Eyecare Experts

Episode 10 – Aging Eyes & Insurance

Eyecare Experts Dr. Gene Terrezza and Dr. Troy Bell were joined by the practice’s General Manager, Kat Boyden, for Episode 10 to discuss Aging Eyes and Insurance. Together, they discuss practical considerations for those with aging eyes and dive into common questions about insurance benefits, including how we work with patients on claims and other important issues. We’d also appreciate hearing from you! Let us know how we’re doing by subscribing, liking and commenting on our YouTube channel or wherever you get your podcasts.

Duration:: 20m
Broadcast on:: 15 Aug 2024
Audio Format:: mp3

(upbeat music) - Welcome back for joining the podcast. Thank you for tuning in and listening to us and commenting on the sections and asking questions and stuff. We're having a good time. I'm Dr. Bell, it's Dr. Treza again, and we usually have other providers from our offices as far as optometrists, but today we have our general manager, Kat, join us. Kat, give us a little bit. How long you been in the field and all that good stuff? - I've been in this field for about 15 years. I started out at front desk and worked my way as a tech, did optical dispensing, and then did a little bit of insurance and started managing practices. I've been with these guys for almost 10 years. It's been wonderful. I won't say like it's been, I mean, of course there's challenges with these two, but other than that, it's been great being on the team for sure. - Well, I will say this, and I think you would echo this. I've been doing this for 20, a little over 20 years, and certainly there's things I, insurance, especially, progressives, things that I don't have the answer to that Kat certainly does. And I certainly appreciate her being on the team and answering the hard stuff that sometimes I don't know the answer to. - Well, and I like to tell people that I'm also a patient myself. I've been wearing glasses since I was eight, so like I understand the struggles, so I'm a big patient advocate for sure. - There is no doubt by mine that we wouldn't have grown as fast as we have without having her as general manager. I'm well aware of that. And that's why we'll continue to grow. Probably double in size inside of two years. - And also for the patients. That's, I mean, that's a big part as well. We appreciate you, you know, entrusting your eye care and your family to us. You know, we've been in the area, it's rather been in the area almost 50 years next year. And that's a lot of patients we've seen, and he's seen throughout the years, and we wanna thank you patients for, you know, entrusting yourselves, your family, your kids, you know, for all your vision needs, your healthcare, your eye needs, thank you for coming to see us. And that's what's helped us grow. Today's topic is aging eyes and insurance. We're gonna kind of cover both of those. And I would like to say certainly on some of our older podcasts, we've covered a bunch of these individual topics like age related macro generation, cataracts, diabetic retinopathy, dry eyes, glaucoma, rental attachments. Certainly these are things we always discuss with patients as far as when eyes get older, but we went into details on prior podcasts. So if you have any questions, certainly go back, look at those podcasts. We're gonna go a little bit more specific in those, but today we'll just kind of talk in general about aging eyes and insurance. - Well, this segment of the population, the group that's over 55, is the fastest, largest growing segment in the whole demographic population line. And so the number of diseases are expected to at least double in almost every category. And thus, the need for continuous monitoring and continuous treatment of these issues to keep the quality of life, the way it should be becomes even more important. - Well, I will say this, certainly with us living longer in general advances in medicine, things that, you know, cataracts, age-related macadeneration, dry eyes, especially, the longer you live, the older you get. Sometimes the risk factors grow up with those things. They go up, meaning you have a higher chance of getting it. First, certainly diabetic patients. The longer you're diabetic for the more chance, you may have retinopathy and issues and changes. And certainly those are reasons we encourage patients to get an annual eye exam so we can monitor the health of the eye along with the vision aspects. - It's a general rule with most diseases that the earlier you detect them, the better your outcome is. It's like putting out a small campfire with a garden hose as opposed to waiting till half the camp is up in flames and your car's burning, and then decide to go in and get it fixed. - I was gonna say, I know one of the things that we deal with, you know, in clinic is we get a lot of patients that come in, one, their DMV form filled out. You know, you'll get that green sheet from the DMV that says, hey, you've got to get your eye doctor to fill this form out. And, you know, we do this for patients all the time, but in order for us to do it, you've got to come in and get an eye exam. Like, the doctor can't fill it out without seeing