Practice-Building Opportunity: Add a Dry Eye Clinic

Dry eye is an under-diagnosed and under-treated eye condition. Creating a dry eye clinic serves your patients’ needs—and provides you with a revenue stream.

Over 40% of patients mention dry eye as a primary or secondary complaint. You may not have looked into it yet, but there is a good chance, with the aging population of Baby Boomers and the growing number of people on prescription medications that create dry eye, that this percentage is similar among practices. What’s more, most patients with dry eye complaints are unsatisfied with the treatment they have so far received.

According to Gallup, over 70% of people with dry eye complaints have seen at least three doctors and are still searching for a remedy. In addition, the majority of that 70% still searching for a successful treatment have tried at least three different artificial tear products that have not provided relief. With numbers like these, you should consider to launch a dry eye clinic, devoting one to two days per week to seeing nothing, but patients with dry eye complaints.

High Per-Patient Revenue

Patients who have already tried multiple treatments unsuccessfully are willing to do what it takes to find relief. That attitude is borne out by the per-patient-revenue of dry eye patients.  

Click HERE to download a dry eye calculator that lists the expenses and profits of dry eye treatment so you can determine your potential return on investment.

Delegate Dry Eye Pre-Testing

The key to making dry eye clinics profitable is to streamline the process so you can see as many patients as possible on the days you devote solely to dry eye. For example, your staff can conduct osmolarity (Tear Lab) testing, a five-second test that measures the salt to solution level in the eyes (any reading over 308 is considered an indicator of dry eye). Your staff may also perform testing with an  iCaretonometer which does not require a puff of air or administering drops that could affect the surface of the eye and interfere with the rest of the dry eye examination. Patients are then placed in the exam lane and given a more specific dry eye questionnaire to fill out to assess how the condition is affecting their eye comfort and vision.

After the patient has filled out the questionnaire in the exam lane, they can watch Eyemaginations educational videos with animated graphics that illustrate the condition and pose trivia questions. These videos may also be playing in the reception area. Between the questionnaire and the educational videos in the reception area and exam lane, patients are primed to speak to you when you arrive. They have the state of their condition in mind from the questionnaire and have the beginnings of an education on the topic from the animated videos.

Streamlined Doctor-Patient Time

By the time you get to the exam room, your tasks are limited. After reading the osmolarity measurement, you then can do an assessment of the eyes, expressing the meibomian glands in the lower central and nasal eye lid and then using the slit lamp for an assessment based on your observation. The technician instills a drop of fluoresceine and then lissamine green dye and using a Raton filter you can assess the degree of staining, the tear meniscus height and tear film break-up time. You then should do a fundus examination to rule out eye diseases that can lead to dry eye such as diabetic retinopathy because diabetics have a high prevalence of dry eye disease. You can project the images of the patient’s eyelid glands from the slit lamp onto a flat screen monitor via the TelScreen EyeRes system to show patients a picture of their condition and bring to life what you are explaining to them. You may also run through the Eyemaginations animations related to their specific condition while in the lane.

Code and Bill for Dry Eye

When patients visit your office with medical conditions that they already know cause dry eye-often on referral from their primary care doctor-you are able to bill medical insurance for the visit and services, but when patients present with symptoms such as dry eye-related blurry vision, you would bill vision insurance. The extensive testing using instrumentation also offers an opportunity for billing. For example, in addition to offering patients a literal picture of their condition, the pictures you project onto the slit screen enable you to bill for anterior segment photography when appropriate. With dry eye a condition frequently related to medical conditions a patient may not yet know they have, such as diabetes, it is not uncommon for a vision insurance patient to eventually become a patient whose treatment is billable to medical insurance. You may also able to bill for the TearLab osmolarity test which reimburses approximately $46 for two eyes of testing (The AMA CPT recommends reporting 83861 twice, using the “-59” modifier for the second eye tested to indicate that it is a “Distinct Procedural Service”). Click HERE for a detailed article on coding and billing for dry eye.

A Long-Term Treatment

There is no cure for dry eye and it frequently worsens with age, additional medical conditions and the addition of new prescription medications. Your patients will be served by your long-term care, thereby creating a loyal patient base likely to refer you to friends and family as the doctor who finally provided them with relief.

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One thought on “Practice-Building Opportunity: Add a Dry Eye Clinic

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