Pricing pages for virtual assistant services have a way of answering every question except the one you asked. So let's do this the way you'd want a colleague to: the pricing models, the ranges, the costs nobody lists, and the arithmetic for deciding whether it pays for itself in an optometry practice.
The three pricing models you'll encounter
Hourly through a healthcare staffing provider. The most common arrangement for eye care practices. You pay a single hourly rate that bundles the assistant's wage, the provider's recruiting and training, HIPAA compliance infrastructure, management, and replacement coverage. Full-time is typically forty hours a week on your schedule.
Flat monthly rate. Same bundle, packaged as one predictable invoice. Functionally identical to hourly for budgeting purposes; some owners simply prefer a fixed line item.
Direct contract hire. You find, vet, and manage an independent remote contractor yourself. The hourly cost is meaningfully lower — and every function the provider would have handled becomes your job, including backup coverage when your one assistant is out and re-recruiting when they move on. Cheaper per hour, more expensive per headache.
What the market actually charges
Rates move with experience, specialization, and provider, so treat published numbers as a snapshot rather than a promise. As a general orientation in the current market: healthcare-trained virtual assistants through established providers commonly run in the high single digits to low teens per hour, which puts a full-time assistant in the range of roughly $1,500 to $2,500 a month. Eye-care-specific experience and billing skills sit at the upper end; general administrative support at the lower. Direct contract hires can come in under that, with the trade-offs above.
Compare that to the in-office equivalent. A front-desk hire at $18 to $22 an hour costs $37,000 to $46,000 in wages alone — before payroll taxes, benefits, PTO, workers' comp, training time, and the recruiting cycle you'll repeat if they leave. Fully loaded, an in-office administrative employee generally costs half again their wage. The gap between the two options, over a year, funds a lot of new frames.
The costs the pricing page doesn't mention
Honesty requires this section, because a virtual assistant is not free to integrate.
- Your onboarding time. Plan on several hours a week from you or your office manager for the first month — documenting workflows, training, reviewing output. This is an investment, not a fee, but it's real.
- Software seats. Your practice management system, phone platform, and communication tools may charge per user.
- The learning curve. The first few weeks run slower than the steady state. Budget your expectations accordingly.
- A mismatch, if it happens. Occasionally the first placement isn't the right fit. Good providers replace and retrain at their cost; direct hires put that cost on you. Ask about it upfront.
The ROI math for an optometry practice
Run your own numbers with this frame. A full-time VA at roughly $2,000 a month needs to generate or protect that much value to break even. In an optometry practice, the places it shows up:
Recall revenue. If your average comprehensive exam plus optical capture runs, say, $250 to $350 in collected revenue, then eight to ten additional recall bookings a month — from a list currently going unworked — covers the entire cost by itself. Most practices with a stale recall list clear that bar embarrassingly fast.
Answered calls. Some percentage of missed calls are new patients who don't call back. Even one or two rescued new patients a month carries meaningful lifetime value once you count annual exams and optical purchases.
No-show reduction. Every prevented no-show is a filled exam slot. Consistent confirmation calls are the cheapest schedule-density tool that exists.
Cleaner billing. Fewer denials and faster follow-up shorten your revenue cycle. Harder to attribute precisely, easy to see in days-in-AR over a quarter.
Notice what's not on the list: replacing anyone. The ROI case is built on work your practice is currently not doing, or doing inconsistently, because everyone in the building already has a full-time job.
Questions to ask any provider about price
What exactly does the rate include — training, management, backup coverage, replacement? Is there a setup fee or minimum contract term? What happens to the rate at renewal? Are there charges for after-hours coverage or additional software training? A provider with clean answers to these is telling you something about how the rest of the relationship will go.
If you want, we'll walk your actual numbers — schedule volume, recall list size, current answer rate — and show you what the math looks like for your specific practice rather than a hypothetical one. That conversation is free, which is the best price in this article.
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