Incorporating Premium IOLs into your Practice

By Anne Dwyer, COMT, OCS (bio)

Intraocular lens technology has improved dramatically over the past several decades. Ophthalmology has seen the transformation from poor-fitting anterior chamber IOLs to foldable, aspheric IOLs that insert through incredibly small incisions and provide enhanced vision quality. Within the past decade, a wide variety of “premium” IOLs has hit the market in the United States. These IOLs include new presbyopia-correcting IOLs and astigmatism-correcting IOLs. Both are designed to decrease a patient’s dependence on glasses, and both come at a “premium” price, not covered by Medicare or private insurance.

With the advent of premium IOL technology, the physician-patient counseling for cataract surgery has become more involved and certainly more time-consuming. Many patients come into the office requesting information on the new IOL options or requesting implantation of a specific lens. Physicians who offer this technology should take proactive steps to ensure that their entire office staff has an understanding of the services that the practice offers.

Technicians are invaluable physician-extenders. All technicians should have at least a basic understanding of the specific technology of the premium IOLs that the physician is implanting. It is also helpful to train one or more technicians (depending on the office size) to assist the physician in providing premium IOL information to patients. These technicians should work directly with the physician both pre- and postoperatively to understand which patients make good candidates for the different IOLs and how they should be appropriately counseled. In evaluating these patients postoperatively, both the physician and the technicians are able to determine expected postoperative outcomes and get a better understanding for subtle ocular conditions that can negatively affect these IOLs, such as early posterior capsule opacification. Although the physician is ultimately responsible for the patient’s care and counseling, having a highly trained technical staff is invaluable in enhancing patient communication and increasing physician efficiency.

In addition to training technical staff, physicians should ensure that their front office staff has an understanding of premium IOL technology. The front office staff is on the “front line” with regard to patient communication. They are often the first contact with the patient, and will inevitably be asked questions about the premium IOLs that the physician offers. This staff should have a basic understanding of the different IOLs and be able to direct patient inquiries to appropriate technical staff within the practice.

Since premium IOLs are not paid by Medicare or private insurance companies, patients are faced with significant financial considerations when making a decision to receive these lenses. The office billing staff should also be well-informed in the premium IOL technology and be able to provide additional counseling to patients. The billing staff or financial counselors should not be placed in the position of having to “sell” these services to the patient, but their understanding of the pros and cons of the technology can increase the patient’s comfort level when making the decision to spend a significant amount of money out of pocket.