Communicating with Patients About Retinal Imaging Improves Profitability

As practitioners, we understand the importance of retinal imaging, and we need to be able to clearly explain that value to our patients. 

I’ve found that communication is key with patients — before, during, and after their appointments. This helps to eliminate any questions, and it ensures that they’re not only on board with the testing, but they understand why you’re doing it, what to expect, and how much it will cost. By taking the time to properly train your office staff to be able to prep patients ahead of time and answer their questions, it will help you increase your revenue. 

Before the Exam
I’ve developed a script that I provide my office staff to help guide them through conversations with patients over the phone every step of the way. This prepares patients for the retinal scan, and it also includes information on exactly how much it will cost. These conversations typically go as follows: 

Front Desk: “Your appointment is scheduled with Dr. Bui. Your exam fee with retinal screening is normally $180, but with your insurance, your out-of-pocket cost is $49.”

While many conversations end with this information, some patients do have more questions, especially if their co-pay was cheaper at their last exam. 

Patient: “What does the $49 payment cover? My copay was only $10 last year?”

Front Desk: “Your exam copay is $10, but our doctor requires all patients to have a $39 retinal screening to detect health conditions related to the eyes, such as hypertension, cholesterol, or diabetes and other potential vision-loss diseases.”

This explanation is likely to satisfy most patients, but for those who may fight back against the $39 copay, we instruct our front office staff to keep their appointment scheduled and explain that I will discuss their options with them in-office. 

Day of Exam
When the patient checks in for their exam, it’s important to reiterate the previous phone conversation: the exam fee with the retinal screening is typically $180, but the out-of-pocket cost with insurance will be $49. 

If the patient isn’t keen on spending the money on the retinal exam, I still encourage my techs to perform the test anyway. I can make the final decision on whether or not to charge the patient for the exam. For your first year during any transition, I give my ODs the option to waive the $39 fee if there is any serious pushback. In my experience, this has been rare. During our first year, we were at 95% acceptance, and now we are at 100%. 

Before I meet with the patient, I’ll have the tech give them a teaser on their retinal imaging results, without reviewing them, to create a sense of excitement and add value.  

Doctor Exam
When it’s time for me to meet with the patients, I always go over the game plan with them to eliminate any surprises. This makes your patient less stressed out and cooperative during the process, and they leave happy. 

I’ll say something like the following: 

Dr. Bui: “Based on your issues and chief complaint today, I am going to check out your vision to make sure you are seeing well at distance, near, and immediate. Based on that, we will see if we need to adjust your contact lens prescription. Then, I will check the health of the front of the eyeball to make sure there is no dryness. Lastly, I will take a look at your retinal scan to make sure there is no disease back there. We probably don’t have to dilate unless I see something suspicious on your retinal scan. Any questions before we get started?”

After the refraction, I usually offer some words of encouragement to the patient, and then I take the time to reinforce the importance of the retinal scan. Going over the retinal imaging is also where I spend the most time with the patient during the exam. I typically let them know that early glances at their scan showed promising results, and I’ll explain that to them in depth after reviewing their scans with special lenses. After looking at their retina un-dilated with the 90D lens and their retinal imaging scans, I’ll go through the results with the patient. That conversation looks like the following:  

Dr Bui: “Your retinal blood vessels look great, no sign of hypertension, cholesterol, or diabetes. This is your macula; that is what gives you that crisp 20/20 vision, nice and clear! Just make sure you wear sunglasses to protect yourself. Your optic nerve looks great, no sign of glaucoma. Your retina looks great, no tears or bleeding out there. Nice clean bill of health. I will see you back next year. I will take another scan next year so we can compare it to today’s for any ocular changes. Any questions for me before you take off?”

At this point, most patients are amazed by how comprehensive the exam was, and the value of the retinal scan is instantly clear to them. 

Tips/Common Questions

• You can make retinal scans mandatory as a part of your standard fee or leave them optional. Either way, the high-rate capture (over 95%) is due to how you present it.
• This is a cash-pay screening. There are some vision care plans that will pay for it (rare), so check prior, but 90% of the time, it is the patient’s responsibility. 
• This method works in ALL types of practices, from high-end, to corporate, to low-income Medicaid practices. I’ve worked in all types and have helped ODs establish this routine effectively.  
• Will some VCP or Medicaid plans restrict you from making it a requirement? That is going to be up to you. It is a cash service — aka, an elective procedure. Does medical insurance stop you from selling cash-services on top? Nope! Remember: in an audit, you can argue that this is your standard of care (and 50K+ ODs would agree) and wide-field imaging is optimal for best care. 
• $39 cash x 15 exams = $585 x 6 days x 52 weeks = over $182,520 in gross profit annually.

Conclusion
Talk with confidence and a casual tone when presenting it to your patients. Remember that you never have to sell anything as a medical doctor; this is your standard of care and how you want to practice.

Lastly, as a financially focused optometrist, all of your equipment purchases should generate an impressive return on investment, leading to higher profits and better business outcomes. Check out our conservative revenue breakdown for popular equipment here.