Booking Surgery

while booking surgery 2025-12-13

"*" indicates required fields

PATIENT SAFETY CHECKLIST
be excited for them! you are the last bv staff member they will talk to before they request time off from their boss, schedule a babysitter, buy non-refundable plane tickets for grandparents to fly in and be with their kids, or book a pre-paid hotel room at drury. we owe it to them to ensure that we have carefully covered every surgery detail here so when they show up for a monday am sbk we don't have to cancel their surgery because they wore contact lenses at wedding saturday night. this could be our last and only point of contact with the patient until they walk through our glass reception door, full of expectations. sentences starting with a capital letter are meant to be said to patient verbally. sentences with small letters only represent internal guidance for staff.

[prior to going in the room] when able, doctor will provide the preoperative video code to the technician, as well as highlighting the consent booklet with the plan, and sign/dates the examining doctor line on the consent.
[in room] doctor transitions to tech
1) doctor, while facing the patient directly and looking them in the eye: You're an excellent candidate for SBK, and I think you will be thrilled! [Especially given how much you would enjoy travel/snorkeling/biking/taking the turkey out of the oven without glasses fogging up/etc. best to include a meaningful and enjoyable future experience for them, ideally one that involves a specific date in the next few months]
2) doctor walks half-way out of the door and while turning to tech only from the hall/door frame says: Suzie is an excellent candidate for CLR OU with mono and multi target plano. Since she has been out of her contacts for [two days/one day] she is welcome to go as soon as [tomorrow/the day after tomorrow]. this is said to the tech, not to the patient. doctor doesn't need to talk to or make eye contact with patient anymore. doctor leaves and closes door.
3) tech in room
- the #1 most important sales advice at this point is to fully, completely, deep down inside 100% assume that the patient is thrilled and can't wait to move ahead. this is called "assume the sale."
- to prepare for this moment, look back at their intake form and see how long they have been wearing glasses/contacts. has it been a long time?
- for how long have they been thinking about getting out of glasses/contacts?
- what did they put in their intake form -- if they are a candidate for surgery, when did they want to go ahead? in a few months, or asap?
- remember that for most of our patients they have been dealing with glasses, contacts, and poor eyesight for many years! often longer than they have even known their spouse or best friend. and for some even as long as they can remember -- for their entire life!
- don't superimpose your experience with glasses and contacts (whether you have worn them or others you've known) on patients; don't assume that the inconvenience (or lack thereof) that you encounter with glasses/contacts is the same as theirs
- don't superimpose your financial situation on patients!
- we don't bring up finances until we know someone is a candidate, however if while doing the bvoa a patient or guest volunteers specific financial information with you -- e.g. i'm just planning to pay with cash, my parents are paying for this, i'm going to use fsa in january, etc. -- you can pass this on to the doctor. at the same time be careful about making _assumptions_ that someone can't pay based on their dress, age, life stage, family/marriage status, etc.
- credit score ≠ amount of disposable income; it's entirely possible to have bad credit and significant disposable income
- don't make assumptions about time horizon; you might do financial and other planning 3-6 months in advance, but they may be long-term planners looking at 10-15 years of $1000/yr on glasses/contacts/case/solution/inconvenience, and in that context $16,000 for CLR1 OU is a super deal for them
- any hesitation a patient shows is often because it's new and foreign for them, and you get to be their guide to walk them through this journey. they are ready to schedule! one of the most reassuring points you can share with them is that they just have to show up and we will take it from there. You just go into the laser room, lie down on a bed with a blanket, and we'll take care of you. You'll be on your way home to relax before you know it.
- Congratulations on being a candidate for SBK. That's so exciting. This is what we were hoping for, right? tech nods, often the patient will nod, too, and verbalize agreement.
- At this point most patients just want to figure out 1) How soon can I have it done? and 2) What's going to be my best payment option?
- I can talk about payment options in a moment. As far as scheduling, it's exciting that Dr. Poore said you could go as soon as tomorrow. Monday is actually my primary surgery day.
- Do mornings or evenings work better for you?
- I have this coming Monday at 9am or 10:30am. Which would work better for you? [always give time/date options in pairs]
- be careful to not ask too many times "do you have any questions" -- this becomes trite and can feel like nervousness if you don't know what else to fill the time with.
- remember to use first person references such as I/MY rather than US/OUR to show ownership over your surgery schedule. for example, refer to it as the availability "i have on my surgery schedule." in using first person ownership-oriented language, this allows the tech to demonstrate a greater sense of being in control of the schedule and ownership over the process.
- silence or a pause isn't bad; relax and enjoy it if there is silence for a moment

