A L LD O C S

ASSOCIATION OFLEASEHOLDINGLENSCRAFTERSDOCTORS

ALLDocsALLDocsThe

NewsletterRx Therapeutics for Practice Growth

Shortly after his graduation fromPennsylvania College of Optome-try last year, David M. Duffy,

O.D., acquired the lease on the Lang-horne, PA, location from his father,John Duffy, O.D. As much as the sonadmired the business that his fatherhad built over the years, he did makeone significant change: he hired a med-ical billing company. That change, alongwith his clinical protocols, has resultedin nearly doubling the practice’s income.

“Even with the percentage charged bythe billing company, typically close to 10percent of collected revenue, it’s worth it.

May 2004

In addition to improving thespeed and accuracy of payments,the billing service has reviewedall of our procedure codes andfees, and has made suggestions offee modifications. The service hasalso obtained credentialing andparticipating provider status withmany managed care plans wewere not contracted with. Thesenew affiliations have created additionalrevenue with patients we could not see be-fore,” said Dr. David Duffy.

“Many LensCrafters leaseholders onlysubmit claims to vision insurance, whereas

I bill medical insurance.” As a re-sult, he typically receives reim-bursements 30 to 40 percenthigher than he would have. Forexample, let’s say a patient comesin with Blue Cross/Blue Shieldbut no vision insurance. An of-fice looking only for vision insur-ance might tell that patient he’dhave to pay out of pocket for a

routine eye exam. But an office that looksat the entire medical picture, which couldinclude diabetes, glaucoma, conjunctivitisor hypertension, for example, can gain ad-

Make Chair Time More ValuableOO..DD.. ffiinnddss bbiilllliinngg sseerrvviiccee hheellppss bboottttoomm lliinnee aanndd pprroodduuccttiivviittyy

Continued on page 2

VIGAMOX™ ReceivesAdditional FDA Approval

In late April, Alcon received U.S. Food and Drug Ad-ministration (FDA) approval to add a supplemental list

of susceptible pathogens to its VIGAMOX, furtherdemonstrating the breadth of coverage and potencythat has made VIGAMOX the most widely prescribedophthalmic fluoroquinolone on the market today.

With the addition of 22 pathogens added tothe in vitro efficacy section of its package insert, VIGAMOX providesthe broadest spectrum in the ophthalmic fluoroquinolone category.The pathogens newly added to the VIGAMOX package insert are:

Listeria monocytogenesStaphylococcus saprophyticusStreptococcus agalactiaeStreptococcus mitisStreptococcus Groups C, G and FAcinetobacter baumanniiAcinetobacter calcoaceticusCitrobacter freundiiCitrobacter koseriEnterobacter aerogenesEnterobacter cloacae

INSIDE:CD on Treating Ocular Allergy

Dr. David Duffy

Morganella morganiiNeisseria gonorrhoeaeProteus vulgarisPseudomonas stutzeriClostridium perfringensPropionibacterium acnesChlamydia pneumoniaeLegionella pneumophila Mycobacterium avium Mycobacterium marinumMycoplasma pneumoniae

Las Vegas 2004Meeting Spot

Selected; PlansShaping Up

The Palms Casino Hotel Las Vegaswill be the site of the 2004 ALL-Docs annual meeting, October 17-

21. The Palms is known as one of thetrendiest spots in Las Vegas. Look foran announcement soon on specialpricing arrangements ALLDocs is creat-ing to encourage members to attend. ■

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Chair TimeContinued from page 1

ditional revenue by billing the patient’smedical insurance carrier.

Not only does Dr. Duffy increase hispractice revenue, the patient and Lens-Crafters benefit as well, he said. Because thepatient doesn’t have to pay for the eyeexam out of pocket, Dr. Duffy has beenable to raise the annual supply sales of con-tact lenses. Also true is that opticians in theLensCrafters store can more easily upgradepatients to better frames and lenses.

