How To Be a Profit-Oriented Optometry Office Manager

Managing an optometry practice is like managing a clothing department store like Nordstrom, Bloomingdales or Dillards. There’s a lot of departments and you need to be somewhat knowledgeable in all of them. When one department is slow, another one is busy. We are not selling clothing and perfume, but we do sell similar products and services that cost a lot. Eyecare is a feel-good profession. When patients come to see us, they get excited but also scared because they know it’s going to cost them some money.

I know managing an optometry practice can seem daunting, but I’m here to lay out the methodology for managing staff, making a profit, and staying ahead of the curve in your geographic area.


Automation Is Your Friend

Make your weekly, bi-weekly and monthly tasks automated. As an optometry office manager, tasks that are often repeated like payroll, sales-tax-reporting, ordering cleaning supplies and printer supplies often become a burden. If not automated, you will scramble with a minute to spare just to complete the tasks on-time. It’s never fun when that main printer is out of ink and people are trying to print invoices all day for patient receipts. They end up running to the back of the office all day frustrated.




The top 4 things to automate immediately:


1. Payroll

After consulting for enough practices with my business Eye Rock It, it’s amazing to see the doctors themselves spend up to an hour doing payroll every 2 weeks. This task should take less than 10 minutes. It doesn’t matter how many employees you have, 4 or 50, payroll is just a few clicks on the web. Calculating things like paid time off, bonuses, healthcare reimbursements, or holiday pay should all be fairly automated.

Your payroll should be self-service. Things like enrolling new employees and changing wages should be easy and accessible for you. Additionally, you want to make sure your payroll system is integrated with your bookkeeping software like Quickbooks. It’s never fun doing double data entry. Lastly, pay attention to your costs of payroll bi-weekly. Don’t just think you are getting a great deal. If you overpay $100 each week for payroll, that ends up being over $2000 a year.




If you are looking for a good easy-to-use payroll system for small business, SurePay is a friendly platform.




2. Employee Timeclock

The majority of optometry employees are hourly. This means we clock in, clock out, and take lunch breaks. If you are an office manager or optometrist owner you know how many mistakes people make due to “forgetting” to make their clock punches.

If you have an old school system that looks like this, get rid of it now! Whether it involves typing in a pin or a fingerprint, these systems are outdated and you are making your optometric management life hard.





The new way to manage employee timeclocks is using mobile apps.





All staff will download the time clock app on their Android or Apple device. I recommend an affordable app called Homebase. It’s $35/month.

Employees can only clock-in when they are close to your office. The app knows the GPS location of your staff when they try to clock in so it prevents people from clocking in from home or elsewhere. When staff clock-in, you can even customize a welcome message with an inspirational quote or perhaps a task that needs to be done that morning.





Homebase has truly improved the efficiency of many small-to-medium-sized offices. Here are the best features of the app:

  • Manager/Owner gets notified via push notification or text message when a staff member is late to clock in.
  • If an employee is approaching overtime, the manager will be notified so you can tell a staff member to leave early.
  • Allows staff to request time off whether paid or unpaid. The manager will get a notification and can approve or decline.
  • You load the employee’s vacation hours into the app. The app keeps track of how many hours are used.
  • The app can track how much PTO is accumulated based on your rules.
  • The app exports payroll data to the major payroll processors, so no manual entry!
  • Employees can trade shifts.







3. Monthly Patient Statements: Paper, Email, Text Message

An easy way for a private optometry practice to fail is accumulating a high patient receivables list. This means your patients owe you a bunch of money for medical deductibles, products and other services that they have not paid. If this list of patients is extensive, it probably means you don’t have a system in place to send out bills efficiently. I’m guessing you are printing from your EHR, folding, packing into enveloping, licking and then stamping.

