Exam Count as a Foundation for Revenue

Every dollar earned in your practice starts with a patient encounter. This underscores the fact that your patient exams form the bedrock of your practice’s profitability. By analyzing the number of actual exams performed, you can gain valuable insights into the effectiveness of your patient outreach and retention processes as well as your scheduling practices. 

You need a regular routine to explore whether you’re seeing enough patients or if you need to increase your exam volume. This article will teach you a simple method to keep track of how many patients you see every week, so you can a) understand where you’re at now, and b) create and implement strategies to improve your numbers. In later modules, we’ll also be leveraging this foundational statistic to help us evaluate other critical metrics.

The Importance of Counting Your Exams

It sounds like an obvious statement, but you can’t survive without enough exams. The real question becomes: “How many is enough?” Exam count is foundational. You can optimize all of your practice activities, increase all of your other metrics, and still fall behind if you’re just not seeing enough patients. 

According to IDOC consultant Nathan Hayes, when a practice owner wants to improve their revenue, his first suggestion – and most fundamental – is “see more patients.” Understanding and improving your patient exam count is crucial for building and sustaining your business. That’s why we look first at the number of exams a practice is performing, and whether that number is growing, falling, or steady. 

See if this sounds familiar. Your optometric practice is hustling. You’ve got plenty of staff on hand, and everybody seems to be busy. Yet, despite the constant activity, you notice a troubling trend: the practice’s revenue doesn’t seem to match the activity level. This is not an uncommon result. Step one in this case: check the number of exams to see if you’re really as busy as you think you are.

Let’s do a quick review of the basics. While this definition is obvious, it helps to underline why we’re placing such an emphasis on exams. Patient encounters directly influence practice revenue. Each exam not only brings in fees for the service itself, but typically leads to additional revenue from optical sales and follow-up treatments. Furthermore, the number of patient exams can reflect the health of your scheduling and recall programs, indicating whether you’re efficiently managing appointments and maintaining patient engagement. Finally, analyzing patient exams helps you assess if your current staffing and scheduling practices are meeting the demand, ensuring that you’re neither under-scheduling nor failing to maximize your resources.

Are All Exams the Same?

While it may seem logical to count every single patient encounter, this can skew results, as many are minor, like follow-up appointments, contact lens checks, or quick repairs. Those types of encounters are not likely to be significant revenue-generators, and they can vary wildly from week-to-week or practice-to-practice. 

The basic unit for exam count is the refraction. This helps give you a standard that can be more readily compared with other practices in regional or national benchmarks. The simplest approach is to only count patient appointments that result in a refraction. This has the added bonus of making it easier to find the data by tracking your refraction CPT codes in your practice management system (PMS) if you’re not using an analytics program. 

However, every practitioner knows that not all exams are created equal. Your business model can radically influence the number of times that you perform a refraction for a single patient, especially if you have a medically focused practice. There are a couple of different ways to think about these non-revenue-generating follow-up exams. If you choose to include them in your exam count, your targets will be very different from many industry recommendations, so you’ll have to take that into account. If you want to leverage those industry experts and compare your practice performance to external resources, you’ll need to ensure you are counting your exams in the same way that resource is counting exams. 

Either strategy is valid, discount them or keep them. The key is to count your own results consistently, and measure your progress against your own history. However, throughout this series, we will make recommendations about certain metrics in terms of what’s considered “healthy” performance. All of our recommendations assume that these medical follow-ups have been removed from the count, so be sure to take that into account when evaluating your performance. 

Tracking Your Patient Exams

Exam count data can fluctuate – a lot. Something as simple as a change in the weather can impact whether patients schedule and keep their appointments. Holidays, school schedules, and a myriad of other variables will also come into play. That means you need to be looking at your exam counts both regularly and over extended periods of time, so you get a sense of not only what happened yesterday, but what has been trending in your practice. 

Additionally, it’s helpful to break out your new patients from your existing patients. Use your billing CPT codes to identify those established or new patients, and break them out individually. We recommend creating a simple tool to keep track of them over time. 

PATIENT EXAMS

Check your exam count at least on a weekly basis, and keep track of the results over time. In some cases you may want to track daily results, which can help with some basic planning, but this weekly minimum will help you begin to recognize trends and develop an understanding of your own performance baseline. An analytics program like EDGEPro will help with tracking over time, or you can create a spreadsheet to help with analysis. If you are pulling the information out of your PMS, use your existing reports to capture the frequency of your eligible refraction CPT codes over a set period of time – weekly, monthly, or quarterly. 

