Optometry training guide

The information within this page was copied from the document “Optometry entry for the training guide”

Our Optometry department is still growing. As such, please ensure you communicate with your supervisor to ensure that the information you are seeing below is up to date with current practices.

Providers:

Appointment types:

Purpose: Patients with NDMA BCBS Medicaid Expansion must complete a specific form acknowledging that their optometry visit is not covered by insurance. This is a North Dakota Medicaid requirement.

Front Desk Responsibilities:

• Provide the NDMA form to the patient.
• Assist the patient in:
  • Signing the form
  • Adding their insurance ID
• Once signed, deliver the form to the Optometry technician or provider.
• After the visit:
  • Ensure the form includes:
    • Patient Name
    • Patient Signature & Date
    • Provider Signature & Date
  • Explain to the patient:

“Your Optometry visit is a non-covered service per your insurance. This form acknowledges that you are responsible for any costs associated with today’s visit.”

• Optionally, provide access to a laminated Optometry Fee Schedule for reference.
• Scan the completed form to either:
  • The designated billing email, or
  • [Insert responsible person’s name/email]

Provider/Tech Responsibilities:

• Complete the remaining sections of the form with the patient during the visit.

Billing Responsibilities:

• Add the Procedure/Item/Service and Billed Charge after coding is complete.
• Retain the form on file for audit purposes.

We should be asking 3 specific questions

1. What are you wanting to be seen for at this visit?
   1. This should be noted in the appointment notes, even if it is something as simple as “Eye exam for glasses”
   2. This is largely already happening every time we are scheduling a patient, so keep it up!
2. Have you had any recent changes in your vision?
   1. pay attention to trigger phrases or anything that may sound of concern.
   2. Feel free to ask follow up questions if you suspect there could be an issue not covered by a trigger phrase below.
   3. If the patient mentions any trigger phrases, do not ask question 3. Instead move to the next step in this emergency process as documented under “Trigger Phrases”
3. When was your last eye exam?
   1. If under a year, inform the patient that their insurance (if they have any) may not cover the visit and they should contact their insurance provider to ensure that it will be.

If question 3 gets you any of the following phrases, we need to follow up and gather more information to get to a provider.

1. “Flashes of light”
2. “Floaters”
3. “Curtain over my vision”
4. A sudden change in vision
5. Severe pain
6. Intense red eye
7. Severe light sensitivity
8. Vision loss (rapid)

Any mention of traumatic injury or blood coming out of the eye should be directed to present to the ER ASAP.

Gather the following information if you hear any trigger phrases.

1. When did this happen?
2. Does it cause pain?
3. Is this affecting your vision?
4. What is a good phone number to call back in case we get disconnected?

If a patient mentions a trigger phrase, and you have collected the additional information, please get ahold of the Optometrist to get guidance on what next steps need to be taken. In the event that the Optometrist is not in office that day, these questions should be routed to the charge nurse.

They will need the information you have gathered and will either speak to the patient themselves to complete additional triaging or will offer you specific information to relay to the patient.

1. Get in touch with a provider, either the optometrist, or charge nurse if there is no doctor in that day.
2. Present them the information you have collected from the call
3. Await next steps from the provider.
   1. Next steps could include
      1. The provider calling them back/getting the call transferred to do additional triaging.
      2. Being given specific instructions to relay to the patient in question.