[phone] That’s exciting—congratulations on moving forward! Before we begin, we’d like to reconfirm your contact details to ensure Dr. Brinton and our team can reach you with important medical updates. Could you please confirm that this is the best number for calls and texts, and also share your preferred email and date of birth? [answers]

booking TECH's bv email address*

patient preferred first name*

patient last name*

For your medical safety, our doctors need to be able to reach you on the day of surgery. Please provide me with your personal cell phone number and best email address. [patient needs to verbally confirm]

patient personal cell number*

patient best email here*

patient dob*

I confirm that the patient name, phone number and email are correct and match in hubspot and acuity*

Yes

staff enters pronouns for PCP letter*

she/her/hers

he/him/his

they/them/theirs

[phone] Thank you for confirming that, [name]. My next step will be to reserve your treatment day and time on my schedule, and then I can go ahead and process your payment. How were you planning to pay for your care?
1) credit card, fsa/hsa debit card --> skip to next bold text below
2) pre-approved financing --> find out which service and skip to next bold text below
3) regular check, fsa/hsa check, cash --> a) Are you available today to bring it in before 5pm so you and I can go through the booking process together in person?
--> if yes, book custom 2nd bvoa for time they cite, figure out which staff will meet them, then have that staff text them saying something like i look forward to meeting you here at our office at 4:45pm. in office: if they come early enough, go through the whole surgery booking process together. if they show up at 4:59pm, just take payment and arrange to call them the next day. see financing zzz1 for information on how to handle cash and checks.
--> if no, can they come in next two work days? or can check be mailed? if no to both, encourage another form of payment. many patients in this metro are still unsafely wearing contacts because they never got around to bringing their check into the office when they got back from their trip.
4) financing, not pre-approved --> Let's get you approved! I'm going to be quiet on the phone here for about two minutes while I pull up our secure bank portal. I'll need you to have the social security number, address, and household income handy for the individual applying for credit.
Alphaeon
CareCredit
***for all patient financing applications at bv, enter $18,000 per person (so double that for two people) as requested amount. do not enter in just the surgery amount, as this can be a negative on their credit score to have high credit utilization.***
- the best way to make your payments is to go now and enter a bank account routing and account number into their secure system online. you can also send a check, or pay with a debit card, but they charge a fee for debit card payments.
[some answer options if pushback to pre-payment policy]
- It's just like planning a vacation or getting seats to a Cardinals game.
- I prioritize ensuring a smooth and efficient surgery day experience for my patients. As part of this, we collect full payment for clinic/surgery services at the time of booking, much like you would expect if if you bought seats to your favorite concert, made an airline reservation, or planned a night out at the Fox Theater, Busch Stadium, or the Munie. I understand that each patient's situation is unique, which is why we offer flexible payment options including cash, check, FSA, HSA, credit/debit cards, and financing to accommodate your needs and preferences.
- If I let a patient go on my schedule without payment in full, the surgery appointment you want wouldn't be there. Dr. Brinton limits the number of surgeries he does each year, and even with taking payment in full, for much of the year we have more patients than we have surgery spots. so we reserve slots on a first come, first served basis.

[phone] To reserve a spot on my treatment schedule I have a Patient Safety Checklist to walk through with you over the phone. For most patients this takes about 10 minutes. I'm going to press mute so you'll hear silence on your end as I review your medical record, however I'll still be here. Speak up if you need anything. press mute on your phone, not hold.
[if no] When is a better time to call back? [answers] Is this number [read number from caller id] the best number to reach you at?

↓ on hold ↓

If there is an answer to the questions above, then add to the pinned note the following text with highlight: "At the 1m (or 3m appointment *PRK & CLR only*) [when patient is satisfied with vision] discuss whether they would be willing for us to share their contact information with future potential patients in their same career to discuss their experience".

check off all you can verify while on mute. --> when back with patient check off the rest.*

grab juniper rx form from east wall of tech room. fill out everything but surgery date.

