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What is the MACRA Final Rule?

On October 14, 2016, CMS issued the Medicare Access and CHIP Reauthorization Act (MACRA) final rule, that established new payment programs and changes the way Medicare reimburses physicians and other providers. Starting January 1, 2017, eligible physicians need to be on one of two new Quality Payment Program (QPP) payment tracks established by MACRA:

  1. MIPS – A merit-based incentive payment system (most commonly used by Optometrists and Ophthalmologists)
  2. APM – Advanced alternative payment models



  • The goal of MIPS is to streamline reporting to CMS and improve care
  • It consolidates three reporting programs into one – (Meaningful Use, PQRS, and the Value-based Modifier (VBM) – which will all sunset)
  • MACRA does not change reporting requirements or payment for hospitals or Medicaid providers
  • Physicians receive a final score based on a scale of 0 to 100 demonstrating how they performed under QPP. The more points they accumulate, the more incentive they stand to make
  • Eligibility requirements are:
    • Must bill more than $30,000 to Medicare
    • Provide care to more than 100 Medicare patients per year
    • Must have participated in Medicare in 2016 or before


2017 is the First MIPS Reporting Year


Performance Areas & Weights

MIPS has four categories that will determine an eligible provider’s score and revenue:

  1. QUALITY – Replaces PQRS
  2. IMPROVEMENT ACTIVITIES – New Category for Care Coordination
  3. ADVANCING CARE INFORMATION – Replaces Meaningful Use
  4. COST – Replaces the Value-Based Modifiers


Reporting Options

Reporting for 2017 will affect 2019 payment. The performance period for 2017 is a minimum of 90 days for all categories with some limited exceptions. The last day to report for 90 days is October 2, 2017. Physicians must submit 2017 attestations no later than March 31, 2018.

MIPS Reporting Options


Financial Impacts


Quality Reporting

My Vision Express’ integration with the IRIS Registry will assist in the performance percentage for attest station. To get started with this registry please follow the instructions in the link here.

My Vision Express will also be partnering with the AOA More Registry with an expected release at the end of Q2 of 2017.

To view the measures that are related to the Optometric and Ophthalmic fields, please refer to the following link here.


For More Information




The Purchasing module of My Vision Express is built to facilitate inventory maintenance for your optical retail location or optometric or ophthalmic practice with an in-house optical.

The Purchasing module gives you and your staff to the ability to create purchase orders, handling receiving, and process returns all within one software solution, and to generate purchasing, receiving, and returns reports for visibility into your business.

  • Order and receive frames, contact lenses, and other items by scanning their Universal Product Code (UPC) barcodes.
  • Create purchase orders from ordering screens with a click of the mouse.
  • Add items to purchase orders from specific sales orders.
  • Automatically create purchase orders based on your sales for the day and established reorder points for inventory items.
  • Save and retrieve purchase orders and process receiving and returns transactions with ease.
  • Perform item-supplier validation.
  • Process multiple purchase orders in a single receiving transaction.
  • Specify quantities being received, backordered, canceled, or directly shipped, as well as the actual cost for each item on receiving transactions.
  • Attach supplier invoices to the corresponding receiving transactions.
  • Attach credit memos to the corresponding returns transactions.
  • Print, fax, or email purchase orders, inventory receiving, and returns statements.
  • Perform physical counts of inventory.

Order Entry

Order Entry

The Orders module allows your practice to process sales in My Vision Express with speed, accuracy, and efficiency. In addition, the Quick Order feature of the Orders module is the ideal point-of-sale (POS) screen for your eye care practice. It makes it easy for you and your staff to charge for professional services and eyewear, and to figure out patient and insurance balances.

The Quick Order POS is a convenient way to create orders, fill prescriptions, add payments, and more — all on one screen.


Patient Orders and Payments

  • Use a single screen — Quick Order — for fast order entry.
  • Fill order details from patient's prescription and demographic information.
  • Apply promotions and coupons, and have marketing discounts calculated automatically.
  • Perform line item billing and payments.
  • Process adjustments, write-offs, and balance transfers.
  • Choose from multiple receipt formats to show patient savings.
  • Easily search orders by order number, date, patient name, et cetera.
  • Provide quotes without affecting accounting or inventory.
  • Quickly add lens treatments and services.
  • Easily add lens treatments, services, and miscellaneous items.
  • Transmit orders to labs and track their status.
  • Instant access to cost, profit and commission on the order.
  • Automated rim-type charges for drilled rimless and rimless groove.
  • Second pair tracking.
  • Automatic tax calculation.
  • Conduct end of day reporting and payment activity tracking using the Daily Closing module.

