Cinderella Improvement Activities

Improvement activities are hard to pick and complicated to track. There are no dashboards set up to monitor your progress, track if you’re meeting the requirements, or to help find out if you’re doing enough activities. The measure titles can be a little misleading and the documentation requirements are often a mystery to practices. Each activity can seem like a puzzle that’s impossible to solve. With over 100 activities to choose from and the last 90 reporting period coming up on Oct 3rd, time is running out to get started.

Improvement activities can be the easiest MIPS category you deal with all year if you find one that fits your practice! Join our webinar “Cinderella Improvement Activities” to find out which activity is the glass slipper that will fit your practice perfectly. We’ll break down the lesser known, and tough-to-understand activities that might be exactly what your practice was looking for. We’ll demystify the requirements and make sure you know where to find the information you need to succeed. After the webinar you’ll come away with the confidence to choose the right activities for your practice and the knowledge to meet the requirements.

Highlights of the webinar:
  • Category requirements so you know how to maximize your score
  • Where to find data validation criteria and how to use them
  • Descriptions of hard to understand measures
  • A list of common measures that most practices find easy to report
  • Pitfalls to watch out for
In this session you will learn:
  • How to effectively pick activities that won’t be a burden on your practice.
  • How to make sure you’re reporting enough activities to max out your score.
  • How to use data validation criteria to make educated decisions to avoid measures with misleading titles and find hidden gems.
  • Which hard to understand measures could be a perfect fit for you.
  • Which measures are favorites among other providers and why.
 Interested in a Free Consultation?

About the Speaker

Megan Fries

Megan Fries has 18 years of experience guiding providers to successfully report for QPP. Megan’s extensive background with EMR support and Meaningful Use and MIPS attestation, as well as her work in clinical settings as a surgery scheduler, tech, and scribe, give her the ability to apply her insight and knowledge in a way that makes her expert guidance invaluable to the healthcare provider.

Jennifer Jacquez

Jenni Jacquez’s has 11 years of healthcare experience includes EHR implementation and overseeing the successful participation with CMS’ payment incentive programs, from MU to MACRA for her physicians’ ophthalmology-based practice. Not only did she serve as the office’s HIPAA compliance officer and billing specialist, but she was also responsible for performing various screening tests prior to the patient’s exam. Jenni is also bilingual and is fluent in English and Spanish.

CMS Releases the 2022 QPP Proposed Rule – Here’s What You Need to Know

On July 13, 2021, CMS released its Quality Payment Program’s 2022 Proposed Rule, and while it is increasingly clear that CMS intends to move forward with their plan to eventually replace traditional MIPS with MIPS Value Pathways (MVP), there are changes to existing MIPS measures to be aware of. Comments are being accepted on the proposed rule through Sept. 13, 2021.

Overall, there are a number of changes to MIPS quality measures and MIPS healthcare standards that practices will need to be aware of. Here is a brief rundown of some of them that those looking at MIPS ophthalmology best practices should be aware of:

MIPS Eligible Clinician Types: An expansion of what would be considered an eligible clinician under MIPS has been proposed by CMS. It would include certified nurse mid-wives and clinical social workers. Under the MIPS’ Promoting Interoperability category, clinical social workers would reweight to zero.

MIPS Performance Thresholds: Starting with the 2022 performance year, MIPS will follow statute that requires that that performance be either the mean or median of the final scores for all MIPS eligible clinicians for a prior period. This means that:

  • The performance threshold is 75 points.
  • Additional performance thresholds are 89 points for exceptional performance.

The 2022 performance year will be the last for an additional performance adjustment for exceptional performance. By 2023, only penalty dollars will be used to fund the program. It seems likely that more providers will see negative payment adjustments as program changes make it more difficult to fall on the right side of the performance threshold.