[in room] get their stapled treatment instructions booklet from the east wall.

enter pcp info from pinned note into form below

--> check here once back on phone with patient and pcp info confirmed. then: Have you seen any other primary care doctors in the last five years in Missouri or Illinois -- like a dermatologist, cardiologist, ObGyn, or endocrinologist? then enter this info.

pentacam is in patient images

cem530 is in patient images

Check off once:

Patient images folder contains readable contact lens photo marking left and right eye contacts.
Or if n/a and patient doesn't wear contacts, check this once back on phone and patient confirms "I don't wear contacts" or "don't have any."
If patient wears contacts but no photo, back on phone:
- → Can you take a picture, label it, and email to info@ now while we're on the phone?
- → If patient says yes, check box above once patient has emailed this to you and you have dragged the pictures from your email inbox to their patient images file
- → If patient says no, check box above once you have set a task for tomorrow AM for medtech to follow up with patient

co-managed with an AEG doctor? patient will need to bring a check/checkbook on the day of surgery. we will have them write a check to the AEG doctor office and we will refund this amount on their surgery payment. if needed, explain that this is not an extra charge for them; they are reimbursed fully. I apologize for this inconvenience. This is an AEG corporate requirement, not my requirement. Your doctor's practice is one of many in the area that is owned by the private equity group AEG. They own Crown Vision and a number of private practices.

Glasses choice*

#1. bvoa complete

#2. bringing glasses on dot, addendum written

#3. squinting it out

#4. borrowing glasses from my collection of donated glasses here

#5. glasses rx

future eyecare*

hide info on

future eyecare & pcp letters

[future eyecare]
There are three categories of postoperative eye appointments.
#1 Day one, week one, and other care prior to month one; this care is always performed at BV
#2 Month one and month three; may be performed by BV or OD
#3 Annual eye exams with dilated pupils; may be performed by BV or OD
-r means that the patient was forward referred to our practice by a doctor, MD or OD
All BV [patient not referred; BV does #1, #2, and #3]
All BV-r [patient referred usually by an MD who does not do annual eye exams, like Dr. Olk; BV does #1, #2, and #3]
BV/OD [patient not referred; BV does #1 and #2; OD does #3]
BV/OD-r [patient referred, OD does not perform postoperative refractive surgery care or co-manage, e.g. Mercy/Walmart/Sams optometrists; BV does #1 and #2; OD does #3]
All OD [patient not referred, reverse co-management confirmed; BV does #1; OD does #2 and #3]
All OD-r [patient referred; BV does #1; OD does #2 and #3]
Reverse offered, no OD reply, revisit after POD#1 [patient not referred; we are attempting to set up reverse co-management; plan for BV does #1 and #2; OD does #3]
Reverse offered, OD approved

[when we set up yearly exams, in sequential order]
1) allOD-r, BV/OD-r — at surgery booking
2) allOD/reverse co-managed – once reverse co-management is confirmed with the doctor (first) and then the patient (second)
3) BV/OD – day of surgery at 8am or 9am our techs should be making 4-6 calls each surgery day. call when the doctor’s clinic opens, regardless of the patient’s arrival time in our office
—> document all three of these above under the OD’s name in the Pinned Note. if on day of surgery you can’t reach someone or the office says their calendar isn’t open yet, please document this in the pinned note along with what our next call attempt will be, then set a task for the next call to the office. remember that our office calling an OD’s office and setting up their patient for a yearly exam is a very valuable contribution to our relationship with the OD.
4) allBV, allBV-r – we tell patients at day1/week1 to bring their calendar to their month1 visit; try to book their first yearly 240bvoa at month1

[pcp letters]
pcp letters are an extremely valuable tool that we use to communicate with our patients’ regular medical providers, whether md, nurse practitioner, or pa. we use these letters to update pcps on the results of our surgeries and share with them the joy that our mutual patients experience with improved eyesight. many of these pcps will be practicing in our greater metro area for decades, so they are important customers for us, just like our partner eye doctors, and our relationship with each pcp is invaluable. please carefully double check the spelling of the pcp’s name, address, and degree so these letters can be accurate. for the name, address, and practice name of each pcp, we ask these questions of the patient as we book their surgery. in room, you should type the pcp’s name into google on the lane desktop so the patient and family can visually confirm the information. for booking surgery by phone, you can type the pcp's name into your desktop computer to verify the information by phone. we have room for three PCP names; please get as many as you can. almost all patients should have at least one doctor they have seen in missouri or illinois. you do not need to include a doctor outside of missouri or illinois. if needed you could tell the patient: Our eyes are a small part of our bodies, but have really important connections to our overall health. For this reason we want to ensure that our medical charting is complete and accurate.

Can you give me the names of any other doctors you see for any type of medical care?
note: you can use the prescription medications and diagnosed medical conditions listed on their intake form to help ask probing questions of the patient to jog their memory. for example, if a patient is on insulin, they likely have an endocrinologist in addition to their pcp. if they have been diagnosed with lupus, you can ask if they have a rheumatologist they see.

