Healthcare Voucher for Optometrists

1. Healthcare
Voucher Scheme
Dr Helen Eng OD, FAAO
Jun 2018

2. Dr Helen Eng OD, FAAO
 Doctor of Optometry (U of Montreal, Canada)
 Fellow of American Academy of Optometry
(FAAO)
 Private practice
 President of HKCCLS/HKAOK
 Vision Rehabilitaton & Elderly Vision (Clinician,
PolyU)
Sept 2017
https://www.hcv.gov.hk/files/pdf/Guide_for_HCSP_Eng_2017.09.pdf

3. Healthcare Voucher System
 Started 2009 to subsidy primary care services
provided by private sector
 2018 - $2000/year for elderly starting age 65
 Jun 8, 2018 additional $1000/elderly with
accummulation ceiling of $5000
 present valid HKID card or “Certificate of Exemption”
 1.2 million elderly people

4. Health Care Voucher Scheme

5. Restriction
 cannot be used for solely purchasing products such as
medication, spectacles, dried seafood or medical
equipment
 cannot be used to settle fees provided by service
providers who have not enrolled in the Scheme

6. Optometry
 2011 - HK Optometric profession & SO fought to be
included in HCV
 2012 - Optometrists (Part I) was included as private
primary healthcare services
 provider --> logo, security token & listed on HCV
website
Prof George Woo

7. Key Statistic 18-04-2018
641 Optometrists
2110 locations

8. Key Statistics 18-04-2018
$289 millions

9. Key Statistics 18-04-2018

10. Department of Health
https://www.hcv.gov.hk/files/pdf/Key_Statistics_on_HCVS_(ENG).pdf
Transparency of fee
Professional
Conduct

11. Highlights
 “Money follow Patients” - choose freely on
private primary healthcare
 for better health protection
 Preventive care, curative and rehabilitation services
Health
Assessment

12. Primary Eye Care
Refraction - not listed

13. HCV - Terms & Conditions
https://www.hcv.gov.hk/files/pdf/HCVS%20Agreement%20(Eng)_201806.pdf
Optometrist & Company
- must compile with T&C

14. Primary Eye Health
• Case Hx
• VA & Refractive Status
• Visual Functions Tests
• External & Internal Ocular health
• Diagnosis & Management

15. SO - Optometry Clinic

16. 綜合眼科視光檢查
1. 病歷查詢
2. 視力及屈光檢查
3. 視覺功能評估
4. 眼睛內外健康檢查
5. 診斷及處理方法
6. 如有需要，其他更詳細的
檢查項目；如放瞳眼底檢查等

17. Amsler Grid for HCV
Evaluated for all elderly
patients
- assess macular function
- self-test for macular
changes
Dementia, Parkinson, Alzheimer's, Depression, Hearing Loss, etc....

18. Visual Functions
 Cover Test - binocularity, depth perception, sports
ability
 Color Vision - sunglasses & tints, ADL
 Field Test - mobility problems, neurological,
 Contrast Sensitivity - media opacities, reading print
ability, face recognition, night difficulties
 ...

19. Code of Practice - Part III

20. Code of Practice - Part III
Photodocumentation
Record keeping

21. Preventive

22. Reason for Visit

23. Reason for Visit
ALL Services should be done on same day
- all in one Transaction
- exam & spectacles on same day
- more than 1 transaction --> discrepancies

24. Voiding Claims

25. Void Transaction
Same day
- Cancel yourself
- Write down void reference
- Effective immediately
VOID
Void Reference No

26. After 24h - Void Procedure
Formal Request
- Transaction #
- Reason
- Location
- copy of signed consent

27. Depending on Reimbursement
 Before end of month - 1 week processing time
 DH will inform of Void Transaction Reference #
 write on original consent form
 After end of month
Time : 4 or more wks
No partial
Reimbursement
(by transaction #)

28. Proper Practice
 Only after reimbursement - the patient can then use voucher
 Ask Patient to return to charge consultation fee for Primary
eye care
 Cut-off of max accummulation is 31-December of each year
 NOTE: Do not make 2 separate claims ( consultation &
spectacles) because it will create suspicious activities in your
account and your claims can be rejected.

29. Record keeping & Document
Keep 7 complete
financial years

30. Abuse of HCV

31. May 2017 - now News

32. Delisting

33. Illegal eye examination
 eye exam done by optometrists and medical
doctors
 Max penalty is $5000 and 6 Months imprisonment
 “Undercover” activities with police department
(HKAPPO, HKSPO, SO) for Retail stores, CL
Beauty stores

34. AutoRefraction in CL stores
Interpretation of results
should be done by
professionals
- part of eye exam
- reference only
- not a replacement for
eye test

35. Primary Eye Care
Exam
Abnormal
Referral
Normal Incomplete
Follow-
Up/Referral

36. Primary Eye Care
Exam
Abnormal Normal
Cat - UV, Tx Brown
Macula - Bluecoat
Dry eyes - lids & tears
Incomplete

37. Flashcards

38. LOCS III
Arch Ophthalmo – Vol 111, June 1993
UV Protection
Bluecoat Filter
Tint - Color or
PGrey/PBrown

39. Cataract - Sunglasses Tint
Contrast Enhancement
Glare Control
Minimize ↓ VA

40. Temporary Rx - oedema
No progressive - only
Single Vision

41. World Sight Day 2014
World Sight Day 2014

42. Risks of Falls
Single Vision vs Progressive Lenses
Progressive 2-3x
increase Risks of fall

43. Clinical Guidelines www.aoa.org
DM
Cataract
ARMD
Glaucoma...

44. Primary Eye Care
 Flowchart of care
Pt Hx/wear Eye Exam Dispensing
Eye Health ---> Treatment via Spectacles
& Lens Options
Good Vision Healthy People

45. Appropriate Management
 Plano Sunglasses for -3D
Justify and validate decision on the record

46. Liability for HCV
$10 Million for
Professional Indemnity

47. Thank you!
 drenghelen@gmail.com