Justify Your Contact Lens Fees to Your Patients
BY RONALD G. SEGER, OD,
FAAO, AND STEVEN B. RICHLIN, OD
Patients around the world want contact lens practices to provide low-cost contact lenses, and sometimes they want low-cost contact lens care as well. In fact, many contact lenses are commodity items that are difficult to differentiate. We have found that patients do not necessarily want commodity contact lenses, and they certainly don't want commodity eye health care or contact lens care.
Contact Lens Patients vs. Non-Contact Lens Patients
Contact lens practitioners perform a different exam on contact lens patients vs. how they examine non-contact lens patients. We have developed a list of customary services that represent separate and distinct services for contact lens patients.
Table 1 shows this list. We find it a useful tool for communicating with our staff and patients. In the past, patients would ask questions about contact lens service fees, but staff and patients did not have a clear understanding of what occurred in the exam room or what services were associated with the contact lens portion of the eye exam. With this list our staff can discuss clearly identified and justified procedures with patients who have questions about their eye care, contact lens care and the fees associated with each.
TABLE 1: Contact Lens Exam Services
Contact lens fees vary depending on lens type and the amount of problem-solving required, as well as from practice to practice. We charge these fees in addition to basic eye exam fees. Following is the list we use for our practices (which may not be appropriate for your practice). Our contact lens exams can include any of the following services:
1. Review of contact lens history
2. Review of current vision, comfort, handling, care solutions and other contact lens-related concerns
3. Distance visual acuity with contact lenses
4. Near visual acuity with contact lenses
5. Auto refraction over contact lenses
6. Refraction over contact lenses
7. Visual acuity with over-refraction at distance and/or near
8. Reading prescription with spectacles
9. Monovision evaluation with dominance evaluation
10. Biomicroscopic exam with contact lenses
11. Eyelid evaluation/eyelid eversion
12. Corneal topography
13. Keratometry (central corneal curvature)
14. Biomicroscopic exam without contact lenses
15. Fluorescein examination with and without contact lenses
16. Trial fitting of contact lenses
17. Visual acuity and evaluation for trial fitting
18. Discussing recommendations and treatment options
19. Reviewing patient concerns
20. Prescribing and ordering contact lenses
21. Providing contact lens solution samples
Dr. Seger is in private practice in Silicon Valley and performed research and development for several contact lens manufacturers. Dr. Richlin is the senior managing partner of a group practice in Beverly Hills, CA, and clinical vice chairman of optometry at Cedars Sinai Medical Center in Los Angeles.