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VISION The Journal of the Missouri Optometric Association Spring 2012 MOA GOES TO WASHINGTON

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VISION The Journal of theMissouri Optometric Association

Spring 2012

MOA GOes tO WAshinGtOn

Occupy Jefferson CityAccording to Wikipedia, the Occupy Movement is “an international protest movement directed towards social and economic inequality, its primary goal being to make the economic structure and power relations in society fairer.” Because much of the emphasis is related to the financial system, the movement has also been described as “anticapitalistic.”

After recent events in Jefferson City and hill visits in Washington, DC, I better understand the protestors’ discontent, and I am perhaps becoming “anti-Capital-istic” myself.

Our representative democracy allows us to elect leaders to represent us in our state and national Capitals, ostensibly to listen to arguments and make just decisions in the best interest of the electorate.

Our fight is not over yet, but I am beginning to believe that our system may have failed us. Even on issues on which there is a clear right and wrong, our leaders can be influenced to support the wrong decision. The system has embittered me to the extent that when phoned for support of issues for which I used to eagerly grab my checkbook, I emphatically demand to be taken off of the call list. For those of me who know me well, yes, that includes the Republican Party.

So, despite my 30 years of commissioned military service in support of our way of life, I think we may have made a mistake. Perhaps we would be better off with some type of monarchy, even a dictatorship, if only we could be assured of one with the wisdom approaching that of Solomon. Surely, Solomon could solve our biggest issue of the year just by asking who is willing to have their own child have only a vision screening.

But even when things seem bleak, there is always hope. The governmental affairs committee has been busy, and MOA staff and lobbyists even busier, trying to ensure the best futures for the children of Missouri. We still have a few critical weeks left!

Perhaps the best hope for Missouri Optometry is knowing that our colleague Terry Swinger is running for the Missouri State Senate.

While I can’t fathom the length of his speeches if we ever made him dictator, nor do I believe he is quite as wise as Solomon, he will represent optometry and his constituents with honor, sensibility and passion. Terry is one person for whom I will open my checkbook these days, and I hope you will do so as well. He is surely Missouri Optometry’s best hope to Occupy Jefferson City!

PRESIDENT’S MESSAGE

Perhaps the best hope for

Missouri Optometry is knowing that our

colleague Terry Swinger is running

for the Missouri State Senate!

2

Dr. Jeffrey WeaverMOA President 2011-2012

34

MOA GOes tO WAshinGtOn

3

Optometrists and optometry students met in Washington DC for the AOA Congressional Conference and the AOA State Government Relations Center (SGRC) and the Third Party Center(TPC) meeting held concurrently.

We arrived in DC just in time to enjoy the 100th anniversary of the gift of 3,000 cherry blossom trees from Tokyo to Washington DC. What an incredible sight!

Dr. Scott Ream, Missouri’s Third Party Committee Chair attended the TPC lectures while Dr. Lee Ann Barrett made a presentation on grass roots politics at the SGRC meeting.

Drs. Scott Burks, Tom Cullinane and Jeffrey Weaver represented Missouri at the Congressional Conference. Dr. Howard McAlister attended as the faculty liaison from the UMSL-College of Optometry.

UMSL Optometry students joined the MOA for the visits to Capitol Hill. A total of 17 UMSL students attended the meeting with 8 of those joining their home state delegations on hill visits. Missouri welcomed an SCO student to our delegation as well.

Student Delegation Enjoying Washington DC

We were able to speak to the offices of the entire Missouri legislative delegation. Topics covered included:

• the addition of optometry as participants in the National Health Service Corps(NHSC)• and the classification of optometrists as physicians under the Medicaid system.

Congressman Emanuel Cleaver is a cosponsor of the Equity in Medicaid legislation and Congressman Todd Akin and Congresswoman JoAnn Emerson are cosponsors of the NHSC legislation.

A big thank you to the doctors and students that took the time out their busy schedules to lobby on behalf of optometry!