If you want to really hone in on collecting outstanding patient balances, you need to run your monthly statements once per month and on-time each month. Your billing system should be able to send statements out 3 ways:

  1. Mail
  2. Email
  3. Text message

The reason you need all 3 is that people today are so distracted and need multiple forms of communication before they take action. The digital ways are nearly free and mail is low cost. Your older folks may not be paying bills online and prefer to mail a check.

For some reason, EHRs produce really poor statements and they don’t have good online accounting functions built-in. Here’s what CrystalPM looks like. It’s honestly one of the best EHR software programs out there, but the aesthetics of the patient statements are poor.


Example of a bad and confusing patient statement. It looks like someone made it on Microsoft Word real quick.




A clean-looking statement will get you paid faster because it’s less confusing. Guaranteed.


The ultimate billing tool for statements in optometry is BillFlash. It’s a billing integration with links up with your EHR. Here’s why the product is so great.





Send Bills Via Email With 1 Click For Your Whole Patient List Owing Money.


  • Delivery Time: Approved bills are sent, same-day.
  • Cost Savings: Typically, you’ll save over 60% when you convert your mail over to paperless eBills.
  • History Online for Payers: Payers can easily find current and past bills online at which saves you time when responding to requests for a “lost bill.”


Print & Mail


  • Delivery Time: Approved bills are mailed next business day.
  • Payment Coupons and Return Envelopes: Each mailed bill includes a Payment Coupon and Return Envelope which increases your payment cash flow and reduces your processing costs.
  • Address Updating: With the USPS’ National Change of Address (“NCOA”) service, your Mail will be automatically printed with any new addresses for undelayed bill delivery, and you’ll get an Address Change Report to update your billing records.
  • Bad Address Reports: The bad address report helps you find and correct records which have invalid mailing addresses according to the USPS.

This is just the beginning of the features. BillFlash also has soon-to-come text messaging functions. They also allow you to send patients to collections automatically after they don’t pay your bill within a defined time period you choose.



4. Bookkeeping

When you own or manage a business, you can’t do everything. Even if you are qualified to do certain tasks, there’s just not enough hours in the week. There’s a reason why people hire nannies or house cleaners. It’s not that people hate doing the work, it’s just that time is precious. Wouldn’t you rather spend time with your family on a Sunday, than scramble around vacuuming and doing dishes?




I’ve seen way too many optometrists spend their spare time reconciling their Quickbooks. Their time is much better spent seeing patients or working on business development, not busy work. You can hire a bookkeeper to work anywhere from 3-20 hours a month at a fair price to help you manage your bookkeeping and keep your business in order!

Here’s what a good bookkeeper will do:

  • Integrate your EHR reports monthly with accounting systems like Quickbooks.
  • Reconcile bank accounts.
  • Record and categorize expenses.
  • Keep an accurate profit and loss statement and balance sheet.
  • Connect all your credit cards to accounting for easy payment posting.
  • Ask questions when unsure of charges.
  • Allow you to prepare reports that show what you’re over or underspending on.
  • Handle accounts receivable.
  • Handle accounts payable.
  • Prep your books for tax season to allow CPA to work efficiently.
  • Record payroll.

A certified bookkeeper will cost you anywhere from $50 to $100 per hour. Don’t worry about the expense though. Feel good about outsourcing pain points of your optometric practice. It’s okay to let go and not do everything. You don’t do all the optical, front desk, teaching, cleaning, etc. and you shouldn’t have to do the bookkeeping either.
If your accounting system for your practice is managed professionally, how do you expect to know what business decisions to make if your data is screwed up?

Need bookkeeping help? Eyetrepreneur will refer you to a professional familiar with optometry.



Automation is happening everywhere in the world. From electric cars to machine learning, it’s important optometry stays up with the times. There’s a lot of profitability to be made in healthcare, but it means you’re committed to paying for professional services you are not skilled at. Focus your time on patient care and not doing every little tiny task in the office. There’s always an outsourced method of getting something done or software that can relax your workflow.

Email if you need more ideas on workflow help.

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