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How to Set Up a Successful Revenue Cycle for Your New Optometry Practice

Optometry providers are generally unaware of how to establish a revenue cycle for their newly set up optometry practice. Although complicated, building a successful revenue cycle for your optometry practice can be made easier by following the right steps. Once you manage to get past the intricacies of optometry credentialing and billing, keeping your practice’s revenue stream flowing becomes a lot simpler.

The first step in building a revenue stream is to choose insurance companies that will be best for your optometry practice. You then need to complete the credentialing procedures for each of your selected insurance networks.

Once done with the credentialing, you should make sure to take care of a few procedures that help you stay credentialed and reap accurate returns for your services. Here’s how you can establish a revenue stream and enhance revenue-building efforts for your new optometry practice.

Get Credentialed With Your Preferred Insurance Networks

Finding the right insurance carriers and getting in-network with those companies is a crucial aspect of running a successful optometry practice. Which insurance provider you decide to partner with has a huge influence on your revenue cycles as well as workflows.

After deciding on the insurance companies, you need to carry out the optometry credentialing process to join the insurance networks of your choice. The applications for every insurance company must be prepared and filled out carefully. Post submitting the applications, you need to follow up with each plan regularly to know about your contract status.

Right from application preparation to following up, every stage of the insurance credentialing process is quite complex and time-consuming. Hence, it is always beneficial to outsource this process to subject-matter experts and focus on your core task of treating patients.

Take Requisite Measures to Maintain Your Credentials

After you have done all the grinding and are finally credentialed with the insurance companies of your choice, you can start billing networks for services. However, there are a few measures that need to be taken in order to ensure that you stay credentialed and keep on receiving reimbursements.

Complete CAQH credentialing and maintain your CAQH profile through quarterly attestations. Keep making updates in your CAQH profile related to insurance, license renewals, etc to eliminate unnecessary documentation hassles. Carry out re-credentialing processes and respond to the requests from insurance carriers to prevent the possibility of network termination.

Master the Billing Process to Generate Higher Revenue

After starting billing insurance companies for your services, it is important to incorporate the right procedures. This is useful in making your optometry billing profitable. Optimizing every process right from claims submission to reimbursement follow-ups can reap higher returns for your optometry services.

Analyze records associated with every insurance provider. Identify the networks that are providing better patient volume and ultimately contributing more to your revenue. Further, renegotiate reimbursement rates with other network providers to ramp up your practice’s profitability.

Optometry practices must verify the benefits of a patient before providing services to ensure that he/she has insurance coverage for the service you are offering. Staying in line with all the necessary rules and regulations about an insurance carrier is also important to accelerate reimbursements for your services.

Don’t get bogged down by the complexities of setting up a revenue cycle for your optometry practice. CS Eye is here to make this process easier and more efficient for you. Cash in on the CS Eye’s expertise to streamline the credentialing and optometry billing process for your new practice. Contact us to know more about our spectrum of service offerings.

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