ODs in Washington with AOA Optometry Students

• Lee Ann Barrett, OD• Scott Burks, OD• Howard McAlister, OD• Scott Ream, OD• Tom Cullinane, OD• Jeffrey Weaver, OD

• Steve Branstetter• Robert Ensley• Kevin Hoang• Matt McCoy• Carrie McDowell• Jenna Osseck• Emily Pike• Evan Strong• Alan Wegener• Inna Timshina (from SCO)

• Neil David (CA)• Neha Dharia (IL)• Jennifer Dovich (CA)• Aaryn McComb (TX)• Tareq Nabhn (AR)• Andrea Peterson (AR)• Jen Sidun (OH)• Tuesday Warner (CO)

At left: Optometry students enjoying their stay in Washington, D.C.

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6

Thirteen (13) distinguished optometry professionals were recently elected to the National Academies of Practice (NAP) in honor of their achievements and contributions to the health care profession.

Two of them were members of the Missouri Optometric Association.

• William McAlister, OD, MA, MPH, Distinguished Scholar and Fellow, St. Louis, MO • Timothy Wingert, OD, Distinguished Scholar and Fellow, St. Louis, MO Founded in 1981 in recognition of the need for interprofessional collaboration in health care, NAP is a non-profit organization representing 10 health care disciplines— dentistry, medicine, nursing, optometry, osteopathic medicine, pharmacy, podiatry, psychology, social work and veterinary medicine.

Practitioners and scholars are nominated and elected to NAP based on strict criteria that ensure the highest level of professionalism among members.

The MOA congratulates Drs. McAlister and Wingert on their stellar accomplishment

CongratulationsMOA Members

Elected to National Academies of Practice

Midland Optical

At Midland Optical we do more �

� Quality prescription service

� Dispenser education & training

� In-house AR coating:- Crizal Alizé- TD2- RF Reflection Free NP®

- RF Endura�

- RF Endura EZ�

- Kodak Clear� VSP Laboratory

� Varilux® distributor

2360 59th Street, St. Louis, MO 63110 � 314.533.2020 � 800.325.3176www.midlandoptical.com

87

UMsL hOsts COrneAL CLAssiC The University of Missouri-St. Louis College of Optometry AOSA chapter held its annual Corneal Classic golf scramble on April 21st this year and it was a great success!

The tournament was held at Normandie Golf Club and close to seventy golfers participated. Many optometry students participated as well as many optometrists and suppliers around the area. The course was in great condition and the weather cooperated perfectly.

After the round, the golfers enjoyed catering by the famous Pappy’s Smokehouse while we raffled off some amazing prizes. The winners of the Optic Cup this year were Jason Riley, Dan, Mike, and Jay Wright with an amazing score of 59!

A portion of the golf tournament’s proceeds will be donated to the St. Louis Society of the Blind and will also help fundraise events such as the Eyeball, a formal held in honor of the graduating fourth year students.

The UMSL AOSA chapter would like to thank all the golfers, hole sponsors, and volunteers who made this beautiful day so enjoyable.

MOA Assistant Executive Directory, Jay Hahn, and Scott Burks, OD, at the 2012 Corneal Classic

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9

In 1994, the MOA, under then President Carter Glass, developed the Industry Alliance program to foster a working relationship between organized optometry and the ophthalmic industry and to recognize them for their contributions to the MOA.

The program is now 18 years old and despite the many changes occurring in the industry, the program is still going strong.

The Industry Alliance Program has three levels of participation, supporting level, director level and the executive level. The current members of the Industry Alliance are:

exeCUtive LeveL • Duffens/Essilor• HOYA • Midland Optical• Ozark Optical• Sutherlin Optical

Over the next several issues of the VISION, we will be highlighting our Industry partners and urge you to support the folks that support your profession!

Part 1 – Duffens Optical

M O A’ s i n d U s t r y A L L i A n C e

sUppOrtinG LeveL • Firestone Optics, Inc.

Meet Duffens Optical.

At left: John Anderson, Sales Representative Essilor of America

At right: Dennis Bruns, General Manager Essilor of America Duffens Optical Lenexa Kansas.

10

We have exciting events happening at Duffens/Essilor. The biggest news is Digital Surfacing is coming to Duffens Lenexa! We have been awaiting the launch of in house digital at the Lenexa facility for quite some time, and now we are seeing it come to fruition. The date is set for May 9th to begin operating this digital line.

Besides our great employees, ability to run digital in several of our labs, we are also very excited about new product that launched this year.

Thank you for allowing us to shine a spot light on the most innovative technologically advanced anti-reflective lenses on the market today.