O.D.s are their own worst enemies ina financial sense. Dr. Duffy said his father

used to do epilations for free all the time.“Medical insurers will pay $95 for that.Similarly, why charge only $70 for a rou-tine exam, when a diabetic or hypertensivepatient’s medical insurance will pay $135for a comprehensive exam?” he asked.

Dr. Duffy admits that it’s labor inten-sive on the front end, but definitelyworthwhile. “You already have thepachymeters and corneal topographers.Just spend the time to understand the di-agnosis codes and most of these tests andprocedures are billable.”

Dr. Duffy does see patients who donot present with medical indications. Theyhave been happy to pay out of pocketbecause the exam they’ve just had hasbeen the most comprehensive one ever.

Working with a reputable billingcompany also protects O.D.s from mak-ing common billing mistakes. “So manyO.D.s are afraid of being audited if theystart billing medical insurance, but thebilling company has an equally highstake in not submitting fraudulentclaims. So they’re stringent,” he said.

“My chair time is what earns my in-come. It’s what no one can take away.Everybody sells contact lenses, so I tell pa-tients, ‘Here’s what my contact lenses cost.You can get them here or wherever youwant. I’m here to take care of you.’” ■

ALLDocsALLDocsThe

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Letter from the President

Iwant to encourage ALLDocs mem-bers to come to our annual meet-

ing in Las Vegas this fall. A strongturnout benefits us all by providingthe opportunity to share more in-formation with our colleagues. Those of us whohave been to meetings before find we return toour practices with a number of solid ideas forbetter patient and clinical management. Ourmeeting is also our best chance of showing sup-port to our vendor sponsors. Many of these ven-dors come up with unique and interesting con-

tests or promotions just for us.Keeping current with what’s new in products and technologies is

critically important as the industry is changing. As competition forcontact lens sales becomes more intense, and profits are squeezed,this is a good time to find ways to distinguish ourselves. By beinginvolved in the medical end of eye care, we benefit our patients,LensCrafters and ourselves. I refer you to the experience of Dr.David Duffy and the column by Dr. John Rumpakis for more infor-mation. Take heed: this may be our best chance to protect our prac-tices and protect LensCrafters’ patient base.

Finally, as we are putting together a vibrant and informativeprogram for the annual meeting, feel free to make suggestions. Ifthere is a particular topic you want to hear discussed, please fax meat 732.726.1735 with your suggestions. ■

Dr. Gelb

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eration: A look at the history of an-tibiotics and a primer on the latestgeneration of agents. By Alan G. Kabat,O.D., and Mark R. Bloomenstein,O.D. Available online at: http://www.revoptom.com/index.asp?Article-Type=SiteSpec&page=osc/feb04/al-con_antibiosis.htm

◆ Dry Eyes: A New Look atan Old Problem: While there is along road ahead, we are finally begin-ning to understand how to treat theroots of this disease. By Stephen Co-hen, O.D. Available online at:http://www.revoptom.com/index.asp?ArticleType=SiteSpec&page=osc/feb04/alcon_dryeyes.htm ■

O.D.s seeking online educationon therapeutics can receiveup to three hours of free con-

tinuing education credit sponsoredby Alcon. Each of the followingcourses is approved for one hour.

◆ Ocular Allergy Update: Re-cent developments in understandingand treating allergies make the atopicpatient more treatable. By ArthurB. Epstein, O.D., and John Yanni,Ph.D. Available online at: http://www.revoptom.com/index.asp?Arti-cleType=SiteSpec&page=osc/feb04/al-con_ocular.htm

◆ Antibiosis: The Next Gen-

Alcon Sponsors 3 Hours of COPE-

Approved CE Online

““MMyy cchhaaiirr ttiimmee iiss wwhhaatt eeaarrnnss mmyy iinnccoommee..

