• Who Does What: 5 Key Roles in the Ophthalmic Practice

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    Every ophthalmic practice runs operations a bit differently, but most involve several key roles. Whether you plan to join a large practice or set up a solo ophthalmology practice, here’s a guide to the most common roles. By knowing who does what, you’ll be able to run a more efficient practice and, ultimately, provide the best patient care.

    The scope of each role will vary significantly, depending on the size of the practice. To give you a behind­-the­-scenes look at the ophthalmic practice, YO Info spoke with two seasoned practice administrators about the main positions in their offices and the job duties of each.

    1. The conductor —­ your practice administrator/office manager. “Think of this position as the orchestra conductor of the practice,” said Nicole Kesten, whose Chicago Glaucoma Consultants is a three-MD/one-OD private outfit with three locations operating in the greater Chicago area. “Staff play many different parts, and it’s up to the administrator to create office harmony and fill in the gaps as needed.”

    Typical duties include:

    • Preparing payroll;
    • Obtaining insurance and benefits for staff;
    • Hiring, training and firing;
    • Paying bills;
    • Negotiating contracts with vendors;
    • Keeping current on the latest government regulations and mandates;
    • Providing productivity reports to physicians;
    • Serving as compliance officer.

    At the Virginia Retina Center, Joanne Mansour’s group consists of four ophthalmologists working in three offices — one main and two satellites. In a practice this size, each location might have its own office manager, overseen by a single practice administrator.

    “We might also wear more than one hat,” she said. “In smaller practices, for example, office managers might serve as a receptionist, a biller and a scribe at times.”

    2. The ambassador —­ your front desk staff. “They are the first­-line ambassadors to the practice,” Kesten said. “Patients might interact with the front desk many times before actually meeting the ophthalmologist.” It’s important for these staff members to have a thorough knowledge of the physician’s background, practice experience and general triage.

    The main duties of front desk staff include:

    • Making and confirming appointments over the phone and in person;
    • Checking patients in as they arrive;
    • Arranging for referrals;
    • Triaging patient concerns;
    • Prepping charts;
    • Obtaining authorizations for surgery;
    • Scanning documents into the electronic health record system.

    3. The ones who make sure you get paid —­ billers. Simply put, this position collects payments. If your office doesn’t accept insurance and everything is paid at the time of service, this position is very straightforward; however, most offices accept hundreds of different insurance plans. Thus, billers often have more complex duties, which can include:

    • Entering insurance charges for patients;
    • Coding exams;
    • Scrubbing claims to ensure proper payment;
    • Collecting balances;
    • Answering billing questions for patients.

    4. The staff who prepare patients ­— ophthalmic technicians. This position casts a wide net. In general, technician duties include:

    • Performing the initial workup on patients as well as diagnostic tests;
    • Assisting physicians with in­-office procedures;
    • Ordering clinical supplies and ensuring physician lanes are stocked;
    • Sterilizing instruments.

    Here, too, the size of your business matters. As a high­-volume glaucoma practice with around 22,000 patient encounters a year, Kesten’s Chicago Glaucoma Consultants breaks technicians into three subgroups to maximize an efficient patient flow:

    • Testers administer all diagnostic tests under the direction of the physician and process them via the EHR.
    • Work­-up technicians collect all relevant information required for the patient’s exam.
    • Scribes accompany the doctor during his or her evaluation, document all findings and send exam work to the primary care physician.

    “All of our techs work as a cohesive team,” Kesten said. “And in many ways, they are an assembly line, preparing the patient to see the doctor all the way through the evaluation.”

    Other Staff. There are also a number of other roles that you might have to fill depending upon your subspecialty and your practice dynamics:

    • Surgery coordinators counsel patients after the physician has recommended surgery and take care of everything associated with the case leading up to the procedure.
    • Opticians assist patients with all optical needs, including glasses and contact lenses, and oftentimes assist with refraction.
    • Photographers are especially common in retina practices and perform diagnostic imaging.
    • IT specialists handle all of the practice’s technology needs, ensuring that servers are up to date and addressing any other computer or EHR issues your staff might encounter, from software updates to ransomware attacks. Smaller practices sometimes outsource IT help.

    5. The physician ... and organizer —­ you. Most patients can choose from whom they receive care. Even if they love the ophthalmologist, they might go elsewhere if the office is poorly run. As a physician, you’re more than just the doctor. You must also be an effective organizer and facilitator of a large group of staff.

    “Most patients come to us because of our doctors’ reputations,” Kesten said. “But I truly believe patients stay with us because of the full package of service that all of the staff provide.”

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    About the author: Mike Mott is a former assistant editor for EyeNet Magazine and contributing writer for YO Info.