Optometric Billing: A Cottage Cheese Industry?

As an optometric biller, one of my favorite things to do is stay current on my chosen field of work. Many days, when I am not speaking to clients or just can't sleep, I find myself surfing the web looking for information on optometric billing or just searching for optometry information or optometry blogs. Last week, as a result of my incessant surfing, I came across the optoblog, a peronal opinion blog of a wal-mart vision center optometrist. 

"EUREKA!" I said to myself, as I eagerly clicked the link and began reading. You see, I had just learned a few days earlier that Wal-mart will no longer be performing the billing for the optometrists. Instead, Wal-Mart has dictated that it is now up to the optometrists to do this billing themselves. I was excited to become a member of the optoblog and contribute to his site, hopefully gaining links to my own website and to let him know that, "Hey, RLR Consulting is out here and we want to help!". 

It has always been a business goal of mine to try and get Wal-Mart vision as a client. I mean seriously, it makes great business sense. First of all, Wal-Mart vision is every where and so it is a huge potential for my own brand recognition and a huge cash-flow potential. Also, it would help my company meet one of our stated goals: to become synonimous with Optometric Billing.  However, I learned about 3 years ago that Wal-Mart, being the ever inventive business outfit that they are, performed the billing itself through a huge network of billing software coregraphed throughout the company. So I gave up and persued other ventures since we just could not compete. Recently, however, we began writing our own free software specifically for optometry that would be a great fill-in for these optometrists that are being left to fend for themselves by Wal-Mart. 

So as I was surfing that night and came across the optoblog I immediately began trying to create a business contact with the blog owner, an optometrist at Wal-Mart himself. I left a comment to one of his posts which blasted President Obama saying it was his fault Wal-Mart is doing what they always do, looking for the best way to save money and keep their prices low. 

My comment was left amidst a myriad of competitors comments; medical billers who themselves swore they had what it took to do the job for this man. (If you want to see what I feel about medical billers over-extending themselves into areas of billing they have no business being in, see my article posted on this blog entitled: " Optometric Billing....How I See It." ) I told the doc that I specialized in Optometric billing, check my websites and if you don't want us to help at least lend a helping hand by becoming a contributor to our blog so that his voice can help other optometrists and he will get a few links to his own blog in the mean time. A win-win offer I assumed.  So I waited eagerly for his reply.

Then, on May 2, 2009, I received my reply. Instead of posting my comment to his article, along side the other people who just plain out advertised to him, the owner of the blog, called optometric billing a cottage cheese industry and a response to Wal-Mart's decision to stop doing it themselves! In fact i quote the optoblog: 

"With Walmart’s announcement of a sweeping change about getting out of the business of billing vision insurance companies for their doctors, a whole new cottage industry has sprung up. Businesses are soliciting Walmart doctors to let them handle all the insurance billing.

Yup, I’ve said it before and I’ll say it again. Ophthalmic vendors think we optometrists are so stupid. Just because we picked this profession, they think we are prone to making poor financial choices just like some people are accident prone."

A cottage cheese industry he says! I bet my clients would have some strong words for him about those statments!

Now this optoblog post illustrates some very important facts about optometric billing and medical billing that I have been shouting for years. First, it is obvious that the field of Optometric Billing is largely unknown by those that it is intended to serve. Second, many optometrists, as well as other specialists, are jaded by the idea of outsourcing their billing to someone rather than perform this job themselves or in-house. It is obvious from the cacaphony of medical billers soliciting not only optometrists but the other specialists in the world, that there are too many medical billers who are just searching for work and they do not take the time to specialize in one aspect of the trade. As a result, many doctors have had bad experiences with medical billers they have hired and believe, rightly so, the old addage that "if you want something done right, you need to do it yourself". Lastly, because of said experiences, many doctors do not take the time to even research the idea of outsourcing their billing and as a result are led to have un-founded beliefs about the field that was born out of necessity, which is the mother of all invention, and consequently they themselves and their patients are shortchanged.

The optoblog states that "Opthamalic vendors...think we prone to making poor financial choices". The bottom line is that it is not just opthamalic vendors that assert that poor financial choices are being made. Business owners and colleges of business alike are teaching the benefits of outsourcing, from not only a financial stanpoint but from a customer service standpoint as well. Let me give you an example. Optoblog asserts that it only costs $0.43 cents per claim to perform their medical billing using their own software. The blog writer believes this is a great deal and he is right, in terms of percentage of amount billed, it is a GREAT deal, espescially when it costs me $0.39 cents as a company to submit a piece of paper to the insurance company. However, there are other costs associated with submitting these claims that a business owner generally understands and that an optometrist, or other specialist, takes into consideration when making the decision to outsource his or her billing.

