3 Tips for Converting Vision Plan Patients into Self-Pay Patients

By Kayla Groves November 02, 2021

There are some cold hard facts about accepting insurance. It’s difficult, time-consuming, and draining on a practice. In addition, the insurance claims submission process can cost your practice a significant amount of revenue. Think about all the time you spend verifying benefits, submitting claims, working denials, and let’s not even think about the amount it costs you to hire a qualified biller, whether it be your in-house biller or out-source billing. One solution is to convert all patients, regardless of insurance plan, into patients who pay in full up front and then get reimbursed by their insurance plan later or drop their insurance altogether.

Here are three easy tips your practice can leverage today to convert vision plan patients into self-pay patients. 

1. Comparison

The point of contact is the most crucial step in converting insurance patients to self-pay patients. Simply saying, "We don't accept your insurance plan," will only cause patients to end the conversation. How you present it to your patient is imperative in this step. Instead, try saying, "We don't accept your insurance. However, let's make a cost comparison together, because it may be more beneficial not to utilize your insurance vs. paying your co-pays and your deductible." Who doesn't love saving money?

2021 Example:

Vision Plan






Frame ($220)






Anti-reflective Coating



Scratch Coating









Prompt-Pay Discount (20%)



Average Cost of Premium







With this structure, it's essential to offer packages that can compete with cash-paying business models like America's Best and other discounted retailers. This does not mean you shouldn't offer your patients your best quality packages, no matter the cost. You're going to have patients who leave and get lower-end products elsewhere. If that's the case, why not also offer a package that is more budget-friendly? It would be best to keep those patients within your practice and hopefully upgrade them to higher-quality lenses. That's why it's vital to offer your patients at least three packages that can fit everyone's budget. A good-better-best model will help you accomplish this. Over time, educating your patients on the importance of lenses will benefit your patient and your practice. Building long-lasting and trusting relationships with your patients are the keys to a successful conversion.

2. Out-of-Network Reimbursement

Many patients are unaware that they can see doctors outside of their network and still get reimbursed. This tactic cuts out the middleman (biller) and can save your practice thousands of dollars every year. At your point of contact, instead of saying, “I’m sorry we don’t accept your insurance plan,” you say, “Unfortunately, we do not take that plan; however, we do have the forms in the office to help you fill out an out of network reimbursement. That way, you continue to see your doctor.” You can find these forms on the insurance website for plans that you don’t accept in your office. Helping your patient fill out the form gives them reinforcement that they will still be paid after they pay your office. Typically, all you need is an itemized receipt, which adds very minimal time to your practice. Instead of spending hours billing, you are utilizing that time to help patients do it themselves.

3. Specialty

If you haven’t already investigated finding a niche for your practice, you should spend some time focusing on the medical side of your practice. With insurance plans, you are capped with your profit margins. However, if you transition your practice to concentrate on the medical aspects, you can significantly improve your profits. For instance, if you love sclera lenses or want to focus on dry eye management, you can dramatically increase your bottom line by shifting your business model. This model is perfect when trying to take fewer insurance plans. Most people pay out of pocket for sclera lenses or dry eye treatments. Expanding your portfolio and having a good relationship with some of your local Ophthalmologists can make the transition a little simpler. 

Your patients come and see you because they have built a solid and trusting relationship with you as their doctor. You would be surprised how many of your patients would pay out of pocket so that they can keep you as a doctor. If you take steps to help your patient understand their insurance and help them with reimbursements, you are helping them save money, and you are building the type of clientele you want to see again.

Kayla Groves

Kayla Groves is a highly accomplished Optician who has worked every aspect of the Optical industry. She has successfully run several Optometry practices, including her private practice. Kayla has over 13 years of experience in the optical field and specializes in practice management. Currently, she provides business consulting services for private practices and strives for continuous growth. When she is not working, Kayla Groves enjoys spending time with her family and writing.

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