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Originally Posted by shiro1
I have a simple question...what is the stance of insurance about proceedures performed by these optometrists? I assume they must have their own insurance. Why aren't their patients suing them for millions and increasing their premiums to astronomical heights? I'd think that this could be a way to deter this unless they somehow have better relationships with optometrists than medical insurance does with ophthalmologists.
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To my knowledge there has never been a claim against an OD for a Yag, ALT, or PI. Insurance rates for OD's in OK are not any higher than those for OD's in states that cannot perform anterior seg lasers. I guess the real answer to your question is that it has never been proven that an OD caused real harm to a patient by performing these procedures.
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I work in a rural area and the level of competance runs a broad range of completely incompetant (sending me a nine year old with COMPLETELY NORMAL eye exam after scaring the s### out of them by telling them she has retinoblastoma or EYE CANCER!) to very competant (efficiently managing straightforward glaucoma, minimal BDR and prompt referrals to ophthalmology as needed).
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This is true within ophthalmology as well. I have seen referrals from OMD's (when I was at Bascom Palmer) that are just as scary as your retinoblastoma example. And don't get me started about all the discount LASIK places butchering patients.
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However, many DO NOT TRUST me to send cataract patients back to them lickety split so they can collect post-op care fees which would be free and part of cataract surgery fees paid by insurance if done by myself. It goes to show there is a great divide between optometry and opthalmology that doesn't bode well for any compromise or good working relationships in general.
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The post-op care is paid for by insurance when the OD performs it as well (as long as the OD is on the panel). Medicare, for example has an 80/20 split for co-management. The only additional fees collected by the OD during the post-op period is for the refraction which is not covered by Medicare.