Supplying a New Office on a Shoestring Budget

So, you've decided to open your new office, and now you're considering taking out a large equipment loan to purchase everything you need. The equipment rep has assured you that it won't be a problem - you'll be so busy, and the money will be rolling in! All you have to do is sign. But wait! Before you do that, let me share a cautionary tale from my own experience.

The Costly Mistake I Made in My First Private Practice

My first attempt at private practice was disastrous for many reasons, one of which was buying too much equipment. I listened to salespeople who assured me that my equipment was a good investment and would pay for itself in no time. The exhibit hall at Vision Expo became my shopping mall, and I thought with the best (most expensive) equipment, there was no way I could fail. But I did. Eventually, I was more than 90 days behind on my equipment payments and had to close my practice.

Learning from Failure: A Second Chance

Fast forward ten years, and I'm a lot smarter about my money. When I decided to try private practice again, I promised myself I would do better. With a little searching, I discovered that you can purchase new, high-quality equipment at a fraction of what big brands are asking.

My best advice for new business owners: Check out AliExpress. I know dealing with Chinese suppliers can be intimidating, but when buying from a reputable seller, you can get some really amazing deals.

A Reliable Supplier for Affordable Optometry Equipment

Below, I've compiled a list of inexpensive ophthalmic equipment from one of my favorite suppliers, Link Ophthalmic. I've ordered from Link for many years and have had good experiences with both the quality of their products and their customer service. The prices listed are current as of the time of this blog posting and include shipping.

ML-400 Phoropter

Manual Lensometer

LCD Visual Acuity Chart

SL-5A Slit Lamp

Retinoscope and Ophthalmoscope

YZ-25B Binocular Indirect

Tonometer

Patternless Edger

Combined Chair and Table

1. Manual Phoropter - $793.24 This is a standard minus-cylinder phoropter. In my opinion, it works just as well as more expensive brands like Topcon or Reichert.
   

2. Lensometer - $382.55 This lensometer reliably measures sphere, cylinder, axis, add, and prism. It can also be used to mark lens blanks for edging.
   

3. 19" LCD Chart with Remote - $419.36 This chart is high tech and looks amazing. Also available in 21". Compare to similar charts priced at over $1500.
   

4. Slit Lamp - $2,201.23 A solid option for a slit lamp. This base model works just as well as any slit lamp I've used before. You will need to add a tonometer like the one below.
   

5. Retinoscope and Ophthalmoscope - $545.09 A retinoscope is a must have, especially if you don't have an autorefractor. This streak retinoscope works just as well as other big name brands.
   

6. Binocular Indirect - $1473.84 This base model BIO works great and is comparable to other models priced at over $2500.
   

7. Slit Lamp Tonometer - $392.53 This tonometer attaches to your slit lamp. If given the option, choose a "R Type" tonometer over a "T Type". They both work well, but you'll find the "R Type" in most optometry offices.
   

8. 3 Instrument Stand with Chair - $3500 Technically, you really don't need this fancy of a chair/stand unit, however, I think the price makes this a great buy, even for startups. Place your slit lamp on one table and add more equipment as your practice grows. Check out my blog post where I talk about the space saving features of this table.
   

9. Molo-1000 Patternless Lens Edger - $4500 I wouldn't say that a lens edger is 100% necessary for starting your own practice, but you may want to consider it if you have an optical. The outrageous price of lab fees make this a smart investment and can lower your cost of goods significantly.
   

Total equipment cost $9,707.84 ($14,207.84 with edger)!

As you can see, you can buy new equipment for your practice without breaking the bank. This list is just a sampling of all the great deals you can find. If you have any questions about finding a reputable supplier or ordering from overseas, please reach out to me and I'll be happy to help.

Some products may be subject to import taxes. These are additional fees you might pay (usually to the shipping company, such as FedEx.) Please contact the seller if you have questions about import fees. I may receive a commission from the seller for the products featured in this post. However, the opinions are my own are not influenced by any money I may receive. You, the buyer, will never be responsible for any commission fee.

How to Check for Hidden Vision Plans in Your Patient's Medical Insurance

As an optometrist, we're dedicated to providing the best possible care for our patients, and understanding their medical insurance, especially regarding vision coverage, is critical for providing that care.

Uncovering Hidden Vision Plans

We know that medical insurance plans cover medically necessary eye care, but did you know that some medical insurances also cover routine vision exams? These "hidden" vision plans, often included within broader medical insurance policies, can significantly impact coverage. Providers who effectively navigate these plans can ensure their patients receive optimal care while also maximizing their optometry practice's revenue through strategic insurance billing.