IItt’’ss wwhhaatt nnoo oonnee ccaannttaakkee aawwaayy..””——DDrr.. DDuuffffyy

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tient could benefit from punctal occlusionand begin with using a collagen plug toocclude the two inferior puncta. At a fol-low-up visit two weeks later, determine ifthe combination of the palliative therapyand collagen plugs have helped. Basedupon these results, then continue your

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

As primary care O.D.s, we need tosee ourselves as the entry pointinto the eye care health system,

not just the world of refractive correction.Since nearly two-thirds of all first-time eyecare encounters takeplace in an op-tometrist’s office, in-tegrating primarycare eye care intoyour practice is es-sential to capturingour full marketplacepotential, and ex-panding our rev-enue base far abovethat of providing re-fractive care only.

To illustrate,consider a specta-cle-wearing patientwho reports dis-tance blur, wateryeyes, bothersomeglare and regularscratching and burning sensations.While doing the routine exam and pre-scription change as well as the anteriorsegment examination, you notice thatthe tear film looks irregular and that thelid margins are suspect for tear insuffi-ciency. Rather than simply provide asample of an artificial tear (perhaps evenwithout any direct recommendation onformulation or use), recognize that thispatient may benefit from palliative thera-py, and may also have some underlyingcondition/medication that could be caus-ing these symptoms. Schedule additionaltests such as Schirmer I & II tests, phenolred, lissamine green and tear break-uptime to reach a formal diagnosis relatedto their non-refractive complaints. Rec-ommend palliative therapy, such as SYS-TANE™, with a treatment protocol andschedule the patient for a follow-up visit.

At the follow-up visit, perform the ap-propriate level of case history, review ofsystems and medical testing. In addition tothe SYSTANE therapy, determine the pa-

The Medical Model

Paradigm Shift toward Primary Caretreatment plan withocclusion of the inferi-or puncta with semi-permanent siliconeplugs and schedule follow-up visits for onemonth, three months and six months.

Look at the economics in the ac-companyingtable. It recog-nizes the diag-noses and treat-ment of the pa-tient’s refractiveand medical is-sues. The addi-tional amountof time spentwith the patientto perform theancillary testingand procedureswas most likelyless than 45minutes. Thatis time ex-tremely wellspent. ■

Look at the EconomicsREFRACTIVE MODEL MEDICAL MODELCPT code used: CPT code used:92004 – New patient, CE $79.00 92004 – New Patient, CE – Recommend SYSTANE $79.0092015 – Refraction $25.00 92015 - Refraction $25.00Spectacles $300.00 Spectacles $300.00Give Samples 99213 – E/M return $65.00

68761-E2,E4 – Occlude inferior puncta (collagen) $365.0099213 – E/M return $65.0068761-E2,E4 – Occlude inferior puncta (silicone) $365.0099212 – E/M return $45.0099212 – E/M return $45.0099212 – E/M return $45.00

Total $404.00 Total $1399.00

(Schedule of visits and fees used for example only. )

ALLDocsALLDocsThe

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Dr. Rumpakis

Inside this issue of ALLDocs, practition-ers will find a CD containing practice-building tools to help uncover allergic

eyes. The CD, supported by a grant fromAlcon, contains customizable recallcards, a patient letter and a patient sur-vey to help practitioners identify patients

suffering fromseasonal aller-gies—year-round.

The op-portunitiesfor practicebuilding areenormous.Consider thefollowing:

◆ 60 percent of all allergy sufferers have ocular conditions.

◆ There are 30 million potentialocular allergy patients.

◆ 50 percent use OTC products.◆ 41 million bottles of OTC aller-

gy drops are purchased yearly, com-pared to only five million prescrip-tions for allergy eye drops. ■

Allergies: The Practice-BuildingOpportunities

Recall card

CG_240558 7/21/06 10:05 AM Page 3

Supported by an unrestricted educational grant from Alcon Laboratories

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“We have a large contactlens practice and seecontact lens-related

complications rather often,”said Nancy Wolf, O.D., Man-chester, NH. Corneal ulcersfrom extended wear or over-wear of daily wear lenses andoccasional corneal abrasions arethe typical problems for whichshe’ll reach for VIGAMOX.

