August 2023

Don’t Take a Chance at Missing Great Opportunities at SNAPP Las Vegas Meeting

From the SNAPP Board

If you haven’t yet signed up to attend the SNAPP National Meeting in Las Vegas, Nevada, Sept. 26-28, you’ve got a narrow window of opportunity left. Don’t gamble that you can get the same on-point, relevant information anywhere else.

Here’s what the SNAPP Las Vegas meeting delivers: a veritable royal flush of fresh ideas for productivity and profitability.

• Five hours of free COPE CE for doctors

• A Meet Fellow Operators event to network with those who understand your business

• Financial information on how to increase profits and overall revenues

• A Vision Expo West trade show pass

• A great kick-off welcome reception at the Laguna Pool House


• A sponsor trade show

• A three-hour workshop on how to improve conversions and sales

• The opportunity to qualify for a stipend based on the Member Rewards Program

• The chance to attend a unique meeting specifically designed and delivered to your needs and interests

If you haven’t made plans to come, please check our agenda and meet our speakers. There’s still time to register, so don’t miss out. Register here.

Life Outside of the Business

The logo, featuring a squirrel looking like it’s ready to serve, was designed by Dr. Sexton’s sister. The club features indoor and outdoor courts.

Serving up a New Interest

A way to spend some time with family and burn off some steam during COVID-19 has turned into a new venture for Kyle Sexton, OD, of Sexton Vision Group, a Pearle Vision subleasing doctor with six locations in Washington state.


Dr. Sexton

He had some drainage issues with his driveway at home, so while the crew was pouring a new driveway, he had them turn a part of it into a pickleball court. Neighbors and friends started coming by to play, and Dr. Sexton and his wife Kristen Sexton became proficient. In 2022, she was a medalist at the U.S. Open pickleball championship.

Pickleball is a paddle sport that looks a little like a cross between tennis and ping pong, with some badminton thrown in. It’s a “cerebral game with a lot of strategy. We say it’s easy to learn and hard to master,” Dr. Sexton says. “There are so many nuances to becoming a pro. In terms of strategy, it’s almost like chess; you have to think three shots ahead.”


Pickleball enthusiasts can get instruction, league competition and open playing time.

In early August, the Sextons opened their own pickleball court in Tacoma. It’s called The Drop—named for the critical third shot. After a service and return, the third shot is either a drive or a drop. “If you’re smart, you drop the ball just on the other side of the net,” he says.

Theirs is the second pickleball court in town, which is a little surprising as pickleball got its start not far away in Bainbridge Island, Washington. The Sextons’ club is catering to the more serious competitor, while the other is connected to a restaurant and is focused on introducing people to the sport. Dr. Sexton says that members at The Drop should expect to engage in some good competition.

The club features seven indoor courts and one outdoor court. Even before they opened, people were signing up. “It’s fun and easy. There’s a low cost of entry to the sport. You don’t need lessons, and you get great exercise and fulfillment. It’s a very social sport because you’re near other players.”

Right now, Dr. Sexton’s patients don’t know much about his involvement with pickleball. But as the club becomes more popular and his own level of competition continues to rise, he may not be able to keep pickleball out of conversations with patients.

Revenue Cycle Management

I’m Working So Hard…Where Is My Money?

By Joe W. DeLoach, OD, FAAO, Dipl. ABO, CEO, Practice Compliance Solutions

Sound familiar? Are you even certain that you’re collecting all the money you think/hope was submitted? If this worry hits close to home, you need to take a hard look at your insurance claims process.

You must understand three key variables and one nasty life issue in your revenue cycle management process.

Accounts receivable (AR) days: This is the average time from services rendered to the money is posted. It is calculated by dividing total AR by the annual gross revenue, divided by 365. Management Business Academy (MBA) states the median is 17 AR days. If the number is less than 9, things may be in great shape, but greater than 24 can point to a big problem.

Accounts aging: How long has the claims submission been in process—unpaid? Many look at “buckets”—30, 60, 90, 120 days—but 60 days or greater is key. Per MBA, the median percentage of claims in the 60 days or greater bucket is 20%. Less than 15% indicates that you may be doing great; over 30 days means you could have a real problem.

Although your metrics might be incredible, we say you may be doing great because of these two potential hiccups.

Insurance write-offs: How much money that you submitted for reimbursement was not paid and “written off” or taken off your AR? There is no standard value. If you submit amounts close to insurance allowables, this metric should be very low. If you submit amounts well over allowables, the value will be much higher. The key is establishing an expectation for your office, and it should have a very low variability.

Embezzlement: It’s sad, but this is pervasive. Some experts argue that business owners either know they have been stolen from or they haven’t figured it out yet. Watch your metrics and your cost of goods. Monitor everything, and have a zero-tolerance policy for theft.

Metrics can fail you. If you are not tracking down unpaid claims and simply “writing off” unpaid amounts, metrics can look great, but your expected gross receivables can suffer by 5%-30%. Damage from theft can be immeasurable.