As you begin tracking your exam counts, you’ll start to notice clear patterns, seasonal fluctuations, and the impact of marketing efforts on exam volume. Those insights will help you connect your daily practice activities with the flow of your patients, creating a foundation for informed decision-making and strategic planning.

Improving Your Results

The best data is just numbers until you figure out what it means. As you begin looking at your exam counts over time, here are some critical questions to ask yourself:

• What are my busiest days of the week or week of the month?
• Am I consistently seeing a minimum number of refractions every week? (Your minimum will vary depending on your practice structure and focus.)
• Are my booked appointments resulting in refractions, or is my cancellation / no-show rate too high?
• Do I have too many / not enough staff on hand for the exam count?

Tracking your exams will help you answer these questions, and it will also help you evaluate some of the other systems in your office.

Scheduling and Recall Programs

Assessing the effectiveness of your current scheduling and recall programs is vital for maximizing patient encounters. A high number of new-patient CPT codes (around 30% or more in well-established practices) may indicate that you need to work on engaging with and re-capturing existing patients.

Potential Solutions: 

• Implement online booking systems to facilitate patient access. 
• Evaluate the effectiveness of your recall programs in bringing patients back for regular exams.
• Automate reminders via email, text, or phone calls to significantly improve recall rates.
• Train your staff to handle scheduling efficiently, including pre-appointments.
• Educate your patients on the importance of protecting their vision with regular scheduled eye-health appointments.
• Work on scripting during pre-testing, in the exam room, front desk and the optical to promote follow-up appointments or suggest scheduling for family members during patient visits.

New Patient Outreach

Another important avenue for increasing exam frequency is to attract new patients. Engage in marketing efforts such as social media campaigns, community events, and partnerships with local businesses to stimulate awareness of your practice and position your business as a community health resource. Encourage satisfied patients to refer friends and family by offering referral incentives. Additionally, promoting specialty services such as specialty contact lens fittings or advanced diagnostic testing can attract a broader patient base. These strategies can help increase the volume of patient visits.

Adjusting for Sustained Growth

Once you’ve established routines for monitoring your patient encounter metrics, you need to be consistent about regular reviews of patient exam data. When you’re implementing new strategies to improve your exam count, it is absolutely vital that you are able to see what works – and what does not. Ongoing monitoring allows you to fine-tune your efforts so they have maximum impact, but it also helps identify any emerging issues before they become urgent problems. 

Be prepared to adjust your strategies based on the data. For example, if you notice a drop in exam volume during certain months, adjust your marketing campaigns to address the dip. Create a feedback loop so your staff can also provide input on scheduling practices and patient engagement strategies. By continuously monitoring and adjusting your approaches, you can ensure sustained growth in patient encounters and practice profitability.

Conclusion

Tracking your exam counts is an important initial step in managing your practice more profitably. Building those exams will start – or keep – your business on an upward growth trend. Effective scheduling and recall programs, coupled with targeted marketing efforts, will lead to more patient exams. Regular patient encounters will strengthen patient loyalty and lead to higher retention rates. More patient exams translates to increased revenue from exam fees and associated optical sales, boosting overall profitability. Efficient scheduling ensures that your practitioners and staff are fully utilized, reducing downtime and increasing productivity. Monitoring your results will help you adjust your strategies appropriately to ensure that your practice continues to grow and thrive.

What happens in a practice that actively and successfully implements strategies to build exams? Imagine a waiting room consistently filled with patients, a staff that is efficiently managing appointments, and a noticeable increase in revenue from both exams and optical sales. Successfully keeping your appointment book filled at an optimal level creates a foundation to help you take the next step in your practice growth. Perhaps the goal is to invest in new technology, hire new associates, or expand your services and functional capabilities of your team. Knowing that your practice’s financial health is robust and sustainable will help you confidently work toward your business goals.

So far, we’ve explored understanding your top-line revenue in your clinic and optical, and your practice exam count. The next step is to begin putting that information together. We’ll be looking at the actual value of these patient exams, and how you can maximize each exam to build that top-line revenue successfully.