Key Takeaways:

  • Performance category weights for Quality and Cost will finally equalize at 30 percent each.  Remaining the same from the 2021 performance year level are categories for Improvement Activities and Promoting Interoperability.
  • CMS wants to extend the web interface in traditional MIPS for registered groups, virtual groups, and APM entities with 25 or more clinicians.
  • Electronic Clinical Quality Measures (eCQMs), Medicare Part B Claims Measures, MIPS Clinical Quality Measures (MIPS CQMs), and QCDR Measures all remain available for traditional MIPS Quality category reporting.
  • Performance category weights for Quality and Cost will finally equalize at 30 percent each.  Remaining the same from the 2021 performance year level are categories for Improvement Activities and Promoting Interoperability.
  • CMS wants to extend the web interface in traditional MIPS for registered groups, virtual groups, and APM entities with 25 or more clinicians.

Electronic Clinical Quality Measures (eCQMs), Medicare Part B Claims Measures, MIPS Clinical Quality Measures (MIPS CQMs), and QCDR Measures all remain available for traditional MIPS Quality category reporting.

Quality Measures Get Updates

Look for 195 quality measures for the 2022 PY.  You can expect :

  • Substantive changes to 84 existing MIPS quality measures.
  • Changes to specialty sets.
  • Removal of measures from specific specialty sets.
  • 19 quality measures removed and 5 added, including 2 new administrative claims. Risk-Standardized Acute Unplanned Cardiovascular-Related Admission Rates for Patients with Heart Failure for MIPS is proposed, as is the Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions.

Meanwhile, benchmarking impacts due to COVID-19 will continue, and the agency wants to maintain the current data completeness threshold at 70%, though it could rise to 80% by 2023.

Quality Measure Scoring

There are plenty of new proposals here, including:

  • New measures: During the first 2 performance periods for a new measure, CMS proposes to create a 5-point floor scoring model.
  • Measures with and without a benchmark, and for those that don’t meet the minimum: The 3-point floors will be removed.
  • The ability to earn bonus points for both high-priority measure end-to-end electronic reporting will be removed.

To read the full post please Click Here

Patient Payment Collection Strategies For Long-Term Success

The COVID-19 pandemic placed many challenges on both patients and medical practices. Patients were hit hard financially with many losing their jobs and their health insurance coverage. At the same time, practices saw a decrease in patient volume and revenue.

Healthcare organizations needed to quickly adapt to the new “normal” by increasing the use of telemedicine and implementing digital tools in order to reconnect with patients and keep their practices in business.

Now that more people are re-engaging in social activities and entering indoor spaces, care that was previously deferred will return. Practices will need to evaluate how to handle this influx of volume while also catering to patients’ need for flexible and affordable payment options.

In this webinar we will highlight current trends affecting the industry and discuss strategies your practice can use to collect more patient payments for long-term success.

This event is brought to you in collaboration with Eye Care Leaders &  

 Interested in a Free Consultation?

About the Speaker

Lora Woltz and Katie Buckholtz

Sandra Anderson has over 15 years of experience working in healthcare. Sandra started her career in billing and registration at Northeast GA Healthcare Systems, a level II trauma center, before transitioning into a client success role at Navicure (a Waystar company) an RCM solutions and IT healthcare corporation. She has spent her career building long-term client relationships through her project management and analytical expertise. In her current role as Strategic Account Manager, Sandra analyzes the performance of various healthcare clients to help improve revenue growth.

Decoding the Cost Category

To participate in the Cost category of MIPS, you just submit your claims…the rest is out of your hands. Or is it? The measures are different, the scoring is complex, the attributions and how they are processed can be pretty confusing but you have more control than you think!

The Cost category does not have to be an enigma. Learn how it works and how to make it work for you. Join us as we shine a spotlight on this often overlooked but increasingly important performance category.

