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EW SHOW DAILY 18 ASCRS News Tuesday, April 17, 2018 by Erin L. Boyle EyeWorld Contributing Writer patient relationship, to do whatever we think is right," Dr. Berdahl said. "What I want to make sure of is we don't let the tail wag the dog and do what we took an oath to do, which is to meet patients in their moments of vulnerability and do the right things for them." He said patients should at least be informed about all available op- tions, even if the practice's surgeons don't want to use them. Patients also need to know costs and reim- bursements upfront. This patient ed- ucation is important not only from the physicians' standpoint, but also as a value proposition for patients and the practice itself. Mr. Mack said that administra- tors should be aware that reacting to payment first and foremost will alter what their practice and surgeons can offer. "When we have new treatments, and if you're always reacting to the payer, you will always be behind in trying to offer what's the latest and the greatest. One of the things I tell everyone is technology—new treatments, new therapies—is always ahead of payment policy. That's just the way it is. So if you want to be at the forefront getting your patients the best options, you'll always be struggling with this on some level to get coverage and to get payment." Editors' note: Dr. Berdahl and Mr. Mack have no financial interests related to their comments. best opportunity to get a covered procedure if it's at all possible. Seek that kind of information from those payers [with] pre-authorization, pre-certification, if you can." Dr. Berdahl made the distinc- tion between on-label and off-label indications for these devices, which are often narrow for on-label uses. A device might be paid for by insur- ance, or it might not. "Labeling and reimbursement are two separate things," he said. But he wanted to be clear: A surgeon needs to pursue the best option for individual patients. "I am allowed, and with your consent to us agreeing in the doctor/ Mr. Mack, a senior consultant with Corcoran Consulting Group, spoke to the reimbursement side of MIGS, while Dr. Berdahl, in practice at Vance Thompson Vision, spoke to his experience as a glaucoma special- ist using the devices. They discussed costs, patient types, indications, cov- erage, educating third party payers about use of the devices, and other information on MIGS devices and procedures currently available. Mr. Mack's recommendations for practice administrators? "Do your due diligence for your- self and your sanity as well as the patient's benefit to give them the T he iStent (Glaukos, San Clemente, California), a MIGS device, has gained widespread reimbursement as a glaucoma treatment option, leading more practices to be likely to use the device and making it even more important for admin- istrators to know how and when to code and bill for this and other new MIGS options. This was the opinion of Kirk Mack, COMT, COE, San Bernardino, California, and John Berdahl, MD, Sioux Falls, South Dakota, at their ASOA course "Adding Minimally Invasive Glaucoma Surgery (MIGS) to the Practice." MIGS is here to stay, so learn how to best code, bill for devices Dr. Berdahl and Mr. Mack consider the future of reimbursement for MIGS procedures. has a 5- to 10-minute "CSI" meet- ing. The "C" stands for caring, and it's a time that staff offer thoughts or prayers, or that birthdays and anniversaries are acknowledged. "S" stands for sharing, and it's when staff share important information for that particular day. Finally, "I" is for information that managers need to share with staff. Leading by example is anoth- er way to show employees how you want or expect them to act. Mr. Stubenbordt said that practice administrators and other practice leaders can step in to help answer phones, cover the front desk, pick up trash, or similar tasks in a pinch. It shows employees that there is no job task beneath them. Practice administrator Tony Sterrett, Las Vegas, shared during the session how he attracts and re- tains great employees using "Tony's rules"—six rules he keeps visible out- side his office door. Other practice administrators may use these rules or come up with their own; the idea, however, is to make sure employees know what they are so they are part of the company culture. Here are "Tony's rules": 1. Watch your spin. Choose your words wisely, and don't exaggerate to manipulate the listener. 2. Flex a little. Work harder when needed, and be accountable. 3. Show up. Mr. Sterrett said this is less about arriving on time and more about improving your atti- tude. "Leave your personal drama at the door," Mr. Sterrett tells employees. 4. QBQ. This is the name of a book that Mr. Sterrett recommends that all employees read. It stands for "question behind the question," and encourages users to reframe questions or information. One example: If someone asks, "What are we doing to hire the right people?", a better question would be, "What responsibilities can I take on to help?" At the QBQ.com website, there is a 15% discount on the book through late May by using the code ASOA. 5. No whining. You can usually cut down this issue by simply point- ing out when someone whines, Mr. Sterrett said. 6. Fill someone's bucket. This focuses on a positive outlook from your perspective and encouraging posi- tivity in others. Staff appreciation goes a long way toward employee satisfaction, Mr. Sterrett said. Although his prac- tice has a healthy budget to keep up staff appreciation, it also has a high retention rate. In turn, the practice's costs for new employee training are low, he explained. EW Think continued from page 16

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