime proposal will change the salary threshold from $455 a week (which is $23,660 a full-year) to $970 a week (or $50,440 a year).

In addition, the salary threshold would update automatically each year based on either the Consumer Price Index (CPI) provided by the Bureau of Labor Statistics or a fixed percentile of wages maintained by the U.S. Department of Labor.

The proposed rule could possibly affect those considered as "first-line" managers, like office or administrative managers, and office support workers; human resource managers; computer and information systems managers; and medical and health services managers, among others.

Jobs Most Likely To Benefit From New Overtime Rule
(Source: Pew Research Center)

What Your Small Business Can Do

Take a close look at the makeup of your practice or chain of practices. How many of your current staff may be considered as any of the above? Some? None?

Now think on how you're keeping track of their hours worked, breaks, time off. Are you keeping this information manually or are you using a computerized system to assist with your payroll?

One of the first steps you should take as a small business owner is to determine if any of your staff will fall under the proposed overtime rules. The next step? To make sure that you are optimizing your practice to be ready for this possible change with a system that is designed to grow with you and the needs of your office.

What the Newly Overtime-Eligible Do
(Source: Pew Research Center)

More than 150,000 health care workers are estimated to be affected by the proposed rule. Half of those who are anticipated to be affected fall under various aspects of management, including office management. Help ensure that hours are properly accounted for regardless of the outcome on the proposed rule by automating your staff management processes.

Are you still using paper time keeping? It may be time to use a software-based solution that ties into your overall practice management. If you're already using software, are you using more than one software platform to address all of your business needs? Are you switching from one program to another in order to perform certain office functions?

Built-in solutions are available to help your practice lower costs and reduce the amount of administrative time lost with paperwork through a built-in, flexible, easy-to-use employee time clock with layers of security and permissions-based access to ensure accuracy. Do you have more than one location? Or more than one workstation? Ensure that your interoffice communications are more efficient with integrated employee messaging and task management. Gain full insight into the operations of your practice and optical retail, all from one software solution, instead of hopping from program to program.

Changes are coming that affect all areas of your optometric or ophthalmic practice or optical, changes that range from business management to increased specificity in diagnosis and coding under the Health Insurance Portability Accountability Act (HIPAA) and ICD-10. Make sure you're ready by using a practice management and electronic health records (EHR) solution that is ready to accelerate your practice.