Sign up for this webinar today to learn about:

  • The purpose of the Cost category
  • Cost category measures
  • How Cost is scored
  • Attributions and how they affect you

Attend this fast-paced webinar to learn:

  • Which measures apply to you
  • How to use codes to trigger measures
  • Co-morbidities and how they come into play
  • Learn by example with a real world cost case
  • Tips and tricks for achieving the most possible points

This webinar is perfect for:

  • Healthcare practice administrators
  • CEHRT users
  • MIPS eligible clinicians

This event is brought to you in collaboration with Clinical Quality Experts & Eye Care Leaders

 Interested in a Free Consultation?

About the Speaker

Lora Woltz and Katie Buckholtz

Lora Woltz is the Director of Clinical Quality Experts. With over 30 years working in healthcare, Lora Woltz brings her experience with clinical and patient care, health insurance referral and eligibility management applications, as well EHR software support to the team. Lora is an expert in compliance support for CMS incentive programs ranging from early Meaningful Use to present day MACRA.

Katie Buckholtz has led and assisted hundreds of clinicians across the United States towards maximizing their MIPS and APM payment incentives for the CMS Quality Payment Program. Prior to this, Katie had a 10-year clinical background in ophthalmology and optometry Including her experience with managing the practice’s participation in the Meaningful Use, PQRS, and MACRA programs.

Your Complete Guide to Patient No-Shows

How much are cancelled appointments and no-shows costing you?

Nothing is worse than being stood up — especially when it affects your bottom line.

Patient no-shows are a longstanding thorn in the side of many eye care practices and can hurt your bottom line, snarl your operations, and result in negative health impacts to the patient. As practices come under increasing revenue pressure, stemming the tide of no-shows is particularly important — and a potentially easy way to pad your bottom line.

Reasons why patients don’t show up for appointments

  • Patient no-shows cost the healthcare industry $150 billion annually
  • For a standard checkup, a no-show can cost your office as much as $200 in lost revenue. This figure jumps considerably for specialty appointments and surgeries.
  • No-show rates vary by practice, discipline, and location, with estimates hard to come by. Many practices which have made a concerted effort to lower their no-show rates got those rates down to around 7%.

No-shows occur when a patient fails to show up for a scheduled appointment with no prior notification to the healthcare provider. Not only is this lost revenue for the provider, but it represents an inadequate use of resources and may even lead to wasted resources. It also can impact the health of patients in the form of missed diagnoses, and lead to patient dissatisfaction when they run into trouble rescheduling their appointment.

So why are these patients going to the trouble to make an appointment and not show up? There are several possible reasons:

Patient-related issues:

  • Patients may not see a no-show as that important to them
  • Their condition may have improved
  • They have fear and anxiety about the appointment, its procedures, or its findings
  • They may not be able to arrange child or elder care in their absence
  • They may simply forget or oversleep
  • Patients may fear the cost of the visit and/or procedure

Environmental-related issues:

  • Patients may not be able to arrange suitable transportation
  • Weather may prevent their arrival
  • Patients, especially those who are older or have physical limitations, may not be able to find suitable parking

Time-related issues:

  • Appointments made months in advance are more likely to result in no-shows or last-minute cancellations

Who is most likely to be a no-show? According to one study, the patients most likely to miss appointments include those who are:

  • Single
  • 34 or younger
  • On Medicaid or who have no insurance coverage
  • Have chronic conditions
  • Live more than 60 miles from your office
  • Are elderly and/or recently widowed or divorced

What happens when patients don’t show up for their appointments?

Two parties are impacted when patients don’t show for their appointments: You and them.

For patients, the impact mostly boils down to delayed treatment and diagnosis. Delayed treatment can add to patient discomfort and result in more involved appointments down the road. Delayed diagnosis can mean patients live with pain or injury, and potentially with life-altering conditions which could be cured or mitigated.