Insurance Processing

  • Automatically determine the patient's due, insurance due, and discounts based on insurance fee schedules;
  • Utilize the system functionality to calculate patient and insurance balances based on discounts, sales taxes, and insurance plan benefits;
  • Accept patient and insurance payments, and process refunds and store credits;
  • Generate a claim for every line item in an order simply and quickly;
  • Generate insurance claims at the click of a button.

Inventory and Transactions

  • Print lab orders, receipts, and letters.
  • Mail-merge order data into custom letters and forms.
  • Quickly track FedEx®, UPS®, and USPS shipments (please note that an Internet connection required).
  • Instantly send contact lens orders from the order screen directly to the distributors.
  • Handle payments for multiple orders or multiple patients efficiently with the Checkout module.
  • Manage return, exchange, reprocessing, and warranty transactions using the After Sales Wizard.

Interfaces and Integrations


What is ICD-10?

The ICD-9 codes used to report medical diagnoses will be replaced by the ICD-10 codes for services provided on or after October 1, 2015. The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA), including optometrists, ophthalmologists, and opticians.

Changing to ICD-10

Medicine and knowledge of medical conditions and diseases has advanced, so the codes used to identify them need to be updated in order to stay relevant.

  • ICD-9 is thirty years old and has outdated and now obsolete terms.
  • The structure of ICD-9 limits the number of new codes that can be created.


ICD-10 provides more detailed and specific diagnoses that will aid providers in accurately documenting a patient's condition. The goals of ICD-10 transition are:

  1. Streamline billing processes for increased efficiency.
  2. Accommodate innovation in technology and treatment.
  3. Allow for more precise methods of detecting fraud.
  4. Better analysis of disease patterns and treatment outcomes.


Insurance claims will be rejected for claims with a service date of October 1, 2015 or later that do not have
ICD-10 codes.


The My Vision Express practice management and electronic health records (EHR) software provides multiple features and resources to help your practice streamline your insurance claims management, such as:

  • Our Injury Builder tool, an industry first.
  • ICD-10 ready insurance clearinghouse interfaces.
  • Automated ICD-10 coding.
  • Easily switch from the ICD-9 code set-up to ICD-10 with the click of a mouse.
  • Preloaded optometric, ophthalmic, and optical ICD-10 codes (with the ability to import all ICD-10 codes if desired).
  • Pre-mapped ICD-10 and SNOMED codes.
  • Comprehensive Training and Support

Centralized Inventory Management

Centralized Inventory Management

Centralized Inventory Management for Multi-Location Practices

The Distribution Center module features central inventory management for multi-location practices, allowing the distribution center to supply locations with frames, contact lenses, finished and stock spectacle lenses, and other inventory items such as optical accessories. All locations order via through My Vision Express using the Distribution Center, which then fulfills the requests.

Distribution Center includes the base inventory features of My Vision Express such as purchase order management, barcode scanning compatibility, reorder points, and maximum inventory limits. Using Distribution Center provides your multi-location practice many additional features, such as:

  • Single-point ordering from vendors/suppliers to fulfill customer orders and replenish inventory needed for each location.
  • Purchase ordering from the Distribution Center allows for items to be drop shipped directly to an individual location.
  • Real-time status updates of inventory allowing transparency on customer's orders.
  • Creation of pick tickets and packaging slips that include bar codes for scanning.
  • Location invoicing for inventory provided through the Distribution Center.
  • Option to hide Distribution Center inventory details and/or cost from locations.
  • Single-screen view to create pick tickets, verify inventory stock, ship requested items, and view/print order item history.
  • Customizable inventory statuses.

Please note that the Distribution Center module is not a lab management software. To transmit orders to your lab, you will need to use interfaces like DVI, Optivision, or Labzilla. Learn more about the lab interfaces My Vision Express supports.