We at Duffens/Essilor are thrilled about offering the revolutionary new Crizal UV lenses. These lenses are currently available in Crizal Avance UV and Crizal Sapphire UV.

We look forward to the launch of Crizal Easy UV and Crizal Alize UV later this summer. Crizal UV lenses continues to give the WOW, factor to its wearers for being the clearest, easiest to clean, most scratch resistant no-glare lenses on the market today. Now, we can add to that long list the benefit of maximum UV protection for long-term eye health.

Essilor’s R&D departments have spent countless hours researching the harmful damage done to the eye by reflective UV rays.

In addition, to aiding in reversing the UV damaging trends; we are committed to fighting this enemy of healthy eyes by eliminating harmful UV reflection. Crizal UV lenses stamp out those harmful UV reflections. Now, the WOW factor of the clearest, easiest to clean, most scratch resistant no-glare lens to ever hit our industry also gives the best protection against UV, promoting long term eye health.

Duffens /Essilor has partnered with the Missouri Optometric Association’s Industry Alliance for many years. We are proud to continue this partnership now and in the years to come.

M O A’ s i n d U s t r y A L L i A n C e

UV Light Transmission

andReflection

NO!11

WHAT TO DO When A

MAnAGed CAre OrGAnizAtiOn sAys

Take the Right Approach and Know State Law can Overturn a Rejected ApplicationMany optometrists drop the issue once an HMO or PPO rejects their application. Or maybe they didn’t even get the application form in the first place. When the MCO was contacted, a provider relations representative told then the panel does not include optometrists or that the plan isn’t taking applications right now.

When an HMO or PPO tells you no, there are steps you can take to appeal the case. The following looks at the most common reasons MCOs reject a doctor’s application, and how to overcome them.

Resubmit the ApplicationIn some cases a low-level plan employee erred or the application when to the wrong person in the organization. Some HMOs and PPOs have local or regional offices; where the application ends up could determine its outcome. Resubmitting it to the right person in the right office can save you much trouble.

Follow ThroughMany optometrists make a phone call, or have a staff member call, to ask for an application, only to be told that optometrists are not allowed to participate on the panel. Unfortunately for many, that call is the end of contact with that plan, yet in many cases the plan representative is passing on incorrect information.

Document the phone call with the time, date and notes on what transpired. Make sure you have the name of the representative that you dealt with and the person’s extension and title. Try to get a letter from the HMO stating the reason for denial. Without this letter, you will have a difficult time pressing any further actions.

NO!Explain Full-Scope OptometryEven if the HMO or PPO does not include routine eye exams and materials, medical eye exams and diagnostic services should still be reimbursable. Explaining to the plan executives that optometric participation does not mean new benefits is critical. It shows them that including optometry is a relatively simple process. We use the same diagnosis and treatment codes as other providers. And plans that don’t have supplemental vision care benefits for routine eye exams should still include ODs to provide services that fall within the scope of optometric practice.

Know the LawPerhaps the plan is flaunting state laws. Be sure to check the state laws regarding managed-care organizations and providers.

ERISA PlansThis federal program supersedes all state laws regarding anti-discrimination, freedom of choice or any willing provider. But these laws only apply to self-funded, company-sponsored plans, usually set up by large corporations. Some ERISA plans are not easy to identify. Sometimes they appear to be an insurance company plan regulated by state laws, but actually the insurance company acts only as plan administrator. So if you contact the insurance company, you could be contacting the wrong entity. The plan’s key decision makers can be halfway across the country.

The Harkin amendment in the new Patient Protection and Affordable Care Act (Obamacare) addresses discrimination in ERISAs, but does not take effect until 2014.

Automatic DisqualificationAmong factors that can cause this to happen: pending or past malpractice litigation, criminal charges, state board disciplinary action and more. Some HMOs and PPOs will not consider you if any plan has dropped you from its panel for any reason.

The best strategy here is prevention. You should realize that plans expect you to act in a responsible, business-like manner.

Other reasons are that the optometrist does not meet the credentialing requirements, or that the optometrist has to belong to a specific vision plan in order to participate in the medical plan (a problem the MOA is working on currently).

Closed PanelsThis happens when a panel already has too many of one class provider in a certain geographic area. You might still be able to convince the network to add you if you provide a specialty that it does not offer, such as low vision or vision training.