For practices, no-shows can result in:

  • Lost revenue and profit
  • Inefficiencies
  • Wasted resources
  • Increased patient attrition
  • Difficultly building a reliable and accurate staffing schedule
  • A tendency to over-book appointments in the future, which carries its own set of risks

Ways to reduce the number of no-shows at your practice

Understanding why patients are no-shows at your practice is the first step to creating a plan to reduce no-shows. With that knowledge in hand, it is possible to pursue one or a combination of tactics that will reduce the number of no-shows at your practice. Those tactics include:

  • Create appointment reminders: Since many patients simplify forget to show up, an effective reminder system can help fight this. Methods include phone, email, text, and even social media. Stick to one platform for each patient, and consider sending more than one reminder: one week out, one day out, and one hour out, for example. In the reminders, make sure to include personalized information such as appointment date and time, reason for visit, doctor they will see, office location, and a means to confirm that they will be there.
  • Make it easy to cancel: Provide many opportunities for patients to cancel their appointment. No, no one wants a cancellation, but a cancellation is better than a no-show since it gives you the opportunity to fill that time slot. Cancellations could be made by phone, text, or email. Have you moved to a digital scheduling system? If so, cancelling appointments using your calendar can be much easier on patients who may hesitate to look up your number, call, wait on hold, and then engage with staff. Click and done.
  • Starting a wait list: Even responsible patients may need to cancel from time to time. Technology is making this process easier, and special messaging apps and programs can immediately alert patients who are on a wait list that there is an opening.
  • Ban bad patients: No one wants to turn patients (or money) away, but simply banning patients who reach a certain number of no-shows can save you money and headaches in the long run.
  • Don’t reschedule missed appointments: Similar to banning bad patients, this means simply not encouraging them to make a second try, although you may accommodate those who call to reschedule.
  • Develop a relationship with patients: Just like you do with your neighbors and friends, you are less likely to inconvenience people who you have a relationship with. Building a relationship with patients takes time but can go a long way toward easing many aspects of your practice. You can build this relationship in many ways. For example:
    • Treat patients as friends, not transactions
    • Know the patient’s name and greet them by their name
    • Enable your staff to take extra steps to help them feel valued
  • Reward patients for showing up: This could be seen as the opposite of charging patients for a no-show. Charging is tempting tactic that will likely backfire and eventually result in lost patients — including those who would likely never become a no-show but who would recoil at the thought of possibly being charged in the event of a situation that is out of their control. Your reward policy could work in any number of ways — on-time patients are entered into a drawing for a prize each week, for example, or are allowed to spin the wheel for a prize on their way out the door.

Since many of these methods involve communication, make sure you are closely following all HIPAA rules. Need help? A consultant like Eye Care Leaders can offer valuable advice.

Other scheduling strategies your office can use

Besides rewards, reminders, and relationship building, your practice can also strategize to handle no-shows by adopting the right scheduling strategy.

As noted by Eye Care Leaders, there are three scheduling options that can decrease wait times, shorten turnaround times, and maximize efficiency. Those include:

  • Integrated scheduling: Practices create appointment slots for long exams or short follow-ups, with one, for example, occurring in the morning and the other in the afternoon, or alternating by doctor.
  • Top of the hour scheduling: Allowing for a set number of appointments per hour so the doctor’s schedule resets every hour.
  • Cluster scheduling: Grouping patients with similar exam types, conditions, or treatments and scheduling them during a certain time block.

Which scheduling method is best for accommodating no-shows in your eye care office may depend on a number of factors. One factor that you should likely avoid, however, is double booking in anticipation of no-shows. Double booking is an easy way to create rushed visits, poor patient engagement, and hurt feelings, which upsets patients and stresses staff.

An alternative may be so-called open access scheduling, which leave a certain portion of each day open for new patient appointments. By leaving same-day and walk-in appointment times, you can capture a large number of new patient appointments — the very kind who may be likely to cancel or no-show.

No-shows and COVID-19: What you should know

Studies have shown that patient visits to doctors of all types decreased dramatically during the COVID-19 crisis, due in part to reduced practice hours, social distancing rules, and rising unemployment, which caused many people to lose their health insurance.
With lockdowns relaxing, the medical industry is seeing a return to normalcy. This would seem to indicate that no-shows will again become a factor for eye care practices, with one extenuating circumstance: telehealth. Yes, the rise of telehealth during the COVID-19 pandemic had a silver lining: the no-show rate of telehealth visits during COVID-19 was estimated at 7.5%.

