Prevent Blindness Ohio: Survey - Prevent Blindness Ohio Adult Vision Screening Survey

Prevent Blindness Ohio Adult Vision Screening Survey - 2007

1.

Since attending the adult vision screening training provided by Prevent Blindness Ohio, have you used your screening skills and equipment to perform vision screenings?

2.

If you answered Yes to question 1, have you experienced any difficulty in performing the vision screenings? Please explain.

3.

If you answered no to question 1, what are the reasons you have not performed a screening? Please explain, then go to question 12.

4.

If you answered Yes to question #1, have you implemented the vision screening steps consistent with the training, including a near and distance visual acuity, risk assessment, and visual fields test?

5.

If no, please explain.

6.

If you answered Yes to question #1, how do you handle adults who do not pass the vision screening?

(Select one of the available choices or enter a different value.)

7.

If you answered Yes to question #1, how do you handle adults who are unable to complete the vision screening?

(Select one of the available choices or enter a different value.)

8.

When do you perform a vision screening in your office? (Check all that apply)

	With all Well Adult Exams (standard practice procedure)
	When adult expresses a concern
	When behaviors/risk factors associated with vision problems are observed (ie. Difficulty reading print, family history of glaucoma, has diabetes, etc.)

9.

Please describe any other situation(s) when you perform a vision screening in your office.

10.

How many adults have you screened in the past 12 months?

11.

How many adults have you referred in the past 12 months?

12.

Have you used CPT Code 99173 to seek reimbursement for an adult vision assessment?

13.

If yes, what percentage of third party insurers will reimburse your practice for this code? (% estimate)

14.

If no, why haven't you used CPT Code 99173?

15.

Do you currently use risk assessment questionnaires to identify patients that need additional test performed or referral for additional care?

16.

If Yes, what are the conditions that you use risk assessment questions to identify (such as diabetes, vision, etc)?