You should try to obtain a provider list to find out whether the plan has enough optometrists or if it has based its eye care needs on ophthalmologists. You may be able to check the provider finder for optometrists on the managed care plan’s website.

Continued on page 13

12

CyberAccess Optical Help Tips For those of you that are MOHealthnet providers, you are aware that there have been some changes to the CyberAccess program that allows you to precertify exams and materials for our Medicaid patients.

Kimberly Hicks with ACS has provided us with some helpful hints for using the improved multiple service feature on now on CyberAccess.

• Make sure you save www.cyberaccessonline.net to your Favorites

• Turn off the pop up blocker• If using Internet Explorer 8 or 9, you will

need to adjust for “compatibility view” by going to Tools and adding the CyberAccess website

• Allow the demographics page to completely load before proceeding with precertification requests

• Be aware that there is a Help Text in the upper right hand corner of the web portal (question mark in the upper right hand corner next to the printer icon, under the MO HealthNet logo).

• DO NOT use decimal points when entering the diagnosis code

If using the multiple services feature, you select “multiple services” on the menu.

Please Note: You are not to use the multiple services feature for exams and lenses/frames in the same request. However, you could order lenses and frames together, just do not include the exam in the same pre-certification request.

If you have questions, contact the ACS Help Desk at 888-581-9797 or contact your Provider Outreach Representative.

What to Do, continued from p. 12

Reasoning with MCO executives is always best, especially when they can choose between you or a colleague down the street. Do not threaten litigation, legislation or bring an attorney to the initial meeting. This puts the plan on the defensive and will end the open dialogue you are striving for. Remember many insurance plan representatives do not understand what services optometrists can provide and may not realize why your issue is even an issue.

Keep your focus on providing them with information, helping them solve a business issue or prevent a small issue from developing into something larger. Be a resource and positive solution. The plan providers may not know that ODs can prescribe medicine, manage ocular and systemic diseases, use the same diagnosis and treatment codes as other providers, and can improve their HEDIS score. They may not realize ODS are in more areas for better access, and optometric care can be cost effective for the MCO. There is a PowerPoint available from the AOA Third Party Committee to help with your presentation.

Know the options and the chances before you apply. Afterward, if you don’t like the answer, retrace the steps, so you are sure you covered all the bases. Your inclusion in the panel may not happen immediately, but over a period of time positive and persistent communication with managed care organizations can yield positive results for optometry.

If you have been denied, let the MOA and the AOA’s Third Party Center assist you. The more optometrists that report the denial, the more likely action will be taken.

13

SOCIETY REPORTS

Central Missouri Optometric Society (COS)

In February, we were fortunate to have AMO sponsor our evening at CC’s City Broiler in Columbia where Scott Ghormley informed the group on the benefits of Revitalen contact lens solution. The current status of the Children’s Vision Law was discussed and a reminder for Keypersons to contact legislatures was made.

Our March meeting was held at The Grand Cru in Columbia. The evening was sponsored by Allergan, who provided dinner and a presentation by glaucoma specialist John Lind, MD. The presentation was well received.

April took the group back to CC’s City Broiler in Columbia to hear about the tax and liability advantages of incorporating the right way from a company called Legally Mine.

The Central Optometric Society meets together on the fourth Tuesday each month.

Greater Ozark Optometric Society (GOOS)

The Greater Ozarks Optometric Society had a good turnout at our most-recent GOOS Meeting at Mr. Yen’s restaurant in Springfield on April 17th, 2012. Dr Carol Scott presented a one hour CE course for

our members titled ‘Amblyopia as a Window to Neuroplasticity in the Visual System.’ Dinner was sponsored by HTS computer system and drinks by Missouri Eye Institute.

Our next meeting is May 15th at 6:30pm at Metropolitan Grille in Springfield. It will be a regular business meeting with a guest speaker from Zioptan. During the summer months, we will take our annual break and then return for an August Election Meeting.

A Fundraiser for Rep. Lincoln Hough will take place on May 3rd at 5:30pm-7:30pm at Bruno’s in Downtown Springfield. Rep. Hough is running for the 135th District and would like Optometry’s help. Please come and show your support.

Kansas City Optometric Society (KCOS)

The next meeting of the Kansas City Optometric Society is May 7 2012.