To learn more about how you can reduce the impact of no-shows at your practice, don’t hesitate to contact Eye Care Leaders today.

What Scheduling Strategy is Right For Your Practice? 3 Options

3 Options That Decrease Wait Times, Shorten Turnaround, and Maximize Efficiency

In today’s competitive climate, many doctors are content to have a steady stream of patients each day. However, failure to implement a structured appointment system could mean missing out on revenue. Clinical management expert and AAO presenter Zachary Cain notes that an effective scheduling program is essential to achieve smooth practice operations and the satisfaction of both staff and patients.

There are many different ways to design an appointment schedule, and Cain cautions against a one-size-fits-all approach. It’s tempting to simply schedule a patient every 15, 20, or 30 minutes. This revenue-driven method, known as standard scheduling, may add up to high productivity and financial success for some practices. For others, it results in long patient wait times, reduced patient satisfaction, and little to no time for walk-ins or emergency appointments.

A customized scheduling template designed with your practice needs and physician work styles in mind can do more than alleviate patient wait times and staff stress. Altering the composition of your schedule often frees up blocks of time, allowing for additional appointments. Depending on your average revenue per appointment, it could add up to real income over the course of a year.

Keep in mind that there is more to scheduling than the frequency with which appointments are timed and when certain practices are performed. The top way to make a positive impact on your scheduling is to use a digital self-scheduling tool. Digital schedulers are increasingly popular for everything from oil changes to dinner reservations, and customers are becoming more and more familiar with them, and many now prefer them over traditional phone appointments.

In addition to being preferred by patients, digital appointment tools can reduce strain on your staff and free them up for more engaging and profitable exercises. While some patient visits will always need to be handled over the phone, a move to digital scheduling allows staff to handle administrative tasks more efficiently and allows a clinic as a whole to operate more smoothly.
Which scheduling strategy is right for your practice? Below, Cain suggests some alternatives:

Integrated Scheduling

Also known as long/short scheduling, appointment slots are set aside for either long, full exams or short follow-ups. Many times, one type of appointment is allocated to the first half of the day, while the other type fills the second. For practices with multiple doctors, the day is coordinated so each doctor gets a mix of appointment types. For example, in a two-doctor practice, Doctor 1 might see all long appointments in the morning and short appointments in the afternoon. Doctor 2 would do the opposite.


  • Helps doctors get in the mindset of doing quick appointments or full exams.
  • Frees up the pretest area, since short appointments usually don’t need pretesting.
  • Allows for more efficient use of tech time since shorter appointments usually require little tech time.
  • Eliminates any guesswork in scheduling staff, since you can anticipate the flow from hour to hour.


  • Short appointments sometimes turn into long appointments.
  • Must be careful to assess your overall patient needs to avoid an imbalance of available appointments.

Top of the Hour

The goal of top of the hour scheduling is to allow the physician’s schedule to “reset” every hour. It allows for a set amount of appointments per hour, leaving an open block of time at the end of each hour for administrative tasks or to be repurposed for the physician’s needs at that time. Sometimes, all patients for an hour are scheduled at the beginning of that hour and seen in the order they arrive. Other times, complex appointments are scheduled for the first half of the hour, with the remainder of that hour’s patients arriving on the half hour.

Before a practice decides to implement top of the hour scheduling, Cain suggests conducting a detailed review of historical data to determine average number of patients seen and patient contact time, and to predict the number of work-in visits needed and the likelihood of no shows.


  • Emergency visits or same day appointments are more easily accommodated due to the time at the end of the block.
  • Physicians are less likely to fall behind on administrative duties, thus achieving more complete and accurate patient records.


  • Patients may become upset if they notice that other patients were given their same appointment time. An explanation will require some finesse from your front desk staff.
  • Not finishing the block on time will result in back-ups over the course of the day.

