Do You Need Ophthalmology Practice Management Software?


Here’s how practice management software can help make you more efficient and help transform your business.

Ophthalmoscopes. Retinoscopes. Biomicroscopes. Eye charts. These are just a handful of the tools needed in an ophthalmology practice. But when it comes to ophthalmology practice management software to help improve the clinical, operational and financial facets of your practice, what tools do you have in place?

The ophthalmology software you implement should bring efficiencies to help transform your business. One such tool is a practice management system.

Let’s set the stage first by defining practice management software (PMS). According to

Practice management software (PMS) is a form of software found in medical offices that is designed to deal with day-to-day operations using desktop software, client-server software and Internet-based software.

PMS is generally used for financial and administrative functions although it sometimes ties in with electronic medical records (EMR) based on varying medical practices’ needs

Practice management for your ophthalmology practice should bridge the gap between your front and back office. At a very high level, the three key functionalities that comprise a practice management system are:

  • Appointment scheduling
  • Claims and statements
  • Reporting

Ophthalmology practice management software can help transform your business and make you more efficient.

Just as ophthalmologists prescribe the right drug to patients based on the diagnosis, you want to diagnose your practice needs and shortcomings of your current practice management system. You can treat both by selecting the best practice management software based on those needs.

Four of the main goals your practice management software should help you achieve are:

  • Speeding up check-in, checkout, billing, scheduling and collections
  • Empowering staff to speak about charges when assisting patients
  • Measuring your business’s health
  • Adopting a more comprehensive approach to medical billing

So what should you look for when deciding on practice management software for your practice?

Integration With Your Ophthalmology EHR System

If you’re looking for a seamless connection between your ophthalmic electronic health record (EHR) system and your practice management software, you’ll want to make sure you work with a vendor that offers an integrated, all-in-one solution

Sure, you can have bridges to connect to different systems, but the costs and frustrations of doing so may make it worthwhile to switch to a vendor that can provide both practice management and EHR systems for a seamless process. If you’re considering making a switch, it may be helpful to watch demos of the EHR system in action and listen to client success stories. 

Working with one vendor can streamline communications. Instead of managing multiple points of contact, it helps you minimize the back-and-forth part of the process, both during and after implementation.

Ease of Use and Financial Transparency

Making the switch to a new process and new technology does come with challenges. However, using an intuitive system that fits with your practice’s workflow can help make the transition to new ophthalmology practice management software worth it in both the short and the long term.

With your current practice management software, can you and your staff easily access patient information, run reports and see visuals that shed light into the health of your ophthalmology practice? Some of the reports you would want to access could include:

  • Financial trends
  • Financial dimensions
  • Patient encounter count by dimension

By gaining deeper insight into your ophthalmology practice’s financials, you’ll be able to keep a better pulse on the operational and financial facets of your practice.

Improved Inter-Office Communication and Enhanced Collaboration

Transparency and streamlined communication between your front and back offices are key components of how practice management software can benefit your practice. The software should come equipped with the features that can help enhance productivity for each role in the practice, from financial managers to front desk, medical staff or practice administrators. Here are just a few examples.

  • Financial Managers – Billing workflow with financial dashboards, including tasks and reports
  • Front Desk – Appointment finder to pinpoint time slots based on selected criteria
  • Medical Staff – Check-in alerts on the iPad to show patient status and room location, along with the power to access both clinical and financial patient data
  • Practice Administrators – Reports that display key performance indicators (KPIs) and an integrated suite to eliminate interfaces between different practice management and ophthalmology EHR system

Ophthalmology is a complex field and has its own set of workflow and billing processes that differ from other medical specialties. Because of this, look for a system that can:

  • Manage your practice’s medical and vision billing needs
  • Allow for automatic splitting of bills based on medical and vision payers
  • Support both electronic and paper submission of vision claims
  • Support interfaces with retina injection inventory management solutions

Technology should help improve communications, not hinder them, and your staff will reap the benefits.

Patient Personal Data

Practice management software will help you collect a patient’s personal information upon check-in, such as demographic information, employment and insurance details. It’s a bonus factor if this information is collected via a digital kiosk where the patient can enter this information on a tablet and it will be automatically pulled into both the practice management system and the EHR.

This puts the patient at the forefront of their care while helping collect more accurate information. Plus, it eliminates the burdensome task of staff manually inputting such data so they can focus on other tasks.

