Practice Improvement Tips

Here’s another round of practice improvement tips. You need to put your head down, grind hard, sharpen that saw, yeehaw!

These are things you can do right now to generate revenue in your practice. These tips will help you improve your practice’s public appearance and prove yourself as an elite location for eyewear, contacts, medical, or anything it is that you’re into.


1: Improve your outside building signage.

LED signs make a major difference in your appearance. Old beat-up signs with stains behind them from weather damage, or dull colors from old age all make a huge impact on people’s first perception of your business. Old signs equal crappy business in people’s minds. Just like we eat with our eyes, we subconsciously judge businesses with our eyes based on appearance.

IKEA comes to mind when I think of great signage. They have MASSIVE signs that really stand out. They’re huge, yellow, and always right in sight – nearly impossible to miss.

I want to give a shoutout to a doctor in Houston, Texas. He’s opening his second practice, Evolutionary Eyecare. I was scrolling through Facebook and saw that he has a great new sign on his building. I’m sure at night it lights up a beautiful green that people can’t ignore. That’s the kind of attention you want for your practice.



With that said, please, please, please consider replacing your signage! I know it might sound frivolous to spend money to buy a new sign. It could cost anywhere from $3,000-$10,000 depending on your location and type, but proper signage is really important! Especially in the winter as it gets dark earlier and people need to look for you. It’s an expense that will pay off in the long run, trust me.


2: Fire your complaining staff member.

They suck the energy out of everybody, like a Dyson vacuum from Costco that isn’t even on sale. And this vacuum is sucking HARD.

We’ve all had these Karens on our staff – and they’re crap. Like a toxic piece of kale rotting the rest of the bunch. When you go to work and see them in the morning, you think to yourself “Oh Jesus, Mary, and Joseph, how can I avoid them today!”

They might be decent at their job. They might show up to work on time and sell a respectable amount of glasses a month, but one small interaction with them and they blow a fuse. A piece of shit belongs in the toilet, not in your workplace!

Just CAN them. Make sure you go through the proper procedures, of course. Document everything, give them their three strikes, then get them out of the ballgame. It’s important. Even if they have great skills, remove them from your practice. They’re going to piss off your patients and make it impossible to have a comfortable work environment where you can breathe.



3: Consult ABB Contact Lens monitor publication or Dr. Contact Lens, the eyewear ordering platform for eye doctors to sell online.

They have contact lens price monitoring that will tell you if you’re too high or too low. You may not know this, but the boxes of contacts you buy fluctuate in price all the time. I would recommend looking at least biannually to see if your contact lens prices need changing. You might need to bump up the price by $3-$8, or you may even have to reduce something. Costs change all the time, so make sure you’re well aware of where you are in the market. The last thing you want someone doing is going to 1-800-Contacts and thinking you’re way overpriced. Choose whichever strategy you like, but be aware of these resources to check the pricing and make sure you’re on par with other major retailers and other ECPs.





4: Clean your carpet at least biannually. Hire a professional.

It’s really important that you maintain the quality of the infrastructure inside your office. Like all kids growing up, my brother and I absolutely destroyed my parents’ carpet with all sorts of nasty things. From beverages to puke to candle wax. Gross! If you have a nice carpet, maintain it. It’s simple. Hire a professional that will be able to remove stains, dander, and dirt. It’ll make your practice smell better. You don’t need to do it yourself. Don’t get a Rug Doctor at the grocery store. Your professional time is money. When you’re off, use that time to relax. Let a professional come in for 1-3 hours and get the whole thing cleaned. You’ll feel better about your practice, especially in those winter months when the snow falls heavy. People track mud in on their boots and if you let that sink in for 1-3 years, you’ll never get it out. There’s nothing that makes your practice look icky quite like coffee stains on the carpet.





5: Outsource your insurance billing.

For only $40,000+ an insurance billing company can do it better and cheaper for you. Keep in mind, not every firm is going to charge $40,000 to do your insurance billing and posting. It varies based on location, number of doctors, number of claims, etc.

There are a couple of ways these companies will bill you for outsourcing:

1) They’ll do a percentage of collections, which could be anywhere from 4% to 7%. Sometimes they include vision payments in there, sometimes it’s just medical.
2) They’ll estimate and do a flat monthly fee based on the number of hours they think they’ll work.

Why should you outsource if you’ve got Biller Becky and Biller Bob who have been there 10 years and have their insurance billing certificate? Well, what happens when Bob and Becky quit? You’re screwed. You panic and spend hours in front of the computer posting ads on Craigslist, ZipRecruiter, and Indeed, trying to find someone again. Suddenly YOU become Biller Bob when you should be at your son’s baseball practice. Gosh, I miss baseball. It was so much fun. Not the practice part…practice sucked. I just wanted to play the games!



