6 Optometry Billing Prerequisites to Amplify Your Practice’s Profits

A well-rounded billing system is key to improving the financial health of your optometry practice. But to build such a productive and efficient billing system, it is important for you to first have a clear understanding of various optometry billing concepts. This can enable you to make the right decisions and drive high profits for your practice on a consistent basis.


Before you start billing for your optometry services, you need to have knowledge about the correct usage of medical insurance, vision plans as well as the ABN form. To speed up and simplify the billing process, optometry providers should also automate their basic billing functions. Another important task is to verify if the provider is properly credentialed and enrolled before carrying out the billing activities.


Check out 6 of the most significant optometry billing prerequisites that play a crucial role in propelling your practice’s profitability.



Medical Insurance vs Vision Plans - Know When To Bill What


A number of patients have both - medical insurance as well as vision plan coverage. When such patients receive healthcare services from you, it can be difficult to choose which of the two plans to bill - vision plans or medical insurance. But to make that decision, it is first important to identify the exact medical signs and symptoms that medical insurance covers and to know that visual plans are only for routine eye examinations.



Confirm Whether the Provider is In-network


One of the most important steps in optometry billing is to verify whether the provider has been credentialed and enrolled by insurance payers as well as the Council for Affordable Quality Healthcare (CAQH). The billing staff also needs to regularly follow up with the insurance payers to check the optometry credentialing and enrollment status of the provider. If the credentialing or enrollment process is not carried out properly, providers may fail to get reimbursements for the services they offer.



Automate Basic Billing Functions


Getting paid consistently and correctly is essential for optometry providers to maintain a positive cash flow for their practice. As billing and collections processes are at the core of generating finances for practices, they should be as fast and accurate as possible. By automating basic activities such as appointment scheduling, reminders, registration, etc, optometry providers can streamline processes, dedicate time to important services, and significantly bring down their practice’s expenses.



Understand the Correct Usage of ABN Forms


The Advanced Beneficiary Notice (ABN) is a document that informs patients that they will have to pay for the services if their insurance carrier denies the claims. Failure to get the ABN form signed before offering medical services can result in huge financial losses for the optometry providers. It is thus imperative for providers to be informed about all the guidelines that define when (and when not) the ABN form can be issued.



Stay Abreast of LCD, MAC, Listserv Updates


Staying adequately informed about the increasing number of terminologies, rules, and regulations associated with optometry billing and coding can be quite challenging. Every optometry provider needs to know about the latest Local Coverage Determinations (LCD) and Medicare Administrative Contractors (MAC) and also get payer listserv updates. This ensures that the procedures being carried out and claims being submitted are correct, thereby driving maximum returns for your practice.



Calculate ROI of Outsourced Optometry Billing


As your practice grows, the complexities pertaining to billing and coding functions also increase. Maintaining the efficiency of billing operations and other administrative activities can become difficult for an in-house team in such a situation. Hence, providers should consider as well as calculate the benefits of an outsourced optometry billing team. An outsourced team will reduce salary expenses and delegate critical tasks to expert professionals, thus helping you focus on providing good patient care.


Are you looking for ways to minimize optometry billing hassles and boost your practice’s profits? CS Eye can help. We are an industry-leading optometry billing and credentialing service provider. Our seasoned billing experts can transform your practice’s billing operations and deliver top-notch solutions to elevate your reimbursement rates. Get in touch with us to know more about CS Eye’s optometry billing service offerings.

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