The field of optometry has been growing and changing at a breakneck pace. In recent times, the role of optometry in the multidisciplinary care of medical conditions such as diabetes and glaucoma and the popularity of laser surgeries has been on a significant rise. Therefore, having a well-defined optometric billing process is the need of the hour for optometry practices.
One of the most common challenges faced by optometry providers is that their billing staff commits mistakes in optometry billing and coding. This is primarily due to unawareness of the latest regulations and the complexity of coding, billing and claim procedures.
Read on to learn about 4 important optometry billing tips that can help you enhance your practice’s functioning and revenue generation.
1. Optimizing Optometry Billing Practices
For a maximum cash flow and optimum financial health of the eye care practice, it is important to have an optimized optometry billing process. This involves reviewing and selecting suitable insurance payers that best fit your patient population as well as verifying every patient’s eligibility for the insurance benefits.
A regular recap of the meaning of all optometry billing and insurance terms goes a long way in improving collections, preventing claim denials and rejections, and boosting revenue for the eye care business. Additionally, staying informed about all the latest changes and updates pertaining to the billing and coding regulations is also imperative.
2. Understanding Charge Entry Process and Modifier Usage
Charge entry is an essential step in the optometry billing process. Even a small mistake while entering information during the optometry billing charge entry process can result in a rejected or denied claim and lead to significant revenue loss. Having knowledge about when to bill vision plans and when to bill medical insurance, based on the patient’s diagnosis and services provided, is also imperative.
Another important prerequisite while filing a claim is to assign correct diagnosis and procedure modifiers. Modifiers help in describing why a particular procedure was necessary and indicate the location of the body where the procedure was performed. It is imperative to note that errors while assigning medical billing modifiers can trigger an audit, resulting in hefty fines.
3. Timely Submissions of Clean, Error-free Claims
Accurate and timely claim submissions are vitally necessary for consistent cash flow in an optometry practice. It helps in receiving precise reimbursements from medical insurance providers in the expected timeframes. This enables the optometry practice to keep on providing optimal care to patients without any issues.
Optometry providers can either properly train their staff for optometry billing and coding procedures or outsource these tasks to other professionals equipped with the right tools and expertise. Submitting claims on a daily basis can also be a great way to ensure the steady yet seamless flow of revenue into your optometry practice.
4. Following-up On Denied Claims
Owing to the complexities in claim submissions, modifier selection, coding, etc denials and rejections are common in optometry billing. Hence, having a billing staff that is adept at deconstructing claim denials and understanding the actual cause of concern is a must.
To avoid this administrative burden, eye care providers can outsource their denial management process to optometry billing experts. They can track down why the insurance payer denied the claim, make necessary corrections, submit the claim again, and recover the maximum amount without causing a dent in the cash flow.
The above-mentioned tips are key solutions to understanding billing challenges and taking immediate action to improve the revenue stream of your optometry practice. You can also find a reliable optometry billing solution provider to streamline the overall billing process. CS Eye can be your go-to billing partner, offering world-class yet affordable billing solutions. Contact us to know more.