Here are six ways your AR process can fail you.

1. Lack of expertise. The pool of billing experts—even across the entire U.S.—is relatively small.

2. Turnover. Keeping employees has become increasingly difficult. Down time, time for training and a sparse group of experts to choose from all lead to lost revenue.

3. Untimely processing. If a practice is not submitting all claims within 48 hours of the service, it is already behind the eight ball. Every day that a claim is not submitted, a payment is not processed or a rejected claim is not corrected, your potential for collecting your money goes down.

4. Lack of attention to detail. Revenue cycle management (RCM) is tedious. If your front desk personnel is submitting claims, entering payments in between checking patients in, answering the phone and obtaining patient insurance information, it is almost definite that you have RCM problems.

5. A focus on data submission instead of RCM. Is your billing person/company “scrubbing” your claims for accuracy before submission, watching for lost revenue, accurately posting monies and almost never writing off unpaid money? If not, you have a data entry system, not an RCM process.

6. Outsourcing beyond the U.S. Contracting with billing agents outside the U.S. is not wrong but can create issues. Few remote worker companies have legal HR and HIPAA compliance. There can be problems with work delays, expertise and/or communication. We too often hear that remote billers provide a data entry system instead of a robust RCM system.

Outsourcing can be an excellent decision for many practices. A good rule: “Concentrate on your expertise and outsource the rest.”

www.practicecompliancesolutions.com  844.626.6579

HR Update From AmCheck

When Not to Worry About Turnover

Losing an employee can feel like losing an investment, and replacing that person has its own costs—advertising, onboarding, training and coverage, to name a few. But we also know that turnover is a manageable cost of doing business, and sometimes even welcome. In short, turnover is a metric to take seriously, but also realistically.

Let’s examine a few potentially stressful situations related to turnover and explore whether they’re really something you should be worried about.

Potential stressor: Your turnover rate seems high

Whether a given turnover rate is high or low depends on many factors—both in and out of your control. If ineffective or toxic managers are scaring away talent, you should prioritize fixing that. If a bunch of employees resign about the same time, pause and seek to understand why.

But if most of your workforce consists of students who typically leave after graduation or entry level workers who usually put in only a year or two before moving on, prepare for those departures, but they should not keep you up at night.

Potential stressor: New hire quits

It never feels good when a new hire leaves within the first few months of their tenure with you. However, unless it happens repeatedly, it’s less a red flag than a reminder to review your recruitment and onboarding process. Look for disconnects between what is advertised and what the job entails. Conduct exit interviews if the departing employee is willing, and ask open-ended questions about their experience. New employees who come in with a clear picture of what to expect and then have an experience that matches those expectations are more likely to stick around.

Potential stressor: One team has much higher turnover

Higher-than-average turnover rates among certain teams may point to bad management practices or unusually stressful working situations, but they also may be a sign of normal and good things happening. Maybe the teams with higher turnover operate with more entry-level or transitional positions. You may also find that the work that team does is more stressful, grueling or monotonous than work elsewhere in the organization. You may not be able to solve it, but you can account for it.

For many business owners and managers, when people leave, it can feel like you’ve failed. But be kind to yourself. Turnover is normal and expected. Some turnover is good! Approach employee departures with curiosity and patience. They may indicate that something needs to be fixed or tweaked, but they may also be a sign that everything is working as it should.

News of Interest

Study: Low-dose Atropine Not Better Than Placebo in Slowing Myopia Progression

The first randomized controlled trial of its kind aimed at identifying an effective way to manage myopia was published in July 2023 in JAMA Ophthalmology. The study found no difference in the use of 0.01% atropine and placebo in treating children between 5 and 12 with myopia.

The study contradicts earlier studies from East Asia that showed the small dose of atropine is effective in slowing progression of myopia. Researchers noted there may be racial differences in atropine response, and further study, with higher levels of atropine, are warranted. Read more here.

Back-to-school Season Brings $40+ Billion Opportunity for Physical Retail Locations

The back-to-school season is the busiest for American shoppers, only beat out by Christmas.

Forbes reports that the annual back-to-school survey found that 79% of consumers plan to do their back-to-school shopping in stores this year, up from 76% in 2022 and 2021.

Retailers—including optical storefronts—that make the shopping experience more convenient for customers of all ages can take advantage of this busy season, which generally runs through most of August. Read more here.

Respiratory Illnesses Expected to Rise This Fall

Health officials across the country are anticipating an increase in respiratory illnesses this fall, and they are encouraging people to get vaccinated against COVID-19, flu and respiratory syncytial virus once those shots become available. They’re recommending that everyone older than 6 months get their flu shots, preferably by Halloween—an approach called “flu before boo.” Read more here.


Getty Images photo credits—back-to-school: FatCamera; child eye: Michael_Dunning; flu: Oleg_Breslavtsev; Las Vegas: f11photo; and turnover: Prostock_Studio

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