Furthermore, mark your calendar for our legislative BBQ schedule on June 4 2012. Please remember to support Dr. Terry Swinger with a contribution to his Senate campaign. Dr. Swinger is running for Senate and would be a huge asset for optometry and the citizens of Missouri as a senator.

14

Missouri Optometric Society TrusteesCentral Society (5) — Jeffrey Gamble, OD | P: 573-874-2030 | [email protected] Ozark Society (8) — Katie Robertson OD | P: 417-886-5444 | [email protected] City Society (3) — Melanie Linderer, OD | P: 816-781-2100 | [email protected] Society (2) — Mindy Blackford, OD | P: 660-665-6262 | [email protected] Society (1) — Stephanie Erker, OD | P: 816-322-1872 | [email protected] Society (9) — Dan Obermark, OD | P: 573-471-1080 | [email protected] Southwest Society (7) — Justin Stilley, OD | P: 417-781-9900 | [email protected]. Louis Society (6) — Thomas Cullinane, OD | P: 314-579-0909 | [email protected]. Louis Society (6) — Robert Goerss, OD | P: 636-272-1444 | [email protected] Central Society (4) — Jason Lake, OD | P: 660-747-2000 | [email protected]

Northeast Optometric Society (NEOS)

The NEOS met Feb 1 2012 at The Pear Tree in for our presidential visit. Special guests were Dr Jeff Weaver, Dr Leeann Barrett and Jay Hahn. Topics of discussion included Children’s Vision and Board Certification. Our society day is scheduled for Feb 28.

The NEOS society day was Feb 28. Dr Duane Thompson and Dr Bob Sloan visited with our elected officials and educated them on the Children’s Vision bill. The other society members who were unable to attend our society day made personal calls to their senators and representatives.

Northwest Optometric Society (NWOS)

No Report Available

St. Louis Optometric Society (SLOS)

The January meeting was sponsored by Eye Solutions and a presentation by Dr. Jerome Sherman from SUNY was given where he discussed establishing an AMD center of excellence.

February’s meeting was sponsored by Bausch and Lomb, and a grand rounds presentation was given by the UMSL College of Optometry.

At the March meeting, Ciba Vision/Alcon sponsored Dr. Dwight Akerman.

In April, Alcon sponsored Dr. Art Epstein, who discussed various fresh technologies and therapies for detecting and treating anterior segment disease.

The St. Louis Optometric Society continues to meet at the Marriott West in Chesterfield, MO on the second Tuesday of the month. May’s meeting will be sponsored by AMO and the benefits of their new Revitalens solution and Blink family of products will be discussed. The annual installation of new officers

will be held in June at the Living World at the St. Louis Zoo.

Southeast Optometric Society (SEOS)

No Report Available

Southwest Optometric Society (SWOS)

On February 21st, the Southwest Optometric Society joined the Greater Ozarks Optometric Society in Jefferson City. Doctors from both societies gave testimony in the Senate Committee Hearing regarding Senate Bill 649.

On April 17th, the Southwest Optometric Society met at Mythos Greek restaurant in Joplin. The meeting was sponsored by Shane Helmig of Ista Pharmaceuticals, and Dr. Chad Betts presented on the topic of ocular allergy treatment.

West Central Optometric Society (WCOS)

The West Central Society has not met this quarter.

There have been significant emails regarding legislative efforts in Jefferson City. We will be sitting up for our Presidential Visit soon.

SOCIETY REPORTS MAKE YOUR PRACTICE THE BRIGHTEST STARWITH RIGEL AR

Rigel is one of the brightest stars in the sky, about 47,000 times as luminous as the Sun, despite being over 800 light years away.

For more information call Sutherlin Optical at 816-421-0369 or 800-999-8193

Rigel is the answer to the success of your glare free program, providing a value solution to add to your product resume. Value AR is an untapped market that exists because 40% of consumers are value oriented. How would an extra 40% capture rate look on your bottom-line? We know that a large percentage of patients who purchase value glare free lenses upgrade to premium the next time around. That means enhanced acuity for every patient in your practice, greater revenue today and in the future.

Ease of Care… Super hydrophobic — finger prints and face oils wipe right off.

Durability… Dramatically improves scratch resistance.

Comfort… Allowing your patients the best visual acuity, all the time.

1 year warranty.

