An $8M practice where nobody can explain where the money goes.
Practice, ASC, and optical shop. Ophthalmology finances are tangled by default. We untangle them into clear, separate P&Ls.
A 4-minute test your accountant hopes you skip.
At a glance
Is This Right for You?
This service is for ophthalmology practice owners who recognize these problems:
Need strategic financial leadership? Our Fractional CFO service for ophthalmology practices may be a better fit.
What's Included
How We Work With Ophthalmology Practices
Ophthalmology-specific accounting that goes beyond reconciliation.
ASC Financial Integration
- •Practice-ASC cost allocation and revenue sharing
- •Facility fee and professional fee separation
- •Shared resource cost tracking (staff, equipment, supplies)
- •ASC profitability analysis per procedure type
Optical Shop Economics
- •Frame and lens inventory management and margin tracking
- •Per-transaction profitability analysis
- •Lab cost comparison (in-house vs outsourced)
- •Insurance vs self-pay optical sales tracking
Surgical Case Economics
- •Per-case cost analysis (implants, supplies, staff time)
- •Premium IOL upgrade margin tracking
- •LASIK/PRK revenue and marketing cost allocation
Provider & Department P&Ls
- •Revenue by provider (surgeon vs optometrist vs technician)
- •Department-level P&Ls (medical, surgical, optical)
- •Medicare vs commercial profitability comparison
Results
What Ophthalmology Practices Experience
| Metric | Typical Outcome |
|---|---|
| ASC reallocation | Corrected cost sharing increased practice reported profit by $340K |
| Premium IOL margin | 22% to 38% margin through pricing and implant cost negotiation, adding $121K annually |
| Optical shop improvement | 12% to 28% margin through vendor consolidation, adding $89K annually |
Case Study
See The System In Action
3-surgeon ophthalmology practice with ASC ownership, optical shop, and 2 employed optometrists. Total revenue across the practice and ASC was $8.2M, but the owner-surgeons each took home less than they expected. Nobody could clearly explain the financial relationship between the practice, ASC, and optical shop.
What we found:
- •ASC cost allocation was subsidizing practice overhead by $340K annually. The practice looked profitable, but only because the ASC was absorbing shared costs disproportionately
- •Premium IOL upgrades were generating $380K in patient revenue but the practice was only capturing a 22% margin due to untracked implant costs and underpriced upgrade fees
- •The optical shop was running at a 12% margin when the benchmark is 25 to 35%. Frame purchasing was fragmented across three vendors with no volume negotiation
- •Anti-VEGF drug wastage billing (JW modifier) was not being submitted, resulting in $74K of unbilled drug waste per year
The results
Corrected cost sharing increased practice reported profit by $340K
ASC reallocation
22% to 38% margin through pricing and implant cost negotiation, adding $121K annually
Premium IOL margin
12% to 28% margin through vendor consolidation, adding $89K annually
Optical shop improvement
“We were a $8 million practice and nobody could explain where the money went. The ASC was hiding half the problem.”
— Managing Partner, South
Common Questions About Accounting for Ophthalmology Practices
Don't pay for reports. Pay for progress.
Take the 4-minute financial assessment—and find out if your books are helping or hurting your ophthalmology practice.
The test your accountant hopes you skip.