you, essentially. So we always recommend patients, you know, when you get to the point of the age where they require you to get that reading or that a vision test form filled out, we'll be happy to fill that out for you, but you've got to come in and get scheduled. And a lot of times they require you to come in every year, you know, for the doctor to fill that form out, but again, you'd have to come in to fill that out. - Well, it's funny you say that. I will say this as far as, since I've been with Tereza, I can think of two patients that came in just because they'd either DMV form filled out, or maybe, hey, I just never won glasses, but my vision has just gotten a little bit blurry within the last year or so. And those two cases were both young males that had major issues in the eyes. One had tumor, cysts, things going on that we wouldn't have seen if he never came in for that exam. So, you know, certainly this is an extreme case, but, you know, vision, we always want to check and make sure you're seeing the best, but certainly there's a lot of other things we can pick up and detect inside the eyes that, you know, that we need to fix and make sure we can get that corrected as well. - Well, Florida's one of the few states, too, if you're over the age of 80, you're gonna need a vision certification to make sure you can still see well, regardless of your previous position or driving record or whatever other parameter you'd wish to measure. So after age 80, we come in, we fill out those forms for you and hopefully keep you driving. - And we're always happy to do that as far as federal, any forms for driving, any work-related forms that you have to get to kind of prove that you can see a certain thing. So, you know, drop those off. Certainly a lot of patients will bring them the day of the exam, but even if you don't, you can bring them in after the fact, maybe leaving with us. The provider may not be there that day, it may take us a day or so to get it filled out, but we're happy to fill that out and get that back to you for both the DMV purposes and other purposes, you know, flying. I can think of some that drive 18 wheelers. There's a lot of things out there that they have to, you know, get things checked, get the vision checked for. So certainly we want to do that and make it as easy as we can. I think a lot of times maybe they're scared that they won't pass, but, you know, even if one eye doesn't see that well, and I have certainly patients that are amblyopic, or maybe one eye doesn't see, you know, 28, but as long as the better scene eye sees a certain, you know, certain vision, you're still gonna pass. So I think a lot of times patients are scared and they're still would pass, but let's get it filled out properly and get everything done for them. - There's another group of patients who think they see well because they've adjusted to their level of seeing. And this thing goes down so gradually that you're not aware of it, when in fact you're not seeing well at all, until you get hit with a major symptom where you get in an accident. You say, "Wow, I didn't see that guy coming." So rather than wait for that as the endpoint to trigger your new behavior of getting an eye exam, I suggest that you just do it on a regular basis, kind of like changing the oil on your car, whether you need it or not, every 5,000 miles. - Well, those are the patients. Ones that come in every year, I'm less concerned about those patients 'cause we'll pick up things, you know, if it is glaucoma, we'll usually pick that up in most cases. But the patients who only come in every three years, every five years, every seven years, and we have some that do that, just come in when they have an issue or problem. In three or five years, a lot of things can change in the eyes. And those are the ones I'm most concerned about because hey, maybe they had a high pressure for three years and it wasn't addressed. Or maybe they had bleeding, you know, maybe they had a retinal tear to attachment and they never came in. Well, a lot of times it's harder to treat it or get back that vision after the fact than it would have been if we'd have just seen it on the, you know, proactively or seen it when it first happened. - Exactly. I will add on to that, you know, we get patients that are scared to come in to get their eyes checked because they feel like their driver's license will get revoked and things like that. But really, it's more of a safety thing. Like if you're having difficulty seeing road signs, that's like, here's your sign, you need to get your eyes checked. You have trouble seeing things up close or like things that, you know, are in your car instrument and things like that. Definitely come in and get your eyes checked 'cause, you know, safety is always, you know, the number one priority, obviously, when you're driving. You know, there are different tips that we suggest to our patients that are seniors, you know. Dr. Treza could probably elaborate a little more. - You're saying because I have experience in that regard? (laughing) - Personal experience. - My son indicated to me that I wasn't driving as well as I should have. And so anyway, I get a new car that he picked for