Without Rigel AR With Rigel AR

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14

MAKE YOUR PRACTICE THE BRIGHTEST STARWITH RIGEL AR

Rigel is one of the brightest stars in the sky, about 47,000 times as luminous as the Sun, despite being over 800 light years away.

For more information call Sutherlin Optical at 816-421-0369 or 800-999-8193

Rigel is the answer to the success of your glare free program, providing a value solution to add to your product resume. Value AR is an untapped market that exists because 40% of consumers are value oriented. How would an extra 40% capture rate look on your bottom-line? We know that a large percentage of patients who purchase value glare free lenses upgrade to premium the next time around. That means enhanced acuity for every patient in your practice, greater revenue today and in the future.

Ease of Care… Super hydrophobic — finger prints and face oils wipe right off.

Durability… Dramatically improves scratch resistance.

Comfort… Allowing your patients the best visual acuity, all the time.

1 year warranty.

Without Rigel AR With Rigel AR

Without Rigel AR With Rigel AR

Because every patient deserves the best vision possible

ESSLER_SORigelflyerFeb10.indd 1 2/16/10 9:22 AM

WELCOMENEW ODs

WELCOMENEW PARAs

MOA members, please take every chance to encourage optometrists and paraoptometrics who are not currently members of the MOA to join us in supporting the optometric profession.

To those of you who have reached out and brought a new member to the MOA membership roster–THANK YOU!

OD Members• Mahnaz Bangash• Jerri Birsinger• Diane Curry• Julia Dombek• Kamron Hunt• Scott McSpadden• Douglas Nosacka• Angel Rivera• Shelley Williams16

The MOA Paraoptometric Section urges all paraoptometrics to become part of this important professional organization.

Join the MOA’s Paraoptometric Section today, then encourage your friends who work in optometry to become part of the paraoptometric section, too!!

Para Members• Cynthia Doss

MOA CALENDAR

October 11 - 14MOA Annual ConferenceChateau on the LakeBranson, Missouri

2012June 14 - 16MOA Leadership RetreatCamden on the LakeLake Ozark, Missouri

January 26 - 27. 2013MOA Legislative ConferenceCapitol Plaza HotelJefferson City, Missouri

February 15-17Heart of AmericaHyatt RegencyKansas City, Missouri

May 31 - June 1MOA Leadership RetreatStoney Creek InnColumbia, Missouri

June 26 - 30Optometry’s Meeting®San Diego, California

October 11 - 14MOA Annual ConferenceBallpark Hilton St. Louis, Missouri

2013

June 27 - July 1Optometry’s Meeting®Chicago, Illinois

Hannibal800-325-4676

Lenexa800-397-2020

MOA LEADERSHIPCentrAL OffiCeExecutive DirectorLeeAnn Barrett, OD | [email protected]

Assistant Executive DirectorJay Hahn | [email protected]

Finance / Membership ManagerSue Brown | [email protected]

LeGAL COUnseLMarc EllingerP: 573/634-2500 | [email protected]

GOvernMentAL reLAtiOns COnsULtAntsJerry Burch: P: 573/636-4599 | [email protected] Marrs: P: 573/636-5873 | [email protected]

OffiCersPresident: Jeffrey Weaver, ODP: 314-983-4244 | [email protected]

President-Elect: John Gelvin, OD, FAAOP: 816-525-3937 | [email protected]

Treasurer: James Hunt, ODP: 573-996-3937 | [email protected]

Secretary: Scott Burks, ODP: 417-345-2901 | [email protected]

Immediate Past President: Duane Thompson, ODP: 660-258-7409 | [email protected]

18

VISION is published bimonthly by the Missouri Optometric Association.

100 East High Street, Suite 301 | Jefferson City, Missouri 65101 P: 573-635-6151

Editors of Publications: LeeAnn Barrett, OD and James Hunt, OD

Contact Dr. BarrettMissouri Optometric Association100 East High Street, Suite 301Jefferson City, Missouri 65101P: [email protected]

Send all unsolicited articles, news, and advertising to the MOA Central Office. All opinions and statements of supposed fact in signed articles do not necessarily reflect the views and policies of the Missouri Optometric Association.

Contact Dr. HuntVision-Improvement Clinic204 Washington St.Doniphan,MO 63935P: [email protected]

ABOUT VISION