Optimization in Optometry Billing Practices

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Optimization in Optometry Billing Practices

• Although taking care of eyes is the main aim of
  every optometrist, staying in the business is
  equally important where billing and coding become
  its vital element. Optometry experience and
  expertise, hence the path being taken in billing
  and the reimbursements which can maximize the
  revenues need to be constantly looked after.
• Certain parameters have been defined which aid in
  optimizing optometry billing
• Implementation of Electronic Medical Records,
  Electronic prescribing, and usage of certain
  software assist in optometry billing.
  Coordination of information and usage of tools if
  communicated to PQRS could qualify the
  optometrists for a bonus. The specific usage of
  specific level and/or add-on codes can enhance
  reimbursements (usage of these codes implies the
  usage of resources to manage time proficiently).
• Another strategy is to take the Accounts
  Receivables into consideration. Apposite
  documentation followed by accurate codes, and
  checking on the monthly status from the billing
  department which states if any insurance provider
  must be dropped due to regular slow
  reimbursements also removes hurdles in optimized
  billing. In the case of outsourcing, revenues too
  could be speedy and apt as the outsourcing agency
  would always try to be on time and work without
  denials or unpaid claims to be followed upon.

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Optimization in Optometry Billing Practices

• Optometrists should also consider billing
  separately to the vision carrier or the medical
  carrier for reimbursements. In case of a
  comprehensive eye examination, the doctor can
  bill the vision carrier. Simultaneously, in a
  follow-up schedule for dry eye testing (disease,
  diagnosis, and treatment), the billing can be
  sent to a medical carrier.
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• Billing in Optometry practice can also be
  improvised using various techniques such
  as educating and marketing the optometry
  business to older patients, understanding of
  medical decision making, and billing a refraction
  service while linking it to a medical diagnosis,
  creating a carrier-specific manual, selling
  supplements, and reporting punctual plugs.
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• Being aware of sub-terms, suffixes, and
  prefixes, ICD-10, HCPCS Material V-codes CPT
  codes, evaluation and management (E/M) codes for
  new and existing patients, apt modifiers,
  anterior and posterior segment, and external
  ocular adnexa, aids the billing process. Along
  with these, a good understanding of the
  difference between vision plans vs. health
  insurance is equally vital.
• Certain rules for optometry billing are Every
  patient must be coded and the coverage is
  determined by the reason of the patients visit
  rather than the diagnosis. Always record the
  patients details incomplete words and
  appointments should be mentioned by the type of
  service.

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Optimization in Optometry Billing Practices
Verify the health and vision insurance at every
office visit and keep a scanned copy of the ID
and insurance card. Keep the patient informed of
the deductibles and co-pays before examining the
patient. Send the claim in the set time period
from the date of service. Correct testing
equipment, protocols, accurate coding,
maintaining records and billing systems, multiple
examination lanes and appropriately skilled staff
leads to optometry billing optimization.