Cluster Scheduling

Cluster scheduling involves grouping patients with similar exam types, conditions, or treatments, and scheduling them within a certain time block during the day. For example, a practice might have “injection afternoons” or “procedure afternoons.” Aside from the normal considerations like exam room availability and number of support staff, you’ll also need to take into account things like the number of surgical instruments on hand and the turnaround time for sterilization.


  • Streamlined appointment types allow a large number of patients to be seen in a short amount of time.
  • Diminished wait time for patients who return on a monthly basis for chronic treatments.


  • Performing repetitive tasks can increase the risk of physician or tech error.
  • Staff shortages (like call-outs) particularly affect this type of scheduling.
  • Patient availability and timeliness is more of a factor, as are geographic considerations. For example, if you practice in an area with harsh winters, there could be chronic backups due to late patients.

Zachary Cain’s 6 Steps to a No-Fail Scheduling System

It’s critical to realize that patient scheduling is one of the most important elements of a smooth-functioning, revenue-optimized practice. Nailing scheduling can increase your revenue and patient satisfaction while unburdening your staff. As patients are increasingly searching for better experiences, reducing wait time can help unlock hidden revenue.

  1. Establish a target goal of patients to be seen each day.
  2. Create appointment types based on practice needs using realistic physician times for each appointment type.
  3. Build a high-performing team of administrative and clinical staff.
  4. Allow for work-in visits from established and new patients.
  5. Communicate throughout the day.
  6. Request feedback from physicians, patients, and staff

You can help your practice improve its scheduling by following some of these practices:

  • Send text or email reminders to patients when their appointment is coming up, and make sure to include your address, directions to your office once the patients are in the building, and anything specific patients need to do before arriving, such as fasting. Automating this process can yield even better scheduling results.
  • Digitize your scheduling process. As mentioned, many patients prefer and expect this — and may favor practices that offer it. Many third-party providers supply plug-and-play options that can that integrate with your website with just a few clicks and pasted code.
  • Set up a waitlist to quickly fill cancelled appointments. Many patients will accept an appointment at a later date but gladly snag a nearer date offered at short notice if another patient cancels. This can be advantageous to practices with a high number of cancellations.

Are you looking for more ways to optimize your practice’s scheduling? The pros at Eye Care Leaders have years of experience in helping to ensure that practices of all sizes operate efficiently. Contact Eye Care Leaders today for a free no-pressure consultation

5 Key Benchmarks That Make or Break Your Ophthalmology Practice

Is your ophthalmology as profitable as it can be? Numbers alone can only offer so much insight, but comparing your practice against widely agreed-upon benchmarks can show your industry position and point out areas for improvement.

Here are five benchmarks that allow you to compare your numbers to your peers, courtesy of Derek Preece, a BSM practice management consultant who presented at AAO.

Benchmark #1:

  • Overhead Ratio

How To Calculate: Divide total operating expenses by total practice revenue. Exclude from “operating expenses” the salary and personal expenses for any revenue-generating provider, including MDs, ODs, and physician extenders.

What’s Healthy: 50-70 percent. A healthy overhead ratio for a retina practice is likely to be 5-10 percent lower than for a comprehensive practice, Preece points out. This gap may close as retina specialists get hit with injection reimbursement decreases.

What to Know: If your overhead ratio seems out of whack, take a look at factors that might affect it, including payer mix, geographic location, operational efficiency, provider productivity, surgical intensity, and how efficient your collections are. An overhead ratio that is more than 10% beyond what’s healthy can alert you to something serious going on, like internal theft. For example, “If you are a retina practice, and you occasionally ‘lose’ some of your Lucentis inventory, that will drive up your overhead quickly,” says Preece.