Maximizing Revenue

My practice is in-network with Spectera, as are thousands of other optometry practices across the US. However, despite a large percentage of our patients having Spectera, we rarely ever bill them. Why? Because Spectera is the vision carrier for United Healthcare, and many United Healthcare plans include their own vision coverage. This means we can choose to bill either United Healthcare or Spectera (but not both) for a patient's routine visit. Currently, United Healthcare pays almost three times as much as Spectera, and both plans have zero copay for the patient. That makes it a pretty easy decision.

Navigating Insurance Coverage

Finding out which medical plans cover routine vision can be tricky. While some eligibility portals offer information, they're often vague on specific vision benefits. I prefer calling the insurance company's provider line for clarity. Specify that you're asking about routine vision benefits. They might ask for a CPT code (use 92015) and a diagnosis code (use H52.03). Ask the representative about the patient's exam copay, coverage limits, contact lens fitting, and eyewear coverage.

Billing Strategies

If I'm unsure, I usually bill the routine codes to the medical plan first. A paid claim indicates coverage for routine care, while a denial prompts me to submit to the vision plan. Maintaining a list of medical plans with routine vision coverage can streamline billing decisions and save time

Important Billing Tip

When billing medical insurance for a routine exam, ensure the claim only includes refractive ICD-10 codes. Any medical diagnosis codes will trigger the patient's regular specialist copay and deductible. However, if the patient presents with a medical complaint, remember to submit the exam to their medical plan, regardless of any routine benefits.

I hope this article has provided valuable insights into uncovering patient benefits that you may have been missing. Taking just a few extra minutes to explore insurance coverage could lead to a significant increase in your optometry practice's bottom line. If you have any questions, please don't hesitate to reach out to me. Your success is important, and I'm here to help in any way I can.

The recommendations in this blog post are based off of my own practice experience and not a guarantee of any income you will receive.

Optometry Practice Management: The Benefits of Outsourcing Payroll

Hey everyone! Today, I want to dive into the world of payroll, a crucial yet often challenging aspect of running an optometry practice. Many of us are optometrists first and HR specialists second, so managing payroll isn't always in our comfort zone. Over the past fifteen years, I've tried various approaches, from using different payroll providers to assigning the task to employees or handling it myself. Through this experience, I've come to believe that outsourcing payroll is one of the best decisions you can make for your practice. Let me explain why.

The Benefits of Outsourcing Payroll

Firstly, outsourcing payroll saves you a significant amount of time and effort. As practice owners, our plates are already full with various responsibilities. Dealing with payroll on top of everything else can be overwhelming. By outsourcing to a professional payroll service, you can free up your time to focus on more critical aspects of your practice.

Additionally, outsourcing can help reduce the risk of errors. Payroll involves complex calculations, including wages, deductions, and taxes, along with compliance with regulations. Mistakes are easy to make, especially if you're not well-versed in payroll procedures. Tax regulations can be intricate and subject to frequent changes, and errors can lead to penalties, fines, and legal issues. Outsourcing ensures that your payroll is handled accurately and in accordance with the law, reducing the risk of such consequences.

Outsourcing payroll can also offer cost savings. While there is a cost associated with outsourcing, it is often much less than hiring an in-house payroll specialist or spending your valuable time on payroll tasks. Outsourcing eliminates the need for additional staff, training, software, and other expenses associated with managing payroll internally.

Recommended Payroll Providers

When it comes to choosing a payroll provider, there are several options available. Here are a few of my favorites:

1. Gusto: Known for its ease of use, Gusto offers automated tax filings, direct deposit, and employee self-onboarding. It integrates well with other small business tools and features automatic tax liability withdrawal with each payroll, preventing large sums from accumulating in your accounts.
   

2. Intuit Payroll: Part of the Intuit family, Intuit Payroll provides tax calculations, direct deposit, and employee self-service. It seamlessly integrates with QuickBooks, which is convenient for businesses already using QuickBooks for accounting.
   

3. Wave Accounting: Wave is cost-effective and easy to use, with accurate payroll calculations that take only a few minutes. However, it does not offer automatic tax filing in most states, which may require more manual tax management. Suitable for those seeking more control over tax filings or with inconsistent income.
   

Choosing the Right Provider

When selecting a payroll provider, consider your familiarity with accounting software, the level of automation you prefer, and your ability to manage tax filings. Gusto is recommended for its ease of use and automation, while Intuit Payroll integrates seamlessly with QuickBooks. Wave Accounting offers cost savings but requires more manual tax management. Choose a provider that aligns with your practice's needs and capabilities.

Why Outsourcing Makes Sense

In summary, outsourcing your payroll can save you time, reduce errors, ensure compliance with tax laws, provide peace of mind, and offer cost savings. It allows you to focus on providing excellent optometry care to your patients, which is what you do best.

Subscribe to Gusto here and get up to $200.

I may receive a commission from the above payroll companies for any business they receive on account of this blog posting. That being said, the opinions in this post are my own and are not influenced by any potential earnings.