From my perspective, and what I have witnessed working with numerous practices and speaking with colleagues, ophthalmologists typically take one of three stances to collaborative care.
STANCE 1
You are fully engaged and have positive firsthand experience participating in a sophisticated collaborative care program with your optometric community. Point of fact, you lose sleep over harming these delicate relationships, as you know how important they are to your bottom line and reputation.
STANCE 2
You roughly understand that shared care has contributed to your colleagues’ success; however, you lack the energy or drive to introduce yet another change in your practice.
STANCE 3
You think, “There is no way I am cutting off the hand that feeds me; why would I pay someone else when it is money out of my pocket?”
Certainly, these are all concepts that every practice has considered at some point; however, the advantages of collaborative care are multiple. This article details a few pearls that have led to the success of an extremely well-organized collaborative care program at the Eye & LASIK Center.
BUILDING A COLLABORATIVE CARE PROGRAM
When we felt ready to promote our comanagement program within our optometric community, we first did our due diligence, brought in the help of outside consultants, and visited successful practices with experience in this area. From there, we set up a list of our current referrers and added potential referrers.
We set up meetings to introduce the win-win strategy for our collective patients and promoted the power of working together—an extremely important step in getting both teams prepared to manage patients. The topics addressed included:
- How referrals would be processed for our patients;
- What forms needed to be completed (it is imperative that the patient is allowed to make the decision on who follows up with their care);
- How both teams should successfully submit clean claims with appropriate modifiers;
- How communications between the two offices would be handled; and
- How and to whom payments would be made when it came to splitting fees.
We developed a comprehensive protocol manual with all relevant information, from the surgeons’ names and information to overviews of the premium technologies available at our practice. This manual contains sample patient consent forms, with a step-by-step outline of what the patient experience at our practice or surgery center. Also enclosed is a staff roster for the Eye & LASIK Center, detailing who to call in any given situation, from making the initial consultative appointments, to querying the billing department, and even to getting in touch with the surgeon.
We invited the optometrists to come into the operating room with the surgeons when their patients were being treated, and we spent time reviewing the postoperative care that was required for the different types of cataract procedures performed at our practice.
As our community of comanagers grew and our surgical volume increased, we felt the need to also enhance our relationships with external optometrists. We created a calendar to schedule regular visits to their practices, and our community outreach coordinator stopped by on a consistent basis to bring pastries and cookies to the offices and help build top-of-mind awareness. Another valuable tactic we employed was bringing back to our office the optometric practice’s business and appointment cards so that we could schedule patients’ postoperative appointments using their collateral. The little things can make a huge difference.
Success comes not only from working together and showing support of the optometric community but also from communicating and working together to provide the best possible patient experience. When the teams align, the optometrist wins by offering services that he or she does not perform, and the ophthalmologist wins by freeing up postoperative time slots with potentially more consultative appointments. We ensure that patients return to the referring optometrist’s optical shops to buy glasses, and the optometrist, in turn, keeps us in mind when it comes to providing services that are outside the scope of his or her licensure.
BECOMING THE GO-TO PRACTICE
In a time when we are barraged with regulations and cuts in reimbursement, we need to look outside of our normal practices to enhance our bottom line. Ophthalmology is a specialty that provides practices with unique opportunities to expand their elective services with technological advances in surgery, diagnostics, and even optical shops for patients to pay out of pocket. In doing all of these things, it is imperative for a practice to fortify its stance in the community as a leader in working with external referrers, understanding what is important to them, and consistently maintaining and delivering the highest standards of care.