1st pcp/doctor info -- sends automated letter so confirm carefully with google!

Confirm all OD's in pin note and add any additional below

from bvoa, pick worst starting udva, whether od, os, or ou -- not all three. enter only the numbers after 20/ and ignore + or -*

Please enter a number from 12.5 to 2400.

for example: "200"

years since first use / dependency on glasses/cls/readers, rounded to nearest year*

Please enter a number from 0 to 80.

for example: "22"

check this if all apply

this patient has no medications, medical conditions, or physicians they have seen in the past five years.

pcp salutation

Dr. (only for DO or MD!)

Ms.

Mr.

provider first name

for example: "Michael"

provider middle name or initial

for example: "Patrick" or "P." -- please include period for initial

provider last name

for example: "Fuller"

pcp degree

practice name

"SSM Health Medical Group" or "St. Luke's Medical Group"

mailing address

for example: "3009 N Ballas Rd #227a"

city, state zip

for example: "St. Louis, MO 63131"

2nd pcp/doctor info -- sends automated letter so confirm carefully with google!

pcp salutation

Dr. (only for DO or MD!)

Ms.

Mr.

provider first name

provider middle name or initial

provider last name

pcp degree

practice name

mailing address

city, state zip

3rd pcp/doctor info -- sends automated letter so confirm carefully with google!

pcp salutation

Dr. (only for DO or MD!)

Ms.

Mr.

provider first name

provider middle name or initial

provider last name

pcp degree

practice name

mailing address

city, state zip

pcp degree

clr and evo only

if one of these is true in either eye, book clr1 or evo1 in both eyes*

cylinder amount ≥2 on ANY test (lenstar, pentacam, prev mrx, gls, tech mrx, dr crx)

hyperopia first number ≥ +5 for any rx number on bvoa note (excluding a contact lens targeted near in one eye for monovision)

myopia first number ≥ -10 for any rx number on bvoa note

at bvoa doctor discretion - for other exam, discussion, or expectations characteristic that is expected to require significant additional doctor time preop, intraop (consider pupil expander ring) and/or postop (consider amblyopia of ≤20/80)

if patient is planned enhancement, schedule their enhancement for a date and time more than three months from surgery; once on acuity, edit the appointment to list either prk enh or sbk enh and which eye(s) in acuity notes section; email surgery team to write voided mrx for dot

if patient booking years later by phone says - they told me a lower price before - then we can just reply: We update our prices yearly on January 1 to keep up with the cost of providing our services. Any price increase allows us to retain top talent and continue using the most advanced, proven technology in the country.

note: if either eye needs clr, clr1, or clr2 then both eyes go on for clr, clr1, or clr2 respectively. we do not schedule different tiers of clr for different eyes. (we never book different level clr or evo in different eyes, unless the goal is to flummox the patient)

none of the above

if one of these is true in either eye, book clr2 in both eyes

for clr patients (whether lal or regular lenses) who on clr day of surgery are having a second surgery, usually superficial keratectomy or prk, at the time of their clr, for bad ebmd or salzmann nodules.

[clr only] mark the first one of these is true. if any are marked, check acetazolamide on juniper rx form and circle the proper quantity.*

indicated in the BVOA plan

AL [mm] on lenstar is ≤21.00 mm

lenstar AD [mm] or pentacam A.C. Depth (Int.) is ≤2.5mm

hyperopia first number ≥+5 for any rx number on bvoa note

none of the above

Is patient over 39?*

yes

Does patient value shooting regularly?*

yes

[if yes] does tolerance to blur eye agree with the eye they shoot with?

[if yes] move on!

[if no] add recheck dominance DOT to BVOA plan

[if no] does tolerance to blur eye agree with two of cover/uncover, hole in card, pt prefers, or camera?

[if yes] move on!

[if no] add recheck dominance DOT to BVOA plan

accurately calculate surgery fee

surgery fee from bvoa plan*

multiply by eyes*

OU (price x2)

when was their last full bvoa*

1-15yrs from surgery date above = after booking surgery below, also book brinton vision ocular analysis, previous surgery or bvoa @240. subtract $240 from surgery cost and run $240 separately from surgery charge --> select $240 below. note: there is a previous surgery funnel online for booking this appointment (if at brintonvision.com/schedule they click yes to previous surgery) but there is not a previous bvoa funnel by which this can be booked online because we don't want brinton vision ocular analysis, previous bvoa @240 booked online -- these patients should be booked asap for surgery, so it is a call with a sales component.

