How To Increase Optometry Billing Collections: Try These Tips!

Billing collection is one of the most important stages for any business in any field. All businesses that are in existence aim to achieve a healthy financial trajectory along with providing their customers the best possible service.

The process of billing collection has been made very efficient since the upgrades in technology, especially in the medical industry.?

So, Here are some tips you can follow to elevate your Optometry Billing Collection experience.

1. Verify Insurance Plan Prior To Visit

Patients nowadays have both vision and medical insurance with them. It might seem obvious to select the plan based on the complaint and medical diagnosis of the customer. However, sometimes this process might make you miss out on collecting bills.

In order to tackle this, make sure you verify both the vision and the medical plans of the patients. If the insurance plan of the customer has co-pay, coinsurance, or deductible, always collect before they leave the office.

Doing this allows the Accounts Receivables of the company to be collected in time without any delays which helps to avoid late payment.

2. Advance Beneficiary Notice

In some cases, the patient is not covered by Original Medicare or commercial non-Medicare plans and he/she has to pay out of their own pockets. This is where you need to make sure you make the patient sign the Advance Beneficiary Notice of Non-Coverage form.

This makes the customer obliged to pay after the appointment making things easier.

3. Making Sure The Provider Is Credentialed

One of the most important and first steps in Optometric Billing Collection is making sure that the provider is credentialed by the insurance payer. It is really important to track provider applications based on their plans. You must also follow up with insurance payers regularly to make sure the providers are enrolled in the network.

4. Keep a Constant Check On LCD Updates

Keeping on track with Local Coverage Determinations and Medicare Administrative Contractors in your area is a good practice that you should follow. This makes sure that you are coding your eye claims accurately.

5. Accurate CPT Codes

There is a mistake that many offices in this practice make which is billing OCT/GDX and fundus photography on the same site. Coding these incorrectly can lead to Medicare denying both the codes. According to Medicare’s National Correct Coding Initiative, if you are looking at a single problem like glaucoma, both tests cannot be paid for.

This is because according to Medicare’s National Correct Coding Initiative (NCCI) edits; codes 92133/92134 and 92250 are considered mutually exclusive.?

The NCCI edits do allow the use of a modifier for OCT/GDX and fundus photography, but be careful and use a modifier correctly, or it may result in a rejection or denial.

Review Denied Claims

In many cases, administrative errors cause a lot of claims to be denied. For instance, the procedure code is inconsistent with the modifier you used or the required modifier is missing for adjudication. Once you correct the errors, you can resubmit the claim to the insurance payer.

Take the time to call and question denials. Many times, something can be corrected and refiled rather than written off completely.

Following Up On Claim Denials?

Finding out the reasons why your claims got denied by the insurance payer, is really frustrating and wastes time. On average two-thirds of the denials are recoverable. The longer you wait for determining what went wrong, the more likely you won’t recover the maximum amount.

Accurate Documentation

CMS regularly announces changes to the E/M documentation to help doctors with the patient records. Doctors no longer have to re-enter the patient’s complaint and any history that the staff already entered in the medical record for E/M office/outpatient visits.

The doctor only needs to add a note in the patient’s 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.

Interpretation and Report

Each and every diagnostic test you perform requires an Interpretation & Report. The Interpretation & Report interprets the diagnostic test results and reports how the test affects the patient care plan.

Establish medical necessity for each diagnostic test you order and perform, or else the insurance payer can deny it as an invalid claim. If an insurance payer requests an I&R and you didn’t create one, the payer can audit your practice, which may result in penalties and interest.

Take Your Time

This might seem obvious but always review your forms. Staff is often rushed to push the patient through the waiting list that they let details slip. Staff might abbreviate a field at the moment with intentions of correcting later; however, they forget to go back.

Issues with patient details, including the correct spelling of the name, date of birth, and policy number, will cause claim denials. These small optometry practice billing mistakes ultimately can result in delays in processing the claim as your biller corrects and re-files.

Need Help In Your Optometry Billing Collections?

Are you exhausted with all the piles of paperwork? Constantly finding yourself around billing issues?

Keeping up with confusing and never-ending optometry billing rules, insurance payer requirements, EDI processes, and managing denied and rejected claims is time-consuming and frustrating.?

Well worry no more, Here at Med-Miles LLC offer you all the required expertise that you need in switching to a better future. Experts at med-miles LLC will provide you with the best help with your Optometry Billing Collection issues.