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Flashcards in VT In Practice Deck (25):

Before starting VT, a therapist should always

-review the symptoms and reasons for the visit
-explain the nature of the vision problem
-explain the proposed treatment plan
-discuss the time and financial commitment
-allow for open questions and discussion


Communicating your findings for VT

Develops your reputation for specialty care in the community
Educated other professionals about the usefulness of VT in treating visio deficits


At least ______ of patient problems cannot be treated with lenses, added lenses, or prism along



Most success rates for BV, accommodative, and oculomotor dysfunction range between ______



VT and money

-VT must be delivered in a cost effective manner
-what amount of money is necessary to make a service financially feasible
-VT can be economically viable when adminiered appropriately


Administration of VT

Should VT be administered by ODs or technicians?
-can impact the economic viability
-requires the ability to perform and procedure and interpret the patients behavior and responses
-improve procedures, sequence of procedures, and coaching can impede a patients progress


When using a technician for VT, the ODs role should include

-develop an initial vision therapy program for each pateitns
-supervise administration of the therapy
-plan or program subsequent visits
-troubleshoot or help the therapist overcome obstacles
-train the therapy staff on procedures


Why use a therapist for VT/

-therapy requires 45-60m of direct contact time.
-most OD can complete several exams in this time
-additional revenue from procedures, eyeglasses, or CL related to the comprehensive exam
-many OD cannot support seeing patients themselves unless the fee is set at a higher rate so that it is financially viable
-a therapist may benefit rom additional training or vision therapy certification


How many patients per VT session?

-some patients will not need a therapist to stay with them the entire session because of motivation and therapy repeatability. Makes it possible to see more than one patient at a time
-however, patients who are more complex will require one on one training

Scheiman suggests a patient to therapist ration of 2:1


Multiple (group) VT

therapist therapist works with more than one patient at a time and requires
- an experienced therapist
-carefully programmed therapy plans
-appropriate selection of patients
-adequate equipment


Home therapy VT

VT procedures are explained in office by OD/therapist and the patient takes the activities home
-limitations: success is dependent on the parents ability to learn how to administer the therapy procedures while monitoring progress and overcoming obstacles. Compliance may be poorer with home therapy (higher drop out)


In office therapy

All procedures are explained and performed in office while no therapy is sent home
-limitation: number of house that therapy is performed


VT recommendations

-most recommend having the patient come in at least once per week. To motivate, directly observe progress, and overcome any issues
-p[atietns perform appx 15m of homework per day
-recent randomized trials support this approach


VT schedules

2 days per week
2 per hour=16 patients per week


VT office space

-often best to have a space dedicated to VT. Can be split with additional testing
-often helpful to have counter space and cabinets for storage



VT fees

-varies from one region of the country to another
-fees tend to be higher in larger cities than rural areas
-general guideline: fees for an in office VT appointment tend to be equal to the fee for a comprehensive exam


The following should be considered when setting a VT cost

-customary charges in the community
-current value of the dollar
-time require for the service


How much equipment needed to start VT

About $3000 worth is what is needed to start a good one
-often useful to establish a patient equipment fee
-some items may be loaned and others given to the patient as part of the equipment fee


Revenue for the typical VT patient

-comprehensive exam
-VT eval: following the initial comprehensive exam, an additional exam is performed to assess a probable accommodative, BV, or oculomotor issue
-VT (12-24 visits)
-midterm eval and final eval


Expenses for VT

-salaries for therapists ($20/hr)
- replacement cost of equipment ($500)
-any secretarial expenses


Insurance coverage and VT

-few health insurance companies now provide benefits for VT
-of the ones that do, they often indicate the number of allowable visits, reduce the actually reimbursement, or both
-VT is considered medical treatment not vision care. Coverage comes from major medical and not a vision care plan. Some insurances consider VT to be routine care like a refraction
-recommended to write a predetemrienation of benefits letter to the insurance carrier before starting VT


Why send them codes to insurance companies

Appropriate diagnostic and procedure all codes allows the insurance carrier to understand that the service provided
-not refraction or routine vision care


Payment systems for VT

Most desirable system for payment
-patient pays: submits to the instance company for reimbursement
-can assist patient with the claim forms and any letters of explanation or appeal
-guarantee income even if the insurance wont pa y


Pre-visit method of payment

-patient pays the fee at the time of the visit
-simplicity and high acceptance by patients
-if the patient does not make appointment, the appointment fee is lost
-maybe do cancellation fee


Monthly fee for VT

-the patient makes one time patient for all of the VT appointments that month
-patients pays in advance (covered if the patient cancels). Provides motivation to attends sessions
-some patients will not have this amount of money ion advance