Advanced Optometry Billing Strategies to Maximize Reimbursements

1
Advanced Optometry Billing Strategies to
Maximize Reimbursements
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Advanced Optometry Billing Strategies to
Maximize Reimbursements
Look, we know you're not just in this for the
paperwork. You're helping people see better,
which is awesome. But let's be real, running an
optometry practice? It's like juggling chainsaws,
especially when it comes to billing. Those coding
rules change on a dime, insurance companies play
by their own weird rules, and the
paperwork? Don't even get us started. One little
slip-up, and boomdenials, delays, money just
vanishing. It's enough to make you pull your hair
out, right? At Medical Billers and Coders (MBC),
we get it. We've seen it all. We know the
headaches, the "seriously, they denied that?!"
moments. That's why we've put together some
straightforward, no-nonsense billing strategies
to make your life easier. We want you to focus on
your patients, not on wrestling with claim
forms. First Thing's First Let's Crack Those
Codes (CPT ICD-10) and Stop the
Denials Alright, coding. Let's talk about it.
Insurance companies? They're basically robots.
They see a wrong code, and it's a hard "nope."
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Advanced Optometry Billing Strategies to
Maximize Reimbursements

• CPT Codes (What You Did)
• 92004 That new patient exam? Code it right.
• 92014 Returning patient? Same deal.
• 92133 Glaucoma imaging? Gotta be perfect.
• 92250 Fundus photos? Don't mess this up.
• ICD-10 Codes (What They Have)
• H52.4 Presbyopia? Yep, there's a code for that.
• H40.9 Glaucoma? Get it right.
• E11.36 Diabetic retinopathy? Common, but
  crucial.
• Z01.00 Routine exam? We've got a code for that.
• MBC has coding experts who are like hawks. They
  catch errors before they become your problem.
• Next Up ModifiersYour Secret Weapon (But Use
  Them Smartly!)
• Modifiers? They're like little notes to the
  insurance companies. Get them wrong, and you're
  leaving money on the table.

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Advanced Optometry Billing Strategies to
Maximize Reimbursements

• The Important Ones
• -25 Big evaluation same day as something else?
  Use this!
• -59 Separate procedure? This is your friend.
• RT/LT Right eye, left eye. Details matter.
• TC/26 Technical vs. professional? Split 'em up.
• Example Fundus photo (92250) and OCT scan
  (92133) on the same day? Modifier -59 gets you
  paid for both.
• MBC are pros at modifiers. No bundling, just
  maximum reimbursement.
• Don't Forget Insurance Verification
  Authorizations (Save Yourself the Headache!)
• Nothing's worse than finding out insurance
  details were wrong after you've done the work.
• Pro Tips
• Check coverage for everything, exams to eyewear.
• Know those co-pays and deductibles.

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Advanced Optometry Billing Strategies to
Maximize Reimbursements

• Get those prior authorizations.
• Tell patients about out-of-pocket costs upfront.
• MBC handles the grunt work, so you don't get
  blindsided.
• Clean Claims Fast Money (It's Simple Math!)
• Clean claims are like winning the lottery. No
  errors, everything's perfect, and you get paid
  fast.
• How to Do It
• Double-check everything.
• Go electronic, it's faster.
• Link those codes correctly.
• Hit those deadlines.
• MBC audits everything before it goes out, so you
  get paid faster.

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Advanced Optometry Billing Strategies to
Maximize Reimbursements

• Denials? Let's Fight Back! (Get Your Cash!)
• Denials happen. It's how you handle them that
  matters.
• What to Do
• Find out why it was denied.
• Fix it and resubmit.
• Appeal if you have to.
• Track those denial patterns.
• MBC are like denial ninjas. We get you paid.
• Stay Up-to-Date (Don't Get Left Behind!)
• Insurance and Medicare changes? They're
  relentless.

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Advanced Optometry Billing Strategies to
Maximize Reimbursements

• How to Keep Up
• Follow those Medicare updates.
• Join optometry billing groups.
• Get those webinars.
• MBC stay on top of it, so you don't have to.
• Think About Outsourcing (Get Your Sanity Back!)
• In-house billing? It's a time-suck.
• Why Outsource?
• Fewer denials, faster payments.
• Spot-on coding.
• We handle the paperwork.
• More time for you to focus on patients.
• Let's chat about how MBC can help you get paid
  what you're worth.

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Advanced Optometry Billing Strategies to
Maximize Reimbursements
FAQs 1. Why do optometry claims get denied so
much? Honestly, it's usually simple stuff wrong
codes, missing bits, or bad insurance info. Just
double-check everything before you send it. 2.
How do I get paid the most for my work? Codes
right, modifiers right, insurance right, claims
clean. Basically, nail the details for fast
payments. 3. What's the deal with prior
authorizations? Know what needs approval early,
and get those requests in ASAP. Delays? That's
money you're waiting for. 4. How do modifiers
really affect my money? Think of them as
explaining your work. Get them right (like -25 or
-59), and you get paid for everything. 5. How do
I speed up my billing? Go digital, Check your
coding twice, and fix those denial patterns. Get
those basics right, and you'll see a difference.
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