Patient Appointment Finder and Scheduling

Tired of the time-consuming “hunt and peck” method when trying to set up a patient’s next appointment? It’s frustrating for staff and patients alike, and the reality is that it doesn’t have to be that way.

A robust visual appointment finder and scheduling feature will help prevent overbooking while maximizing appointment slots. Visible alerts to check time slots can help you more easily accomplish this while providing a better checkout experience for the patient.

Practice management is far more robust than patient scheduling software and can help enhance your current practice’s success.

Insurance Eligibility Verification

Checking a patient’s insurance eligibility automatically—before they even set foot into the office—can save a whole lot of headaches and wasted time for both the ophthalmology staff and the patient. And if eligibility is automatically evaluated in real time, it can help streamline workflow either before or when a patient arrives.

Additionally, practice management software can help create a more personal experience for patients. If your system displays the patient’s picture at check-in, the front desk can greet patients by name, which elevates the personal touch and patient experience.

Create Custom Claim Scrubbing Rules

What if you could identify and fix claims at risk for rejection or denial before submitting to the clearinghouse? Creating custom scrubbing rules in your practice management system will help reduce efforts on your back-end billing staff and may contribute to shortening the revenue cycle process. You should have the ability to create custom claim scrubbing rules by:

  • Payer
  • Provider
  • Location
  • CPT code
  • ICD-10 code
  • Modifier

When evaluating options, ask about the availability of this feature.

Auto-Posting of Electronic Remittance Advice (ERAs)

As per the Centers for Medicare and Medicaid Services (CMS), electronic remittance advice, better known as an ERA, is defined as:

An explanation from a health plan to a provider about a claim payment. An ERA explains how a health plan has adjusted claim charges based on factors like:

  • Contract agreements
  • Secondary payers
  • Benefit coverage
  • Expected copays and co-insurance

Does your current practice management system auto-post ERAs for you? If not, it should, as it is a key time-saving function and helps eliminate the need to go through the whole process manually. The system should also alert your staff of payment posting exceptions so that they can be addressed immediately following automated ERA posting.

Practice Management Reporting

When evaluating ophthalmology practice management systems, a crucial factor is understanding the type of reporting available. In general, it should offer scheduling, billing and financial reporting along with document management. The software should be able to be used to  improve office operations, and include the ability to track and pull data can help identify areas of success and areas of growth.

Examples of some reports may include:

  • Appointments missing charges
  • Charges, payments, adjustments and refund reporting
  • Production summary
  • Accounts receivable (AR) reporting
  • Adjustment reason codes reporting

Appointment Reminder and Patient Recall Solution

With busy schedules for patients and practices alike, the ability to remind patients of upcoming appointments is a critical feature and a win-win. Instead of using a stand-alone system, see if the practice management vendor offers a solution that can help you automate appointment reminders and send mass notifications to both patients and staff in the unlikely case of an emergency.

Automated reminders via email, phone calls and even text messages can save your staff valuable time and serve as a tool to provide proactive customer service to patients.

The reminder solution should also have the ability to contact no-show patients and have the capability to send patient satisfaction surveys. The survey responses will allow the practice to focus on patients at risk for retention.

In addition, the need to remind patients to return for an unscheduled follow-up or recall is critical in keeping schedules full. The solution should have the capability to reach out to recall patients in an effort to get them scheduled with the practice.

Stellar Implementation, Training and Ongoing Support

In life, we enjoy having relationships with and doing business with people we like and trust. Make sure the company you evaluate will work as an extension of your ophthalmology team and provide topnotch implementation, training and ongoing support.

Features and functionalities of an ophthalmology practice management system will rise to the top of the priority list, but a product is only as strong as the people, processes, technology and company backing it.


At the end of the day, your practice management system should support a strong revenue process, streamline staff communications and allow for staff to focus on what matters—the patient experience, not tedious and time-consuming tasks.

See how you can achieve a healthier practice with modmed® Ophthalmology

Krisanne Fieldhouse

Krisanne Fieldhouse

Senior Director of Product Management

Krisanne has been with the organization for over 12 years with a primary focus on operations and has overseen the GI RCM Division. Her previous experience included managing implementations and as Product Manager of gPM has directly contributed to her current role.

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