Back to the main topic: You hire a billing team for backup and security. You want to create the infrastructure that will hold up when you scale, so you don’t have to worry about handling the volume. How can you trust your in-house biller? How do you KNOW they’re working the claims and billing the right codes? Are you running monthly reports to see if you have a long list of insurance receivables? You can easily run those reports in your EHR. Go do it now. If you find items you’re not getting paid for and you have receivables over 90 days, you better run quickly, because some of these payers only give you 6 months to get something in.

Better yet, let the firm you hire do it for you! They’ll manage your insurance receivable list to make sure things don’t expire. When you have a denial, it won’t be set on the back burner – they’ll work it. They’ll ask the right questions. They plug right into your system. If you’re cloud-based, you’ll assign them a login. If you’re on a server, they’ll remote in using something like Google Chrome Desktop, GoToMeeting, etc. There are a lot of methods to remote-in. You get the point.

Your insurance biller is going to make you more money. Instead of having one person dedicated to your account, they might have 3 people dedicated to your account. If one is sick or quits, you have 2 backups. It’s an insurance policy for your insurance billing. It’s important to remember that they may not be perfect and you may get upset with them at some point. I’d still rather have my insurance billing at 85% than worry about Karen leaving because she got a job with a $5,000 sign-on bonus down the street at Target where she’s getting paid $23 an hour to manage the baby department.


6: Consider selling to private equity if your practice has $850,000+ in gross charges.

Don’t be stupid, at least check the value before saying no. How did I come up with $850,000? Well, I kind of just pulled that number out of my hiney, but if you’re doing over $850,000 as a single doc, you’re probably doing something right and are on a track for growth. If you’re not, you need to be reading more of these blogs to get some ideas. Private equity is really taking over. I don’t know what the percentage is, (maybe 10-15%) but doctors do need to retire too. You’ll get a nice payout. They’re paying more than individual optometrists could pay for private practice. All I’m saying is, get a free evaluation of your practice. Yes, it’ll be free, you just have to produce your financial statements. The more doctors and locations you have, the higher the payout. So if you’re burnt-out and feeling like retirement is in 5-10 years, now is the time. Private equity probably won’t be here in 5 years when you’re ready to retire. I’ll likely do another blog on this, but if your practice is at $850,000+ in gross charges, consider getting some type of evaluation, even if you’re young.




7: Don’t let a frame rep stuff you with frames.

Be in control. YOU determine when they get an appointment. Don’t let them decide based on the schedule THEY want. I heard it all the time when I was buying frames.

“Hey, I’ll see you in 8 weeks.”
Hell no, you’re not gonna see me in 8 weeks! Of course, I wouldn’t say that out loud. I’d be friendly and jocular, but I don’t need to see your bread and butter frames in 8 weeks. How about in 4 months?

For me, I like to see a frame rep 2-3 times a year. That’s a good cadence for me. Some of you may have smaller frame boards and like to purchase more often. You like to see every new release. That’s fine too. I like a lot of control when it comes to my optical and the number of frames on the board. I like to be in control when reps come in. I’m not a dictator about it and I actually love it when reps come in cold. Come on in! I’ll never decline an opportunity to see a frame line. But just because someone says they’re going to be in town, it doesn’t mean that you need to take that appointment. Their goal is to get their entire warehouse into your optical. Before you know it, you went from having 35 of their frames on your board to 60 of their frames on your board. How did that happen? You took way too many appointments! So find the cadence that works for you and be firm about it.




8: If you’re a staff member and something bothers you, speak up!

Say something. No one can read your mind, everyone just sees you acting weird and looking pissed off. The truth is that your coworkers don’t know what’s going on in your head. It’s up to you to be open and hash out your issues. If you never speak up, you’re doing a disservice to yourself and to the staff and docs around you.

Plain and simple, let people know when something bothers you. If Judy leaves for lunch 5 minutes early every day and sticks you with the last patient, tell her if it pisses you off! If Jim would rather drink his Monster and hide out than take the first patient of the morning when he’s tech-ing, confront Jim in a friendly way or let your manager know. Speak up.




9: Iron your clothes. Looks matter in sales.

It’s a good look. When you have wrinkled clothes, it tells me you don’t care. You look disheveled.

When I go somewhere, I want to work with a clean person. I want to work with someone approachable and presentable. They don’t have to be clean-cut with a perfectly manicured beard and gelled hair or perfect makeup, but they shouldn’t look like they just rolled out of bed either.

Have a meeting about it and let your staff chime in. You might want to consider keeping an iron or a steamer in the office. When you look good, you feel good. That’s what my dad always says.




10: Invite your friends here, so they can get educated on these things they won’t find in a book.


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