me. And it had the eye view by Subaru. I'm not suggesting you buy that individual car. I'm indicating to you that that thing was beeping every time I turned around 'cause I was going too fast, going too slow, moved over in the other lane, made a turn without checking the lane, all kinds of things that I had become accustomed to. After about six to eight months, those beeps died down pretty well, 100%. And I'm driving a lot better. So I would suggest that as an alternative to getting your eyes checked. Or in addition to getting your eyes checked, you might think about technology as a way to combat the ravages of age. - I will say, I know, especially just in the last couple weeks, it seems the big one that I'm getting is glare issues. You know, patients are coming in, hey, those lights, those LED lights on those cars seem to be getting brighter, maybe the street lights are getting a little bit worse. It's hard for me to see. I don't even drive at night anymore. I mean, these are things that we hear in the office. And certainly, even if you have a small prescription, when it's dark out, your pupils are larger, and sometimes it can make that prescription seem a little bit worse. So we certainly want to check the prescription. I have patients who only wear glasses when it's dim or dark outside. They don't wear them during the day because it shows up a little bit worse then. So let's look at the prescription. Maybe you need an anti-glare, anti-reflective coating on the lens. Maybe you have cataracts that's causing light to scatter, that's causing some of that glare. So certainly coming in, I understand the lights are sometimes getting brighter, but also optically, there's things that we can offer and do that will greatly reduce that glare and sometimes even eliminate it. - Another one that I run into is they'll watch TV and they'll have these glare lenses. And for 1995, you get 10 pairs and they come with a full money back guarantee. And they come in, they said, "Doc, I tried all those, "but now I came in to see it." And sure enough, they have an eye problem. And I'm indicating to you that a better strategy would get the eye exam first. And then if you want to fool around and buy everything you see on TV ads, then go ahead and do that. - Well, anything else? I was gonna go ahead and move the insurance unless y'all got anything else to do. So I guess with the insurance, we're gonna dive into it a little bit more. Certainly we have a great billing department that works with us, that helps us, helps patients, you know, get things billed and gives us the information we need to help us out. But in general, we take, I would say, 98, 99% of most vision and medical plans that are out there. So I get questioned this a lot by patients. You know, you don't have to have vision insurance to come see us. If you have a medical insurance and you have a medical diagnosis that we can build for your eyes, we can build that to your medical insurance as well. So there's some patients who have medical insurance alone. There's some patients who have vision and medical. And if you don't have anything, we have self pay as well. So certainly give us a call at one of our offices. Usually we can figure out, you know, insurance-wise, what it's gonna cost you, get you in there, get you scheduled, certainly cat doing the insurance. - I was gonna say every office, we have patient care coordinators and that's literally what they do. They know your insurance. They may not know it right then on the phone when you make your appointment, but we have people that verify insurance, like verify your medical, verify your vision, verify your deductible, verify your copays, verify your benefits and all that prior to you coming in for an eye exam. So you're not coming in surprised like, oh, I didn't know this wasn't gonna be covered or I didn't know that I had this copay or I didn't know any of this stuff. We always tell patients, we'll go ahead and schedule you. Our insurance eligibility specialist people will verify all that prior to you coming in for the exam and that's probably one of the most important things that when we make appointments, we always ask you for your insurance information ahead of time because we wanna have that information prepared and ready for you for when you come in for your eye exam. And like I was just Dr. Bell was saying, you know, a lot of people they come in and they're like, well, I don't have any vision insurance. Well, do you have medical? Well, why do you need my medical? Well, keep in mind an eye is an organ in your body. That is something that we can build to your medical insurance if there is something medically going on with your eyes. It's not always vision related. So for us, you know, for patients when we have vision related issues we just immediately think, oh, it's vision. But I will say a good portion of the time if there is medical things going on that can cause your vision to deteriorate. And so it's important to give us all that information ahead of time so that way we can coordinate all benefits. Just 'cause we build your medical insurance doesn't mean that, oh my gosh, I'm gonna be stuck with this copay or this bill because