Let me throw some numbers at you for all of those un-believers out there. Let's just assume that an optometrist has decided to hire a biller for his office because he has noticed that business is picking up and he just doesn't have the time to do it anymore. The average starting salary for this position averages about 35-40k nationwide, plus health benefits. Now let's assume that you are using OfficeMate, office management software. At last check it was a few thousand dollars just to purchase officemate+ you need to purchase exam writer seperately. Next it is $1200.00 per year for the annual software maintenance associated with officemate, that comes straight from the horse's mouth over there at optoblog in their February 9th, 2009 blog entitled "OfficeMate and Exam writer VS. Mouse Scroll wheel." So let's add all of these costs up:

1. Estimate that it cost you: $2,000.00 to purchase OfficeMate+Exam Writer
   
2. Now add $1,200.00 per year just for software maintenance
3. Optoblog owner pays $0.43 cents per claim to submit. An optometrist averages about 160 claims per month so that is $68.80 per month for claims submission or $825.00 per year.
4. 35k per year, starting salary not including health benefits, for the new biller you just hired.
5. Average cost of collecting and organizing resumes, interviewing, hiring and training the new in-house biller, according to CFO2grow, =30% of starting salary, per employee, or $10,500.00.
6. Total cost of Optometric Billing for the first year=$49,525.00!!! (This assumes the biller you just hired actually lasts for the entire year, which is not common.)

Now I ask you, optoblog owner, do you really still think you are winning by doing it yourself? Let's just assume that you do it on your own, you are still taking your own time, after hours or in between exams, to do the medical billing. An un-necessary task for you or any other doctor. Is this really a sound financial choice?Take note optoblog guy, this does not even include the time it takes you to reconcile your receivables against your Remitance Advices and EOB's you receive on a weekly or even daily basis. Does it still seem like a sound financial decision now?

I ask anyone reading this blog, billers and optometrists alike, does it make more business sense to go through steps 1-6 just to file an insurance claim at a cost of over $20,000 a year, or is it cheeper to let an outside professional handle the same procedures at a cost of about $400.00 per month or $4,800.00 per year?  I know if it was my business outsourcing seems like a better decision, a no-brainer if I have done my homework.

Back in the early 90's, Dr. Micheal Sutton of Bloomfield, NJ said it best when he stated, "Anything you spend money on to save time saves people; and people time is the most expensive part of any practice." Dr. Sutton was on to something. He said this when medical billing outsourcing was just starting to come into its own as an invention of necessity. He rightly realized that with the inception of electronic billing and the growth of insurances prolifferating the medical world and increasing the overall cost of providing healthcare, one of the best things he could do for his staff, his practice and his patients was to save them time and headaches by outsourcing his billing and consolidating only the procedures that his staff needed to perform in-house to better serve his clients and save his practice money. 

I ask you optoblog and anyone with the same line of thinking as them, is it really a bad idea to outsource your billing or any other procedures in your office? Do you really still think that Optometric Billing is a "Cottage Cheese Industry"? I am sure you do but tell that to all of my clients who have rightly decided to save themselves time and money by researching and outsourcing their billing and receivables functions. Professionals who have put the health of their patients and the health of their practices on the forefront and not their wallet. Are these Optometrists, your colleagues, a part of this cottage cheese industry you so quickly labeled during your un-founded rant? 

Our First amendment right to freedom of speech does give us the right as business owners and bloggers to state our opinion freely. Whether it be in a blog, in an article, on the web or in a journal or news paper, we as Americans have the right to voice and express our opinion. Citizenship comes with responsibilty, however, and it is our responsibility as outspoken citizens to make sure that when we express our opinion we do it with the utmost care and research before splattering it all over the web. Maybe optoblog should check and see just what industry they speak out about, It seems to me that their rants are the only thing that smell like cottage cheese around here. 

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Andrew Roy owns and operates RLR Consulting, a medical billing firm that specializes in Optometric Billing. You can find out more informtion by visiting their website at: optometricblling.rlrbillingsolutions.com