[exception: for non-CLR myope who is now 50+ and turned 50 >6mos after their last bvoa -- essentially, a patient who we might change from sbk/prk/evo to clr -- don't book surgery. book a brinton vision ocular analysis previous surgery or bvoa @240 only.

91-364 days --> select $0 next door

≤90 days [BV policy: BVOA fees paid directly to Brinton Vision are credited towards any surgery booked within 90 days] --> choose BVOA charge amount below

minus bvoa credit*

$0 yelp! or ≥90 days

$80 doctor referral

$120

$240

calculate patient's surgery fee*

e.g. SBK 3200x2=6400-120=6280. 2000 (credit card) + 4280 (carecredit)=6280
calculation forwards to accounting@

↓ patient affinity groups ↓

is this patient a student or professional in one of these areas?*

is the patient an employee of one of these major st louis employers*

other large local employer

↓ back on phone checklist ↓

in room checklist

on phone checklist

↓ social media microinfluencing ↓

We love to connect with our patients on social media. Are you active on any social media platforms? [if they need prompting] Like Yelp, TikTok, Instagram, Facebook, or Reddit?

Are you a Yelper? Do you post content on Yelp? [Thrive Marketing Agency demonstrated that 5-10% of Yelp consumers are Yelpers who post reviews; the other 90-95% only view reviews -- we are looking for the 5-10%]

yes, I post content on Yelp

no, I only read reviews on Yelp; I just read what other people write

Do you make TikToks? Do you like short-form video? [Pew Research shows that 25% of US adults create 98% of public TikTok content -- we're looking for the 25%]

yes, I post on TikTok

no, I'm just a scroller; I'm only on the FYP, I don't post; I'm not a creator - I just watch what other people post

I know if I were to take the time to make a TikTok I'd post it on my other platforms as well. Do you do this? Like Instagram or Facebook Reels?

yes, I post Instagram Reels but not FB

yes, I post FB Reels but not IG

yes, I post both IG and FB Reels

no, I only post short-form video on TikTok

Do you post to your IG? Do you post Reels, Stories, or feed photos? [80% IG users are consumers only. 20% are regular posters.]

yes, I post Instagram Stories

yes, I post single-image or Carousel feed posts on my grid

yes, I post Reels

no, I'm a scroller; I'm not a poster, I just watch Stories; I just scroll IG

Do you post on Facebook?

yes, I post on Facebook Stories

yes, I post photos or videos to my Facebook feed

yes, I post Facebook Reels

no, I'm a scroller; I'm not a poster

[for TikTok, FB, & IG only] That’s awesome that you're on [TT/IG/FB] — we’re on there too! We’re a growing practice on social media, and we’d love your support. Our handle is @LasikStLouis. What’s your handle? We’d love to follow you back and stay connected.

Are you a Redditor who posts questions and comments? Do you comment on local subReddits like r/St.Louis

yes, I post on Reddit

no, I'm a lurker only; I just view what other people post

Does this patient list a Gmail email address in Hubspot?

yes

other social media, add quotes if "none," or extra comments

↓ checklist continued ↓

in room checklist [continued]

face the patient,/ look them in the eye,/ and holding the treatment instructions + consent form booklet in both hands,/ give the booklet to them [see google note below]. This booklet contains your treatment instructions and consent form. Please read through these thoroughly. They explain what you need to know starting today to prepare for your treatment. My doctors have put a lot of time and effort into these, so they are detailed and should answer most if not all of your questions. To have a safe and successful surgical outcome, we must do our part and you have to do your part. The way you know how to do your part is by reading these instructions carefully.

This booklet also includes your consent forms. Our surgeries are very safe and low risk, but that doesn't mean there are no risks. Prepare to spend about 30 minutes reading through this booklet.

Now, let's go over your pre-arrival steps and other important details from this treatment instructions and consent form booklet. Open in front of patient to page 1 and review everything marked with a "§"

--> [has to go] Is there a time today when you can spend 30 minutes reading these? [yes]

The final prearrival step to enter our office on surgery day is having your drops in hand from Juniper pharmacy. We will talk about this more shortly.

By doing this in advance, when you show up, all you have to do is take a Valium to relax, lie down in our surgery room under a comfortable blanket, and let us take care of you!

