Doctor Spotlight: Eric Botts, O.D.
Sixteen years ago I graduated from the Southern College of Optometry and settled in Macomb, IL. My first practice opportunity happens to be my only practice setting as I am still here. I started my own private practice in the Wal-mart Vision Center and have put countless hours, loads of energy and a significant amount of money into my location since I began seeing patients that first day. I took ownership of my one-door state practice from the beginning and involved myself in all the patient care aspects of my office. I have been included in the interview process of almost every assistant and office manager hired since day one and continue to stay involved with training of my staff on the daily tasks required of a great optician. Developing a good working relationship with my office manager is critical for keeping staff morale high. My staff is part of my office family and they understand that they are working in a professional medical office. We make a difference in the lives of our patients and what we do everyday has a huge impact on the activities and quality of life each of our patients enjoys.
Early on in my career the other doctors in my county formed the county-wide association of private optometrists and included every O.D. in the county except the doctor at Wal-Mart who was me. I understood that fear of what the doctor at Wal-Mart could do to dry up their practices was ultimately the driving force behind their actions. Being excluded was a great motivator for me as I immediately joined the Illinois Optometric Association and attended every meeting of the local society and the sooner they realized that I was just a regular O.D. practicing optometry like them the sooner I was accepted as one of them. I remember in the early days being told that I was the enemy or worse yet that I was not a real doctor. I ignored it and went about providing the most thorough eye exam I could for every patient that ventured into my office. One by one my practice grew and I became an active member of my community. I joined several local volunteer organizations and soon the people I met in the community were my friends as well as my patients. Better yet I took an active role in my local IOA society and campaigned hard to pass a therapeutic bill that eventually would become the number one factor for the future success and growth of my practice. Later I became a state board member for the IOA and quickly learned what organized optometry could do for me. I soon realized that without this group, that represents our profession on both a state and federal level, I would not have a medical optometric practice. I would not have the freedom to treat my glaucoma and red eye patients. I would not be able to write prescriptions for antibiotics, anti-glaucoma or anti-inflammatory drugs and patients would come to me for refractions and contacts but not for the rest of their eye care. Treating eye disease is the challenging part of my practice that keeps me interested and motivates me to bring my A-game everyday so that I provide the best care possible for all of the eye care needs of every patient.
Full-scope optometry has been the rule since my first day here. I have always practiced at the highest level my license would allow. I learned early on that a patient will come in the first time for a routine visit but medical care will keep the patient coming back. Not only do they come back but if you take care of all their eye care needs they will also bring the rest of the family with them. I willingly help all of my patients utilize their medical insurance for their eye care whenever possible. I am a provider for Medicare, Medicaid, BCBS and every other major medical insurance plan in my area. My staff helps me educate every patient on the benefits of allowing us to care for all of the patient’s eye care needs and they understand the importance of providing the best care using the newest technology.
Several years ago I began adding new technology to my office. I started with a retinal camera and have since added a GDx and a Cirrus OCT for my glaucoma, diabetic and macular degeneration patients. Training my staff was easier than I had anticipated because they saw how pleased the patients were with it and they understood that we were providing the best care with the newest technology. I also added a second location one hour away in Galesburg, IL and currently have two other doctors (Dr. S.N. Jani and Dr. Elisa Skadahl) who help me cover both offices. The biggest mistake I have made in respect to the new technology is waiting 12 years to invest in it in my original location. I out-fitted the new office with a camera and GDx from the start and although it will take a little longer to pay it off due to lower patient volume in a new practice, it is well worth it. The only question I ask now is not how much a new instrument will cost but how long will it take to pay for it. The GDx may be a financial windfall for an optometric practice but more importantly raises my standard of care and lowers my liability. It has a screening mode and medical mode that easily passes the Medicare litmus test for charging different fees for the two different modes. I increased my routine exam fee a modest amount and screen every patient over age 17 with the GDx. If a patient has an abnormal screening than I recommend a full GDx and bill it to their insurance if possible or the patient pays for it. The patient is educated on the need for regularly-scheduled eye exams either way and understands the new technology provides a more thorough evaluation of the health of the eye.
Medical billing has added more work to my schedule but ultimately has increased my earning potential so much that the extra work is well worth it. Initially I was intimidated by the concept of adding medical billing to my practice and dragged my feet for a couple of years; but as soon as I got the ball rolling on billing medical insurance the correct and ethical way I saw what an immediate and positive impact it can make. At first I submitted my own claims at the end of the day but that eventually resulted in my hiring a billing specialist to do my billing for me. The end result is that I now have 6 billing specialists submitting claims for me and more than 30 other doctors; most of which are Wal-Mart O.D.’s. My one-door location requires that I outsource my medical billing to an off-site location due to space constraints. Other doctors here in the Midwest needed to do the same and the start-up of Optometric Billing Consultants was the result of Wal-Mart doctors needing a resource to help submit their medical claims so they could practice full-scope optometry and afford the latest technology in optometric care.
Two years ago I began my billing company, Optometric Billing Consultants, and at the same time I began presenting a cope-approved course titled Medicare: Start to Finish. My course starts with the basics and goes step-by-step through the coding and billing process. My goal is to make medical billing easier for everyone regardless of your level of billing experience. Medical billing has had a huge positive impact on my practice and I realized that all Wal-Mart O.D.’s could do the same thing in their practice. Encouraging optometrists and their assistants to implement medical billing and increase their scope of practice has been very satisfying. My seminar is a direct result of many rejected claims and frustrations with learning to submit medical claims and collect the Medicare-allowable fees. With a lot of perseverance and studying the ICD-9-CM and CPT coding books from cover to cover I learned everything I could about billing Medicare. Although I don’t necessarily recommend that everyone read these extremely boring books cover to cover I do suggest that you attend courses on medical billing and learn as much as you can from the experts.
Twice I made the mistake of hesitating to do the best thing for my practice. I left thousands of dollars on the table as many years passed by and I continued to charge my routine exam fee for medical care instead of adopting the medical model and charging what Medicare’s guidelines say my services are worth. Many of you can learn from my mistakes. Don’t wait another day to invest in new technology or to begin medical billing, do it now and the reward will be yours to enjoy for many years to come.