AADO course tells how to protect your dispensary from fraud

September 15, 2005

Ophthalmologists are increasingly adding dispensaries to their practices to bolster their income at a time when costs are rising and third-party reimbursements aren't keeping pace. But ophthalmologists may not have learned business savvy in medical school, so may be ill-equipped to run what can be a profitable and patient-pleasing aspect to their practice. For better or worse, many ophthalmologists turn over this portion of their practice to an administrator or dispensary manager, who is trusted to handle large sums of money.

Ophthalmologists are increasingly adding dispensaries to their practices to bolster their income at a time when costs are rising and third-party reimbursements aren't keeping pace. But ophthalmologists may not have learned business savvy in medical school, so may be ill-equipped to run what can be a profitable and patient-pleasing aspect to their practice. For better or worse, many ophthalmologists turn over this portion of their practice to an administrator or dispensary manager, who is trusted to handle large sums of money.

According to Pamela B. Fritz, FNAO, executive director of the American Association of Dispensing Ophthalmologists (AADO), ophthalmologists must beware of the potential to commit fraud.

"Unfortunately, I'm finding mismanagement in some optical dispensaries is, frankly, why a lot of ophthalmologists have hired me (as a consultant)," Fritz said. "The ophthalmologist turns over the reins of the optical dispensary to someone, and no one is watching the (dispensary)."

The second AADO course on Oct. 16, designed as a workshop for practice administrators and optical managers, will include information on protecting the practice from fraud.

Fritz said she has fired some individuals from practices in which there were some "hard-to-prove thefts" from the dispensary.

"It's hard to prove it, but in one case it made a difference in the dispensary revenues of 50%," she noted.

The rest of that session will offer instruction on setting up management systems, job descriptions, and office procedures, how to hire and train dispensary staff, how to evaluate and compensate the staff, and how to track dispensary productivity.

Earlier on Sunday, Vincent K. Young, MD, and Phernell Walker, ABOM, will present the latest advances in ophthalmic lens design, with instruction on the differences between film coatings and lens treatments, conventional and free-form lens surfacing, and aspheric versus atoric lens designs.

Monday morning's session (Oct. 17) on managing contact lenses is also vital in today's ophthalmic dispensaries, Fritz said. Presenters Katherine McNelis, COT, ABOC, and Dr. Young will discuss how to develop a general fitting philosophy for contact lenses and establish procedures and policies for handling patients, determining their needs, and placing orders.

On Monday afternoon, Fritz will moderate a roundtable discussion with Dr. Young, Martin Wilson, MD, and Dwayne Baharozian, MD. Although this course has been held previously, the participants will relate new experiences in setting up dispensaries and key issues to consider, such as Dr. Baharozian's efforts to convert to electronic medical records technology and Dr. Wilson's work with pediatric dispensing.

Managing the post-cataract eyewear business-and getting the Medicare coding right-is critical for practices, Fritz said. That's why the association is presenting a whole course on this topic on Tuesday, Oct. 18.

The course will cover Medicare coding and reimbursement procedures for eyeglasses after cataract surgery, including how to accept assignment, file paperwork with secondary insurance information, and more.

As a consultant, Fritz has had to help practices correct their coding procedures.

"I can't tell you one practice where they were doing it right," she said. "It's a big issue."

Courses have been approved for 12 hours of Continuing Medical Education credits, plus American Board of Opticianry-approved for opticians and Joint Commission on Allied Health Personnel in Ophthalmology-approved for practice administrators. The courses are geared for managers-not optical technicians.

In addition to the courses, the AADO is encouraging ophthalmologists to stop by its booth in the exhibit hall for a free dispensing consultation with members of the association's board of directors.

This is the first year that AADO is presenting its courses at the academy's annual meeting; previously it held its courses during Vision Expo. Fritz said the move more effectively gets the information to ophthalmologists who are expanding their practices with dispensaries to offset reimbursement cuts. About 60% of AAO members have dispensaries, Fritz said.