[note from google] In many asian cultures, a hostess would typically present something, like a menu or a drink, with both hands, signifying respect and politeness towards the guest; this gesture is considered a sign of good manners and is particularly prevalent in countries like japan, korea, and china where using both hands to receive or offer something is seen as a respectful act.

on phone checklist [continued]

I will email you a PDF of your booklet now. Do you have access to your email right now? Great, can you open that email and open that document? Please read through the booklet thoroughly. It explains what you need to know starting today to prepare for your treatment. My doctors have put a lot of time and effort into these instructions, so they are detailed and should answer most if not all of your questions. To have a safe and successful surgical outcome, we must do our part and you have to do your part. The way you know how to do your part is by reading these instructions carefully.

This booklet also includes your consent forms. Our surgeries are very safe and low risk, but that doesn't mean there are no risks. Prepare to spend about 30 minutes reading through this document.

Now let's go over your pre-arrival steps and other important details from your treatment instructions booklet. Review everything marked with a "§"

The final prearrival step to enter our office on surgery day is having your drops in hand from Juniper pharmacy. We will talk about this more shortly.

By doing this in advance, when you show up, all you have to do is take a Valium to relax, lie down in our surgery room under a comfortable blanket, and let us take care of you!

final surgery month, day, year

surgery month*

surgery day in month*

Please enter a number from 1 to 31.

surgery year*

2025

2026

2027

enter date of soonest bvoa prior to their surgery (should be within 365 days of surgery, used for PCP letter)

bvoa month*

bvoa day in month*

Please enter a number from 1 to 31.

bvoa year*

2024

2025

2026

2027

schedule other appointments

checklist

doctor/practice they plan to see on the one year anniversary of their bv surgery for their first yearly dilated eye exam

patient plans to see brinton vision

Other

off the call. surgery booking doesn't end until these tasks below are complete, which should be done before taking another patient, call, or question, even from a doctor.

checklist*

log the call, or check if in room booking

1. fill out juniper form with appropriate information. if pt is having prk, write out percocet prescription and have tjs or jpb sign.
2. have a doctor sign the form.
3. scan and save to patient images.
4. email form to juniper within the patient's hubspot. to do this, compose an email, delete the patient's name from the "to" section, and add juniper pharmacy's email and cc a surgery technician. this will ensure both the email we send and any response we get back are automatically logged.

check once signed drop sheet has either been 1) scanned and emailed to [email protected], 2) handed to the patient in office, or 3) put in postal mail in a stamped envelope addressed to the patient. if extended regimen is checked, send an email to the patient with copy to [email protected] reminding them to start their eye drops a week before surgery. if acetazolamide is checked, email the patient with copy to info@ reminding them to take their acetazolamide two hours before arrival in our office.

check here to confirm that their name in acuity and hubspot are correctly listed as: preferredfirst (legalfirst legalmiddle) last if the patient doesn't go by their first given name

[co-managed only] call od office, schedule pom1, pom3, poy1 visits, email these to patient and cc ODpatient team, currently mstucke/ataubenfeld/[email protected] [email template in comanagement process zzz2), document dates/times in PINNED CRM NOTE

[co-managed only] once post op appointments are scheduled, set appropriate tasks. one, currently to Toba, to call and text to check in with the patient on the day of their week3 appointment to ask how they are doing with their vision. one task, currently to Kelsang, the day after their week3 appointment date to send records. one to Dr. Lamprecht to call the doctor 3-5 business days prior to the 1 month appointment.

finally, check this box before you click "submit" below, then copy the output emailed to you and paste this as a postal mail in the patient's hubspot chart

END of sx booking. give yourself a high five!

surgery cancelation checklist (no new booking)

whoever processes the cancellation is responsible to ensure these steps are done

Why do you want to cancel? listen without interrupting. then ask Are there any other reasons you would want to cancel?

direct patient to cancellation request form at brintonvision.com/requests. this gets sent to accounting and doctors who determine if patient should be contacted by doctors.

Did you use financing? if no, skip to next step. if yes: When you first scheduled your surgery and agreed to start the financing, at that point we lose access since it becomes a private loan between you and Alphaeon/CareCredit. For financial security and privacy reasons, we aren't allowed any more visibility to your loan with them. We are happy to push a full refund right away, which can take up to 10 business days to fully travel through the system, and they will honor this, but we have no information on financing charges, interest payments, late payments, and other similar payments which go directly to Alphaeon/CareCredit and not us. These cannot be refunded by us; we have no visibility or access to them anyway. Be sure and make any payments on time until the refund has moved through the system and you have received your funds back so you avoid any charges from the company, or you are welcome to speak directly with them about this. Do you have any questions about how a refund works with financing?