there's a lot of vision insurance that we can coordinate benefits with that can literally eliminate a lot of your copays and deductibles at the end of the exam. But however, if you don't have any insurance we do see patients for self pay. We start, our exams start at $99, our glasses, packages, you know, frame and lenses start at 89. And I know that's very competitive with a lot of online retailers. We get a lot of patients that are like, well, I don't have insurance so I'm just gonna buy my glasses online. Shop around, ask, look at our package deals. We have package deals starting at 89 and I'm pretty sure we're pretty competitive with online retailers for that. - The other thing I wanna make the point of is that other establishments in this area say that they take insurance. And what they mean by that is you have the insurance, you pay them and they give you a bunch of forms, you go home and fill them out and hopefully you'll get some of your money. That's not the way we do it here. We have six full time insurance employees and we fill out all forms for every insurance and file it and do and then if there's any difference we will bill you that difference or the deductible. But first we get the money from the insurances and then we bill you, not the other way around. So all that headache and all the details of filling those forms out correctly is taken off and that's why we have six people on payroll. - And we try to be as transparent as possible. Sir, we wanna make this process easy for the patients and that's the reason we have a billing department, that's the reason we go through this and a lot of times on the front end we'll say, hey, Ms. Jones, you do have a $20 copay if it's gonna go medical today, we want you to know before the exam even takes place versus other places that I've heard that on the back end, hey, you owe us $100 today. We want the patients to kind of know what to expect, that way there's no surprises throughout the exam and that way they know what the insurance covers and what their benefits are and all that stuff. - Exactly. - Yeah. Let's take a question. We've got one question here. How does my healthcare insurance work with my vision insurance? We talked about that a little bit. - I think I kind of already elaborate a little bit but you'd be surprised a lot of medical insurance we can coordinate with your vision insurance so that way you wouldn't be paying as much in the copays. - We've got another question here as well and we appreciate you sending questions to us for this. I have an aging parent that could benefit from using assistive devices to help with vision loss. However, this is a difficult subject to bring up. Any suggestions on the best way to discuss it with them so they don't feel I'm trying to take away from their independence? - I would say leave it open and talk in general. Say look, there might be some things out there and it depends on their age. You don't want to run them off by talking about computers and technological assistance when in fact they're not geared for that. If they are so much the better, there's amazing new things out there for that. But if they're not just leave it general and say listen, let's see what options we have to help you with your vision and how we can do that. Let's go see the doctor and see what he has to say. - That's great advice. I know the one thing I try to do. Every patient doesn't have to see 2020 to be able to function and do what they need to do day to day. For patients that I see back, let's say for cataract evaluation or they bad enough for cataract surgery, I will look at the cataract and evaluate it. But at the end of the day what I talk to the patient and ask them is hey, what are you doing throughout the day and can you see well enough to perform those daily functions? - Exactly right. - And if they say yes to that, then that may be good enough. That may not be 2020, it may be 2040, but for what they're doing, they're able to see it and they're happy. But if they can't see that and they interfere with their daily activities, that's why we need to intervene and try to do something to get those patients to see better. - I agree. I don't think it's a clinic where we tell you what to do. Ours is a much more power sharing agreement where the patient gets to put his two cents or her two cents in and then make the final call. So even if I recommend, listen, I think your cataracts are terrible, you're gonna need surgery and they say well, I don't wanna do surgery. And I say well, guess what, we won't do surgery. We'll get along the best we can without it. - We can recommend all day long, but at the end of the day, what do you feel is best for you, do you wanna do this or you not wanna do this? Well, we appreciate you all listening to our podcast. Thank you. Thanks for cat for joining in today, our general manager. Keep the questions coming, keep the comments, like us on podcasts, any future topics you wanna talk about, any questions, any family members with certain conditions, we'd love to hear from you and certainly talk about that in the future. Thank you guys. - Thank you. (upbeat music) (upbeat music) (upbeat music) (upbeat music) (upbeat music)