You can reduce your medical practice overhead by evaluating performance, identifying areas for improvement, and getting buy-in from physicians and staff that change needs to occur. A well-tailored action plan can be used as a road map to increase productivity, reduce costs, and improve business operations. You may need to:

  • Review staffing needs and adjust staff size
  • Assess staff compensation
  • Review your retirement plan for potential savings
  • Identify ways to optimize patient encounters
  • Outsource billing and collections to a professional, revenue-focused vendor

Benchmark #2:

  • Provider Productivity

How To Calculate: Divide total professional fee collections by total number of full-time equivalent (FTE) providers.

What’s Healthy: A comprehensive ophthalmology practice is healthy if the average collection per provider is between $800,000 and $1.3 million. This number is similar for glaucoma and plastics practices. The healthy range for cornea and pediatric ophthalmology practices is slightly lower. Retina practices should pull in between $1 million and $1.8 million per provider.
What to Know: If your provider productivity is below established benchmarks, there are two things you need to do: Identify the barriers to productivity, ensure alignment, and enact plan to raise productivity. Examples of barriers to productivity include issues with documentation, problems with lab turnaround times, and time wasted on EHRs. With the barriers to productivity established and buy-in from providers, you can then enact changes to your practice to improve provider productivity. Some possible solutions include:

  • See more patients
  • Improve your billing and coding
  • Consider tech upgrades, such as automated online bill payment
  • Regularly audit and assess services such as telephone and internet
  • Consider if it would be cheaper to eliminate overtime through the hiring of additional staff

Benchmark #3:

  • Non-Provider Staff Payroll Ratio

How to calculate: Divide total staff gross payroll (not including benefits expenses) by total collections.
What’s Healthy: 20-26 percent. Retina practices should be at the low end of this range. If you factor benefits into the equation by adding benefits expenses into your payroll expenses, the range should be 26-32 percent.

What to know: Many practices struggle to find the right staffing level, and a variety of factors, some of which may be out of your control, can come into play here. Keep in mind that higher physician productivity may justify higher staffing levels, and the existence of satellite locations may call for heavier staffing. Ways to move your ratio in your favor include:

  • Adjust your number of mid-level providers
  • Increase physician productivity
  • Improve organization, adhere to schedules, and complete paperwork on time
  • Lower your staff turnover rates

Benchmark #4:

  • Collections Per FTE Staff Member

How to calculate: Divide total collections by number of FTE staff members.

What’s Healthy: $140,000-$200,000.

What to Know: If the number gets close to $200,000 or exceeds $200,000, you should wonder if your existing staff is overburdened and be concerned that essential tasks (like compliance) aren’t getting done, Preece warns. If the figure is at the low end of that range, any number of factors may be at play. In this case, consulting with a firm that can optimize your revenue cycle management will likely help raise this number.

Benchmark #5:

  • Number of FTE Staff Per FTE Provider

What’s Healthy: 4-8 staffers per provider.

What to Know: Ophthalmologists who make more money for the practice than others are almost always in the higher level of this healthy range, Preece observes. Reason: Well-supported doctors are often the highest revenue earners.
Adding staff can help boost your revenue, though it is important to keep in mind that as you add staff to boost revenue, your staffing costs will increase, and you may need additional office space. Efficiencies can be realized in part by removing unnecessary steps in a practice so providers can see more patients in less time.

What Next?

It’s important not only to compare your metrics to other practices, but also to your own practice’s past performance, Preece stresses. Such comparisons can alert you to trends and tell you whether things are getting better or worse at your practice.
It’s also important not to jump to conclusions too quickly, Preece says. Benchmarks are like symptoms—mere indicators that something may be going wrong and that further investigation is required. In your practice, if a patient reports floaters, you don’t assume you know the exact problem without investigating further. So too with benchmarks and good practice management.