move acuity surgery appointments to the previous sunday

cancel acuity postops associated with that patient; select NO confirmation email to patient

delete future tasks for this patient

set a task to follow up by phone in six months, unless dnc

document in hubspot including reasons described by patient

surgery cancellation and new booking checklist

whoever processes the cancellation with new booking is responsible to ensure these steps are done

move acuity surgery and post-op appointments to the desired date

move future tasks to align with new surgery date

confirm patient has drops; if new surgery date is sooner and no drops, remind patient to call juniper

document in hubspot

enhancement booking checklist

definition of enhancement -- per eye, not per patient

the term "enhancement" is used to describe the financial responsibility of a surgery, and is not used as a medical term.

we book an "enhancement" appointment for any surgery where the patient pays nothing or pays a facility fee only

clr/evo are never enhancement

if most recent refractive sx was outside, first bv procedure is never an enhancement

if most recent refractive sx was at bv, sbk/prk/evo exchange/iol exchange/piggyback are always an enhancement

at post op appointment where doctor recommends enhancement:

before doctor leaves room - doctor mrx is very helpful / encouraged when a patient is in clinic and we are contemplating signing them up for an enhancement

if no pentacam within the past 90 days, get a new pentacam; remember that if a patient's prescription isn't on target this is assumed to be due to keratoconus until proven otherwise by pentacam!

if first mrx number is +0.75, +1.00 or more, for sbk/prk enh, get acutarget hd now so staff don't have to get this on surgery day

print ti and consent forms and give to patient.

We highlighted our plan for you. List any questions separately to discuss with our doctors. Don’t mark on this booklet. Initial and sign where highlighted if you agree with our plan. The signature block on the second to last page will be signed in our office on arrival, so leave it blank for now. You will need to bring the original with you when you come in for your procedure. Reply to your confirmation email to confirm you have read your treatment instructions and consents thoroughly. At that point we can send you the link to schedule your enhancement.

Once I get an email from you confirming you have completed your pre arrival steps, (only after this), I will email you a scheduling link!

remind to stay out of contacts for at least three days prior to surgery date, but seven days is preferred.

required steps [in room]

Reminder that you will not be able to drive yourself home after your procedure. Arrange a ride from either a family/friend, uber, or walking to a nearby hotel to safety depart from our office. Make sure to tell your driver that your surgery time is approximate, and that you will let them know by 5pm the night before surgery, even if that is a Sunday, what the final arrival time is as these times are moved or adjusted as in most surgical facilities.

if more eye drops needed, get signed juniper sheet and percocet rx, send to juniper. hand them the drop page and paper percocet rx if they don't go to juniper.

[<1yr] When you book at brintonvision.com/enhancement it will ask for a credit card for $3200. If the surgery appointment you choose is within one year of your original surgery date, enter FIRSTYEAR and it will credit $3200. If the surgery appointment you choose is after one year from your original surgery date, enter HALFOFF and it will credit you $1600. Starting one year from the original surgery date, any enhancement surgery requires facility fee payment of $1600; please be careful to schedule before your one year mark, which is [date of initial surgery]. have the patient write this date down in pen in front of you]

[>1yr] Since you had your last vision correction procedure with us, Dr. Brinton doesn't charge his surgeon's fee. You would just pay the facility fee to cover a portion of what it costs to use the surgical equipment. When you book at brintonvision.com/enhancement it will ask for a credit card for $3200. Enter HALFOFF and it will credit you $1600.

Within a few days after you schedule your enhancement surgery online you will get your postoperative day one time; look for this in your email.

only exception where our staff schedules the enhancement within 1 year for the patient is for an iol exchange after clr (which only goes in a monday 10:30am enhancement time slot), or evo exchange/removal which can go in any morning enhancement time slot.

required steps [on phone]

if more eye drops needed, get signed juniper sheet and percocet rx, send to juniper. if no juniper, mail drop form to their mailing address or they can pick it up in the office.

when signed ti forms are received (only after this), I will email you a scheduling link!

Within a few days after you schedule your enhancement surgery online you will get your postoperative day one time; look for this in your email.

