How to Increase Your Optometry Practice Collection?

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How to Increase Your Optometry Practice
Collection?
Improving collections is an essential strategy
for revenue growth. A healthy bottom line
translates to a healthier financial trajectory
for your eye care business. Follow these
Optometry Practice Collection tips to help your
business thrive. An optometry practice shares
the same end goal as other small businesses i.e.,
you want to thrive. A thriving business is one
that focuses on growing revenue while providing
great experiences for its customers. In your
case, your customers are patients. Optometry
Practice Collection Tips Prior Benefits
Verification Many patients have both vision and
medical insurance plans. While the best billing
practice is to select which plan to bill based on
the patients chief complaint and medical
diagnosis, sometimes its more complicated. It is
critical to verify both vision and medical plans
before the office visit. One of the fastest ways
to increase your practice cash flow is to develop
an upfront collection process. During check-in or
check-out, if the patients insurance plan
includes a co-pay, coinsurance, or deductible,
always
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How to Increase Your Optometry Practice
Collection?
collect before they leave the office. Sending
invoices before the due date reduces Accounts
Receivable (AR) delays, helps avoid late
payments, and increases your chances of getting
paid on time. Open balances also create a false
image of your AR. Obtain an Advance
Beneficiary Notice If you suspect that the
procedure or service you will provide to the
patient may not be covered by Original Medicare
(fee-for-service) or commercial non-Medicare
plans, and the patient may be responsible for
out-of-pocket costs, obtain an Advance
Beneficiary Notice of Noncoverage (ABN), Form
CMS-R-131. The patient must sign the ABN before
you provide the procedure or service to the
patient. And the ABN is invalid for any
contractually obligated write-off.
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How to Increase Your Optometry Practice
Collection?
Get Credentialed One of the first steps in
optometric medical billing is making sure the
provider has been credentialed by the insurance
payer. Remember to submit and track provider
credentialing applications based on insurance
plan requirements. Take it one step further and
follow up with insurance payers regularly to make
sure the providers are enrolled in-network when
enrollment is open. Use Accurate CPT Codes Many
offices bill an OCT/GDX (CPT codes 92133/92134)
and fundus photography (CPT code 92250) on the
same visit. If you do not code this correctly,
Medicare may deny both codes or only allow
payment on the code with the lowest
reimbursement. If you are looking at a single
problem, such as glaucoma, both tests cannot be
paid according to Medicares National Correct
Coding Initiative (NCCI) edits codes 92133/92134
and 92250 are considered mutually
exclusive.  NCCI edits prevent
bundling/unbundling due to incorrectly using CPT
procedure codes and HCPCS billing codes,
including combining inappropriate code
combinations. While the NCCI edits do allow the
use of a modifier for OCT/GDX and fundus
photography, be careful and use a modifier
correctly, or it may result in a rejection or
denial.
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How to Increase Your Optometry Practice
Collection?
Depending on local policies, if both tests are
necessary due to two separately identifiable
conditions, you may be able to link the
appropriate diagnosis code to each CPT and add
modifier 59 to the second procedure. Stay
Current with LCD Updates To ensure you are
coding your eye care claims correctly, you must
remain diligent with Local Coverage
Determinations (LCD) and Medicare Administrative
Contractors (MAC) in your area and sign up to
receive payer listserv updates. Review on Denied
Claims A majority of claim denials are due to
administrative errors. For example, the procedure
code is inconsistent with the modifier you used
or the required modifier is missing for the
decision process (adjudication). Once you correct
the errors, you can resubmit the claim to the
insurance payer. Follow-up on Claim Denials On
average, two-thirds of denials are recoverable,
and nearly 90 are avoidable. While tracking down
why the insurance payer denied the claim in the
first place is time-consuming and frustrating,
the longer you wait
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How to Increase Your Optometry Practice
Collection?
for determining what went wrong, the more likely
you wont recover the maximum amount (or any)
from the insurance payer. Proper
Documentation CMS announced several E/M
documentation changes to help doctors streamline
patient record documentation. Doctors no longer
have to re-enter or re-document the patients
chief complaint and any history that ancillary
staff or the beneficiary already entered in the
medical record for E/M office/outpatient visits
(both new and established patients). The doctor
only has to add a note in the patients health
record that the doctor reviewed and verified the
information. So always keep accurate records that
document the specific Evaluation and Management
(E/M) service the patient received for the
treatment i.e., clear reference, review, and
verify. Perform Interpretation and Report
(IR) Every diagnostic test that you perform
requires an Interpretation and Report (IR) which
is not optional. The IR interprets the
diagnostic test results and reports how the
test affects the patient care plan clinical
findings, comparative data (change in condition),
and clinical management.
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How to Increase Your Optometry Practice
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Dont forget to establish medical necessity for
each diagnostic test you order and perform, or
the insurance payer may deny the claim as an
invalid claim. If an insurance payer requests an
IR and you didnt create one, the payer may
audit your practice, which may result in
penalties and interest. Youll have a team of
professionals working for you, submitting
requests quickly and accurately. In addition,
outsourcing saves up more time for your staff to
concentrate on patients. Managing an optometry
practice is a complicated, demanding job. Give
your optometry faculty more patient focus time by
outsourcing your billing process.
Outsource Optometrys billing process or find a
billing solution that suits your practice
best. We can help you increase your Optometry
practice collection. To learn more about our
optometry billing and coding services, get in
touch with us at 888-357-3226  or email us
at info_at_medicalbillersandcoders.com.