Once you have these basic benchmarks, you can drill down into other benchmarks available from AAO and other sources, including:

  • clinical staff cost per encounter
  • front office costs as percentage of collections
  • clinical staff costs as percentage of collections
  • billing staff costs as percentage of collections
  • new patient ratio expenses per encounter
  • collections per encounter
  • encounters per FTE provider
  • net collection ratio
  • retail optical revenue per FTE optician

For more ideas to remove or lessen the operational burdens associated with running your practice and improving your revenue, contact the pros at Eye Care Leaders, who offer solutions for revenue cycle management, patient acquisition and retention, and MIPS assurance.


Optimize your bonus & uncover benchmarks that really matter.

Do you want to maximize your Quality Score? With more than 900 measures, each measure being individually scored on specific benchmarks, and 4 ways to earn bonuses, the MIPS Quality performance category has some of the most complex scoring algorithms in the Quality Payment Program. No wonder achieving it seems impossible.

Relax — we are here to help. Our new webinar will give you valuable insight into the tips and strategies you can use for MIPS Quality scoring success. True, the scoring algorithms are complex, but we’ve got the expertise and experience to optimize your performance.

Sign up for this webinar today to learn about:

  • Ways to earn bonus points toward the Quality category and the overall MIPS score
  • The history of the Quality category and its measures
  • Historical benchmarks and how to read them
  • What you need to know about Medicare Care Compare

Attend this fast-paced webinar to learn:

  • How to effectively pick measures that help maximize your score
  • How to estimate your Quality score throughout the year so you know where you stand
  • How your reporting method can positively or negatively affect your score
  • How to decide which measures make the cut during the attestation season
  • When it’s good to report extra measures and which measures aren’t worth adding

This webinar is perfect for:

  • Healthcare practice administrators
  • CEHRT users
  • MIPS eligible clinicians
 Interested in a Free Consultation?

About the Speaker

Megan Fries and Katie Skelly

Megan Fries has 18 years of experience guiding providers to successfully report for QPP. Megan’s extensive background with EMR support and Meaningful Use and MIPS attestation, as well as her work in clinical settings as a surgery scheduler, tech, and scribe, give her the ability to apply her insight and knowledge in a way that makes her expert guidance invaluable to the healthcare provider.

Katie Skelly brings over 14 years of practical experience to our team and has worked for an ophthalmology practice, including the optical department, front office processes and procedures, and scribing. Having worked directly with multiple EHRs, Katie understands not only what the healthcare practice does, but what it must do to navigate the complex world of regulatory incentive payment programs.

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  • Quick Payments Without Registrations

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    Take payments without registering the patient.

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ClearGage is revolutionizing the way that healthcare providers do business. We recognize the need for modern payment options and deliver innovative patient payment technology that significantly reduces accounts receivable, elevates patient satisfaction and increases total patient payments.

Best Practices in RCM Services : Optimizing Your Front Office

Key Takeaways

  • Full potential for revenue cycle starts with an optimized front office
  • Scheduling, pre-registration, insurance verification, authorization, patient check-in and consent to treat are the 6 critical areas
  • Reducing no-shows, expediting patient flow, increasing provider productivity, preparing patients for out-of-pocket responsibilities, and identifying whether the patient’s insurance will reimburse for the service are quantifiable benefits to this focus
  • Successful point-of-service collections – by knowing how and when to ask for patient payments – is important to your success

Think about your experience as a patient or caregiver when you walk into a practice. Some front offices are crowded, noisy and chaotic and the staff are scurrying around with their hair on fire. Others are relaxed, quiet, and organized and all the staff move with calm purpose.

Now try to guess which one is going to be doing better at billing and collections?

I tell my clients all the time: your front office drives everything in billing and collections. Everything you do here matters. But some things matter more than others. That’s why I recommend focusing on these 6 critical areas.

Read the full blog post on the Alta Medical Management website.

About the author:
Jacqueline Todd-Washington, VP of Revenue Cycle Management, Alta Medical Management

Jacqueline has over 35 years of experience in Revenue Cycle Management, helping practices of all sizes and across multiple specialty areas capture the revenue they deserve. Her motto is, “It’s your money!” and she loves to share her knowledge with anyone who asks.