“It’s an excellent productand I like to provide immediatetreatment to the patient when I can,” shesaid. Thanks to her Alcon rep’s generositywith samples, she’s able to put the firstdrop in herself. “Otherwise, when I onlyhand out a prescription, the patient maynot fill it until the next day,” she said.

“Go for the Big Guns”OO..DD.. rreeaacchheess ffoorr ssttrreennggtthh wwhheenn ttrreeaattiinngg iinnffeeccttiioonnss

ALLDocsALLDocsThe

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Immediate treatment, combinedwith potency, means patients begin re-covering more quickly. “Especially with

corneal ulcers, you want to gopotent. I want to hit them withthe big guns because I’m deal-ing with something that couldpotentially cause vision loss.”

Overall, having therapeuticsin the practice is “very impor-tant,” Dr. Wolf said. “The pa-tients that I’m fitting with con-tact lenses expect me to be han-

dling all of their eye care. If I had to turnsomeone away who needed treatment fora relatively simple infection, I wouldn’t beproviding comprehensive eye care. In or-der to keep patients in my practice, I needto be able to do that,” she said. ■

VIGAMOX TopsOther Anti-Infectives

VIGAMOX ophthalmic solu-tion is now the most often

prescribed anti-infective by op-tometrists, according to Source™

Prescription Audit (SPA). It is un-like any other ocular anti-infec-tives because the unique struc-ture of VIGAMOX provides supe-rior potency of fluoroquinolonesfor gram positive pathogens.

The therapeutic concentra-tion of VIGAMOX provides pen-etrating results. VIGAMOX has66 percent more antibiotic inevery drop, providing superiorin vitro potency and ease ofuse with one drop, t.i.d. dosingschedule for seven days. ■

Dr. Wolf

G U E S T C O L U M NWhat’s Up Doc?

By Bob Scott, Director of National Accounts, Ocular Sciences

As you gear up for the long, hot summer, your friendsat Ocular Sciences want to update you on exciting

developments. When ALLDocs talks, OSI listens. You’vetold us your wants and desires and we’ve responded.

Watch for information in July on the new Versaflex55% Aspheric lens, which corrects for spherical aberration in the lens andthen incorporates a second aspheric adjustment to correct for the aberra-tion that occurs in the eye. Get ready for clearer, sharper vision and aneven more comfortable lens wearing experience with a new thinner andsmoother edge design. Also, we are ready to provide you with the triallenses you need and to back it up with world-class customer service. Anddid you know that OSI pays the Advantage 2% Administration Fee whenyou purchase any OSI/Sunsoft product via LensCrafters?

Ask your OSI representative for information on:◆ New Versaflex Toric lens banks,◆ Diagnostic sets of Versaflex Toric (plus and –1.75D cylinder),◆ New Toric fax diagnostic reorder pad or postage-paid mail re-

order option,◆ Availability of the –2.25D cylinder for the Versaflex Toric,◆ Introductory offers on disposables and MRP lenses,◆ Colors promotions for add-on sales,◆ OSI rebate offers on Disposable, MRP, Colors and Toric, and◆ Sunsoft Torics—custom fits for any prescription. ■

Bob Scott John Smith, O.D., Elyria, OH,said the annual ALLDocs meet-ing is “always the best meeting

of the year.” He attended his firstmeeting in 2002 in Las Vegas becauseof the location and “came to the de-cision that I’m not going to miss it. Iimagine I’ll go every year,” he said.

The Cancun meeting didn’t disap-point him. The key attraction is thatthese meetings offer a chance to talkwith O.D.s in similar practice settingswith similar concerns. Even thoughLensCrafters leaseholders in his regiontry to schedule a dinner together a fewtimes a year, “sometimes we make it,sometimes we don’t.” But at the ALL-Docs meeting, he gets to hear what’shappening at like practices. “We all havethe same issues and nobody is afraid totalk about them.” The O.D.s’ conversa-tions feel more cooperative than com-petitive, he said. ■

CANCUN MEET ING FOLLOW-UP

ComparingNotes with Others

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