SNAPP Insider Monthly – March 2021

Ocular Surface Disease More Prevalent Than People Realize

Lisa Hamilton, OD, SNAPP Board Member


When SNAPP board member Lisa Hamilton, OD, decided to prioritize the treatment and management of ocular surface disease (OSD) in her practice last year, she was quite surprised by her initial findings. Dr. Hamilton conducted an informal study by performing meibography on all patients of age 25 or older for a period of 90 days. There was no charge for the procedure. “I was shocked at how much atrophy I was seeing, even in my young population,” Dr. Hamilton says in the cover story of the Fall 2020 issue of Corporate Optometrist. She found approximately 30 percent of her patients demonstrated significant asymptomatic gland atrophy. OSD typically stems from inflammation or poor blinking. Cases are increasing as the use of digital devices grows.



Proactivity Through Prevention



Dr. Hamilton strongly advocates prevention as a key to treatment in the area of OSD. “My dentist does not wait for me to complain of a toothache before ordering an x-ray,” she says, noting that optometrists can (and should) provide comprehensive exams that identify ocular surface problems at the earliest, or “pre-clinical” stage. Over the years, she has brought more diagnostic instruments into her office, and as she’s building a dry eye practice, she’s adding even more.



More Than a Nuisance



While many patients believe symptoms such as gritty, watery or red eyes are simply facts of life, many are delighted to learn of progress being made in this area when educated properly. Commonly known as a multi-factorial disease, OSD consists of inflammation, Meibomian gland dysfunction and tear volume/quality deficiencies. Dr. Hamilton has seen that treating just one of those components might provide temporary relief, but it won’t resolve the disease.

Read the article in which Dr. Hamilton explains her approach to OSD and how she has prepared her practice to do more for patients.



Resources for Dry Eye





Poll on Dry Eye/Ocular Surface Disease



This month’s survey is geared to promote ocular surface disease awareness and SNAPP’s exclusive Expert Panels! Please take our survey as we continue to develop this exciting program.

Also remember that you can sign up for any of the five expert panels: Dry Eye/Ocular Surface Disease, Retina/AMD, Safety Eye Wear, Myopia Management and Doctor Efficiency here.



Your Vaccination Responses



SNAPP conducted a poll of readers in the February issue of the SNAPP Insider, and all respondents reported they have either received the COVID-19 vaccine or plan to.

Many are also encouraging staff members to become vaccinated against COVID-19. Two-thirds of respondents said they are sharing their own vaccine experiences with staff members and offering encouragement to receive their shot(s) as soon as possible. About one-third of the respondents said they are offering flexible staff scheduling to support the effort to reduce the spread through vaccination. The survey indicated 20 percent of respondents are offering paid sick time if employees develop significant side effects from the vaccine.


In each issue, we’ll bring you a variety of updates from recent news events.

Patients Bothered By But Don’t Report Dry Eye Symptoms



A March 2021 study, Patient-reported burden of dry eye disease in the UK: a cross-sectional web-based survey, noted that patients with mild symptoms are unlikely to report the condition to their doctor, making it difficult to state accurately how prevalent the disease is. Researchers conducted an online survey of 1,000 patients with known dry eye disease and 1,000 without. “A higher proportion of participants with dry eye disease reported problems with mobility and experience more difficulties in their day-to-day activities than patients without the condition. The surveys also revealed they were more likely to suffer from anxiety and depression. Read more.



The World Council of Optometry and CooperVision Partner to Define and Promote a Standard of Care to Treat Myopia Progression



In March, the World Council of Optometry (WCO) and CooperVision announced a global partnership to raise awareness of myopia progression and encourage optometrists to embrace a standard of care to manage the condition. The joint initiative’s standard of care definition and promotion will be centered around evidence-based approaches not weighted toward any particular treatment type. The partnership will establish a global resource to include multilingual myopia management resources and programming. Read more.



President Biden Adds Optometrists to Expanding List of COVID-19 Vaccinators



A fact sheet issued by the White House in conjunction with President Joseph R. Biden’s prime time address on March 11, 2021, notes that his administration will expand the pool of qualified professionals able to administer shots. The list includes optometrists, dentists, advanced and intermediate emergency medical technicians, midwives, paramedics, physician assistants, podiatrists, respiratory therapists and veterinarians, as well as medical students, nursing students and other health care students in the previously listed professions under the Public Readiness and Emergency Preparedness Act. Optometrists in at least eight states are now eligible to administer the vaccine. Read more.



Heart Disease Marker Present in OCTs



A study published in March 2021 from the University of California – San Diego says that researchers have identified a potential new marker that shows cardiovascular disease may be present in a patient using an optical coherence tomography (OCT) scan of the retina. The finding suggests it may be possible to detect heart disease during an eye examination. The researchers concluded, “Tests that can help identify patients with cardiovascular disease may lead to earlier interventions, thereby reducing the odds of subsequent adverse cardiovascular events. OCT scans are commonly performed in ophthalmology clinics, noninvasive, inexpensive, do not involve any ionizing radiation, and do not require pupillary dilation nor the use of an intravenous dye.” Read more.


Top 5 Ways to Check Your Billing Successes

By Amanda Whitener, VisionWeb

One great way to gain transparency into whether or not your biller is doing the job you expect them to is by running reports to review and monitor the health of your practice. Doing so will help in identifying trends that, upon addressing, can lead to higher and more consistent cash flow. The five essential reports below will provide additional insight into your practice to catalyze revenue growth.

• Denial rate by service line – Be careful to steer clear of denials reported by claim level as this will not give a clear indication of all the issues taking place on each claim. Reviewing your denial rate by line level can help identify if your billing team has the system set up properly, are pulling benefits correctly and are sending claims out with all payer-specific, required data sets.

• Denial count by adjustment code category – Review this report for spikes in specific denial types as they can be an indication of several factors. Perhaps the referring provider is not copying over to the claim forms or maybe there was an update to a particular Dx that now requires a greater level of specificity. This report will give you a starting point for this deep dive.

• Processing time analysis – Time is money and this report allows for insight into how long it is taking to get claims out the door. Since this metric includes rebills, a high processing time may indicate that your practice is experiencing an unusually high amount of rejections. Drilling down to the reason for the increase can not only assist in overturning the current rejections but also mitigate any in the future that would have resulted from the issue. If you see an unusually large decrease in processing time, it may be time to ensure your billing team is working and resubmitting rejected claims.

• Patient responsibility – This report allows for insight into how much patients are being charged for deductible, co-insurance or co-pays. An unusual increase or decrease in the average may indicate that your biller is not calculating benefits correctly. Keep in mind that it becomes much harder to collect any balance from a patient as time goes on. Collecting the correct amount at time of service will help keep your cashflow strong and your patient population satisfied.

• Utilization report – When compared with national averages, this report is pivotal in identifying potential risk of an audit. Insurance carriers are well aware of the national averages and may want to take a peek into any practice falling a decent amount outside those averages, but fear not! Your patient demographic and documentation support the usage, so you will be just fine.

As a final note, having the national average to compare your results can assist in identifying potential opportunity for your practice. Look at the metrics that are significantly outside of this average and begin a deep dive on them. You may find a small change that could result in a big dividend.

Amanda Whitener is a key member of the Revenue Cycle Management team at VisionWeb. She helps practices understand the gaps in their own processes and make informed decisions about how to grow that aspect of their practice.

Reach out to Amanda with any other billing questions you have here, she might have the solution for you.


Benefits of Hiring A Millennial



Should your next hire be a millennial? A team member from this generation could bring many valuable assets to your business.


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