With the Security feature of My Vision Express, you can assign different levels of access to employees according to their job descriptions, and keep track of changes to your data.

For example, you can assign employees to security groups based on their roles within your practice. You can also define an unlimited number of security groups.

Once you have defined the security groups and employee roles, you can choose to show or hide software features for any security group.

This includes hiding reports from front desk/reception, hiding insurance claims from lab employees, showing the refractive section of exams for opticians, and more.


  • Authenticate employees through User ID and Password.
  • Monitor access to patient records through interactions that include date, time and employee name, and are logged automatically by the system every time that a record is accessed.
  • Have the system auto logout after an idle time interval that you specify.
  • Rely on the robust, built-in security of the Microsoft® SQL Server® database engine.
  • Lock exams, prescriptions, and documents to prevent them from being modified or deleted.
  • Audit reports to determine who has added, deleted, or modified sensitive data, using what device, and on what date and time.
  • Use the encryption/hash tool to encode confidential information and verify its integrity in email messages.
  • Integrate with a Windows® domain for single sign-on functionality.



The Commissions module in My Vision Express automatically calculates commissions on products that your practice or optical retail sells. You are able to specify different employee commission types and to base those commissions on orders, product types, or specific products.

Once the commission structures have been specified, you can assign them to individual employees, inventory items, and inventory item types. You can also easily view a report of the commissions earned by your employees using our Reports Portal feature.


  • Specify commissions as a Set Amount or Gross.
  • Percentage or Margin Percentage including Sales Performance Incentive Funding Formulas ("spiffs").
  • Set up commissions at inventory type, individual product, and employee record levels.
  • Create commonly used commission criteria and then later associate them with an employee record, product type, or specific products.
  • Easily change commission rate for items linked to commission structure.
  • Commission amounts can be viewed when orders are created.

Time Clock

Time Clock

Labor management and payroll can be demanding tasks when your practice has to deal with separate, disparate programs to keep track of time punches for your staff. My Vision Express features a built-in, flexible, and easy-to-use employee time clock.

Your practice can lower costs and reduce the amount of administrative time lost with our Time Clock feature.


  • Record arrival and departure times as well as up to three daily breaks for each employee.
  • Track hours worked for your staff.
  • Time punches are clocked from the database server to avoid tampering.
  • Time entry is password-secured to prevent unauthorized submissions.
  • Fingerprint recognition technology adds another layer of security.
  • Administrative access manages adjustments.
  • Keep track of employees' time off from work.
  • Facilitate payroll calculations through time sheet reports that can be filtered by date range and/or employee.
  • QuickBooks® integration means you can directly submit employee and time clock data for streamlined payroll processing.

Employee Messages

Employee Messages

Leave behind sticky notes cluttering desktops and computer monitors, and missing or losing track of tasks buried in long email threads with our built-in Employee Messaging. Your staff can add and send notes without ever leaving My Vision Express, so there's no need to switch between software programs.

The Employee Messaging module allows your practice staff to efficiently exchange information with each other (as well as other offices in a multi-location practice), as well as assign tasks and keep track of task progress all within My Vision Express.


  • Broadcast group messages or send messages to individual employees.
  • Messages automatically pop up within a minute of being sent or immediately after user login.
    • Users will receive a visual cue with the number of new messages/tasks appearing in the toolbar's Messages button.
    • Efficiently communicate between employees and across multiple practices.
    • Schedule and assign tasks and track task status at-a-glance.
    • Link with patient, order, insurance, or exam records.
    • Review messages and tasks by generating a report.

    Daily Closing

    Daily Closing

    Effectively manage accounting and transaction security by using the Daily Closing feature of My Vision Express Daily Closing.

    Daily Closing will lock charges and payments so that they can only be modified by your practice administrators. If any items should remain outstanding for previous dates, you and your staff are reminded to close them the next time you log into My Vision Express.

    Daily Closing is one of the multiple means of loss prevention built-in to My Vision Express.


    • Prevent past charges and payments from being deleted.
    • Specify amounts counted by payment method.
    • Reconcile your registers.
    • Record variances by payment method.
    • Close once or multiple times per day as required.
    • Close individual registers (workstations) or all registers at once.
    • Enter media counts for cash.
    • Get reminders to close outstanding items from previous dates.
    • Print bank deposit slips.