AFTER we receive confirmation from the patient that they completed the pre arrival steps,

verify that all pages are appropriately initialed by the patient and that the patient signed and dated the last page with a correct date

transfer signed ti forms to patient images

email or text patient brintonvision.com/enhancement

AFTER patient has scheduled their enhancement online

in the note section of the appointment, list the initial bv eye surgery date and the enhancement date to confirm they are within one year of each other. or, if over 1 year, list the original surgery date and state "patient has had no outside surgery on this eye since our bv surgery."

put surgery type, such as sbk ou, prk os, in the acuity appointment notes

manually schedule postop day one appointments; acuity will send the confirmation time

[if comanaged (all od-r or all od) and planned enhancement] call referring od office and schedule 1m and 3m postops along with annual exam

[if bv/od-r] confirm annual exam has been scheduled

	A		B		C
1. SBK	brintonvision.com/SBK39-bv	14:49	brintonvision.com/SBK40+plOUbv	17:11	brintonvision.com/SBK40+mvbv	27:10
1. SBK	brintonvision.com/kateSBK	5:58	brintonvision.com/kateSBK	5:58	brintonvision.com/kateSBK	5:58
2. SBK	brintonvision.com/SBK39-od	14:35	brintonvision.com/SBK40+plOUod	15:45	brintonvision.com/SBK40+mvod	27:04
2. SBK	brintonvision.com/kateSBK	5:58	brintonvision.com/kateSBK	5:58	brintonvision.com/kateSBK	5:58
3. PRK	brintonvision.com/PRK39-bv	18:15	brintonvision.com/PRK40+plOUbv	20:57	brintonvision.com/PRK40+mvbv	31:25
3. PRK	brintonvision.com/katePRK	7:33	brintonvision.com/katePRK	7:33	brintonvision.com/katePRK	7:33
4. PRK	brintonvision.com/PRK39-od	18:21	brintonvision.com/PRK40+plOUod	21:02	brintonvision.com/PRK40+mvod	31:42
4. PRK	brintonvision.com/katePRK	7:33	brintonvision.com/katePRK	7:33	brintonvision.com/katePRK	7:33
5. EVO	brintonvision.com/EVO39-bv	20:14	brintonvision.com/EVO40+plOUbv	22:46	brintonvision.com/EVO40+mvbv	33:18
5. EVO	brintonvision.com/kateEVO	6:30	brintonvision.com/kateEVO	6:30	brintonvision.com/kateEVO	6:30
6. EVO	brintonvision.com/EVO39-od	20:24	brintonvision.com/EVO40+plOUod	22:52	brintonvision.com/EVO40+mvod	33:23
6. EVO	brintonvision.com/kateEVO	6:30	brintonvision.com/kateEVO	6:30	brintonvision.com/kateEVO	6:30
7. CLR	brintonvision.com/CLRmfbv	42:00	brintonvision.com/CLRplOUbv	24:28	brintonvision.com/CLRmvbv	31:57
7. CLR	brintonvision.com/kateCLR	7:11	brintonvision.com/kateCLR	7:11	brintonvision.com/kateCLR	7:11
8. CLR	brintonvision.com/CLRmfod	41:52	brintonvision.com/CLRplOUod	24:18	brintonvision.com/CLRmvod	31:41
8. CLR	brintonvision.com/kateCLR	7:11	brintonvision.com/kateCLR	7:11	brintonvision.com/kateCLR	7:11
9. CLRER	brintonvision.com/CLRmfbv	42:00	brintonvision.com/CLRplOUbv	24:28	brintonvision.com/CLRmvbv	31:57
9. CLRER	brintonvision.com/kateCLRER	7:45	brintonvision.com/kateCLRER	7:45	brintonvision.com/kateCLRER	7:45
10. CLRER	brintonvision.com/CLRmfod	41:52	brintonvision.com/CLRplOUod	24:18	brintonvision.com/CLRmvod	31:41
10. CLRER	brintonvision.com/kateCLRER	7:45	brintonvision.com/kateCLRER	7:45	brintonvision.com/kateCLRER	7:45

while booking surgery 2025-12-13

1st pcp/doctor info -- sends automated letter so confirm carefully with google!

2nd pcp/doctor info -- sends automated letter so confirm carefully with google!

3rd pcp/doctor info -- sends automated letter so confirm carefully with google!

clr and evo only

accurately calculate surgery fee

final surgery month, day, year

enter date of soonest bvoa prior to their surgery (should be within 365 days of surgery, used for PCP letter)

schedule other appointments

off the call. surgery booking doesn't end until these tasks below are complete, which should be done before taking another patient, call, or question, even from a doctor.

END of sx booking. give yourself a high five!

surgery cancelation checklist (no new booking)

surgery cancellation and new booking checklist

enhancement booking checklist

Have you had LASIK or lens implant surgery in the past?