Small Moves, Big Practice Improvements

When profit margins feel tight, many optometry practice owners may instinctively jump to add more patients or invest in new equipment as the main solutions. But various other paths to greater profitability are often hidden in plain sight. It can be helpful to think of your practice as a portfolio of many small, low-risk bets that add up to a meaningful lift in revenue, as well as smoother patient flow and, in turn, happier staff.

The tactics for improving your practice discussed in this article are deliberately bite-sized; they don’t require a remodel or a new line of credit. However, small moves, when done consistently, can still lead to significant changes over time. With that in mind, the following offers a practical grab-bag of ideas, each simple on its own but powerful in combination.

OFFER DILATION REVERSAL

Dilation avoidance creates friction between patients and doctors and may cause schedule delays. Offering a dilation-reversal drop, such as phentolamine ophthalmic solution 0.75% (Ryzumvi, Viatris), as an optional add-on for applicable patients who are interested can help turn a common annoyance into a convenience product. To make this a seamless add-on, consider the following:

• Educate the patient about dilation reversal during pretest (eg, “If you have to drive or go to work after this, we offer a reversal option”).
• Understand optimal patient selection and contraindications and educate patients on potential side effects. Be sure to document a signed consent form prior to drop administration.

Capturing this modest fee for multiple daily dilation visits can add ancillary dollars, while also potentially increasing patient acceptance of clinically indicated dilation.

ADD OUT-OF-POCKET RETINAL IMAGE SCREENINGS

Retinal imaging as a screening tool (ie, distinct from medical necessity) delivers high perceived value to patients in minutes. Here’s what you need to keep in mind with this tool:

• Offer this service uniformly (eg, “We recommend a retinal photograph for a more detailed understanding of your eye health. It would cost $X today”).
• Consider bundling retinal imaging into a single wellness package that includes both fundus imaging and OCT screening to keep pricing simple and gather even more data.
• Provide a digital and/or printout takeaway; patients value visual evidence, and if they share the images, it provides great free marketing for your practice’s clinical offerings.

This process can shorten the clinical examination for routine healthy eyes, giving the patient more time for optical purchases and you more time to see other patients.

USE AN IN-OFFICE MESSAGING SYSTEM

Adopt a HIPAA-appropriate messaging/pager tool so doctors can “page” an optician to the lane for a live recommendation handoff in front of the patient. In addition, technicians, front desk workers, and optical staff can request help or flag add-ins without leaving their stations You can expect fewer dropped handoffs, higher capture rates, and better teamwork using this system.

STOCK A FOCUSED DRY EYE FORMULARY

Patients are generally more likely to act when you make it easy for them. Carry a curated selection of preservative-free artificial tears, nighttime ointments, warm compress masks, eyelid scrubs, etc following these guidelines:

• Present the products beautifully at the front of the office so patients can see them when they walk into the clinic and from the waiting room.
• Track sales so you have the data to confidently retire slow-movers and add different products according to demand.
• Give patients a one-page care plan with the exact products recommended; consistency helps build trust and adherence.

SEND ELECTRONIC CARTS

Paper handouts can easily be misplaced, but links convert. For dry eye patients especially, consider using an ordering platform that lets you text and/or email a pre-built cart with the exact care regimen for the patient. Offer a one-click checkout process, with the option to subscribe or receive refill reminders at 30 to 90 days. As a bonus, online platforms can help you keep your in-office inventory lean.

Better adherence improves outcomes and creates recurrent ancillary revenue without excessive effort.

BILL CORRECTLY FOR G2211 (VISIT COMPLEXITY ADD-ON)

When supported, G2211 recognizes longitudinal complexity and the cognitive work you provide to patients beyond basic examination and management encounters:

• Carefully document the ongoing doctor–patient longitudinal relationship, as well as the disease and management complexity.
• Familiarize yourself with payer-specific rules and ensure defensible use of the code.
• Track use of this code and any denials; tight feedback prevents over- or under-coding. Capturing legitimate care complexity ensures your revenue matches your effort.

DON’T OVERLOOK 92060 (SENSORIMOTOR EXAMINATION)

If you evaluate strabismus, diplopia, or binocular vision problems and perform a sensorimotor examination, use code 92060 when medically necessary. When doing so, keep these tips in mind:

• Use a checklist: cover test, Maddox rod, prism test, patient symptoms, effect on function, etc.
• Use a findings template for faster notes.
• Document an interpretation and report for the code.

Appropriately coding for these services allows you to see a return that properly reflects the specialized testing you may already be doing.

FINAL RAPID-FIRE TIPS

Fill the books. Pre-appoint comprehensive visits at checkout. (This is probably the lowest hanging fruit in terms of practice growth.)

Implement daily huddles. Get the office team on the same page regarding the clinic schedule, patient testing, who is floating where, which patients may need more time, etc. Offer self-service intake. Encourage patients to fill out their history forms online ahead of their appointment, reducing time spent in the office.

Buy wholesale frames (strategically). Complement branded lines with wholesale collections that carry higher margins and flexible pricing. Use wholesale frames to power second-pair packages and value bundles without training patients to expect discounts on premium brands.

START WITH A FEW MANAGEABLE CHANGES

No single tactic discussed here will double your practice revenue, but you’re likely to find that these small, stacked wins accumulate in a major way over time. Next week, maybe start with one efficiency (ie, in-office messaging), one ancillary (ie, retinal screening photos), and one coding (ie, G2211) upgrade. Track metrics for 30, 60, and 90 days and meet with your team every couple of weeks to discuss and adjust.

Using this mindset, you will see a noticeable lift in your practice without adding clinic hours or patient volume—simply because the work you already do is now flowing better and is being compensated appropriately. That’s the quiet magic of small moves; they’re simple to teach, easy to start, and difficult to stop once you see the results.