Clinic definitions. We begin with definitions to ensure you become familiar with our terminology, understand how to generate accurate stats, and to grow your knowledge so that you can identify better lead measures to move the needle for positive change and achieve your wildly important goals. The first column is dedicated to terminology, followed by definitions, industry benchmarks, and examples of how to apply the information based on best practices. Let’s jump right in and read through each term and definition.
Under many of the terminology and definitions, you will see US CPT codes. When calculating how many comprehensive exams you have for example, go ahead and run your production report to count these CPT codes.
Let’s review comprehensive exams. Comprehensive exams are also referred to as a full exam, routine exam, yearly exam, annual exam, consult, or a visual assessment. A comprehensive exam involves the evaluation and medical management of the entire visual system.
Refractions – a refraction is performed to monitor various medical conditions, obtain a spectacle prescription, and is a starting point for the contact lens prescription
Problem-focused exams – to develop a medical ratio, it’s important to know percentage of problem-focused exams as well as percentage of diagnostic testing in relation to comprehensive exams. This enables you to grow a medically based practice and ensure clinical care standards are being met. Problem-focused exams are also referred to as office visits, brief exams, emergencies, IOP checks, dilated fundus exam, consults, etc. Your problem-focused exam percentage compared to comprehensive exams should be about 49% when following clinical care guidelines closely. This means if you have 100 comprehensive exams these should result in 49 additional problem-focused appointments
Screenings – screenings are non-covered services used to confirm normal results versus abnormal results. These screenings are performed for a fee and are highly recommended, but usually optional to the patient. They are usually not covered by medical insurance. Screenings play an important role in preventive care and preserving the integrity of your patients’ vision throughout their lives. Examples include fundus photography screening, which can be done with the OPTO screening, wellness screening, which can be performed with an OCT and fundus photography, an OCT screening, a visual field screening, etc.
Diagnostic tests – diagnostic tests are performed to capture evidence of disease, structural changes, visual changes, neurological changes, and monitor disease progression
Procedures – These are primarily surgical procedures. Tracking procedures is important to evaluate the utilization of equipment, staff, time, and square footage. Keep in mind, medical insurances dictate or set guidelines on which procedures are bundled and which are not. Bundling occurs when a procedure with a unique code is included as part of a more extensive procedure provided at the same time. If bundling occurs, the clinic will not get reimbursed for all services provided
Products – you may choose to track up to 20 clinic-related products, stocked for clinic use or available for purchase. This should not include glasses or contact lenses. Examples may include punctal plugs, Prokera, lid treatment products, nutriceuticals, eye masks, eye drops, etc. Obtain the data through your production or vendor reports. Use this data to set maximum inventory and reorder levels. You may already know your turn rate on these products or have a par list. This ensures the clinic is not running out of a product or over-ordering to help prevent expiration before use
Spectacle fittings – the fitting of spectacles related to medical conditions, such as a phakia can be considered a billable service depending on the insurance
Products – You may choose to track up to 20 clinic-related products, stocked for clinic use or available for purchase. this should not include glasses or contact lenses. examples may include punctal plugs, Prokera, lid treatment products, nutriceuticals, eye masks, eye drops, etc. Obtain the data through your production or vendor reports. Use this data to set maximum inventory and reorder levels. you may already know your turn rate on these products or have a par list. this ensures the clinic is not running out of a product or over-ordering to help prevent expiration before use
Fun fact – PAR stands for periodic automatic replacement.
This was a great introduction, now let’s head over to the stats page.