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Optometry Billing Challenges in 2021

Optometry Billing Challenges in 2021

Optometry billing has experienced some problems and challenges aligning with other healthcare providers. Their primary concern is to ensure smooth revenue cycle management and claim submissions.

Although technology has been playing a vital part in enhancing the overall experience for optometry providers as well as patients but hurdles like the payment procedures, the billing process, claim denials are priority issues to be knocked off.

Continuous circulation in the revenue cycle of optometry healthcare is essential to satisfy all stakeholders in the process like the optometrist, billing personnel, staff, patients, insurers, payers, etc.

Optometry billing plays a crucial part in ensuring healthy financial flow in an organization keeping all obstacles in the path of payment collection and revenue generation at bay.

So, any challenges or issues faced in Optometry billing become mandatory to be resolved as soon as they are addressed or even better when they are predicated at an early stage.

In this brief you will understand various optometry billing challenges.

Optometry billing challenges

Inefficient data recording

Staff involved in recording and maintaining patient data play a key role in inefficient data recording problem. Recording relevant and required patient information as per the latest codes is a basic task that should be accomplished without any errors to avoid problem in claim submission process.

So, staff responsible for this task should be well trained to handle and maintain patient records as per the latest norms.

Outsourced billing service provider

If you have outsourced optometry billing procedures to a third-party service provider, you need to ensure that they are equipped with the latest technological capabilities to handle billing operations for your organization because not every billing service provider is in a position to comply with the latest terms of medical billing.

Inefficiency on their part could hamper billing procedures for your organization in the long run. Hence it is necessary to verify the capabilities of your outsourcing billing partner.

Revenue losses

Failure to regular follow-ups with account receivable leads to a loss in revenue for optometry healthcare providers which results in bad debts. Bad debts adversely affect revenue stream and lead to dissatisfaction among providers and staff.

Settlement of claims

With increasing compliance of standards of insurance companies along with Medicaid and Medicare, it becomes difficult for healthcare providers to stay updated and adhere to their changing procedures. This leads to problems in claim settlement because of the inability of providers to comply with changing standards.

Lower reimbursements

The lower reimbursement ratio is the biggest challenge faced by optometrists for the past few years. After conducting eye exams, providing required treatment, submitting claims, the providers are worried about complete reimbursements on their claims. And when the claims are denied, it becomes a cumbersome task to rectify the billing and claim submission process which leads to wastage of important resources.


These hurdles in the optometry billing process are bottlenecks in the revenue cycle. To avoid such challenges, make sure each component in the value chain of optometry healthcare has been taken care of. Such as train the staff for correct and accurate data recording of patients. Prepare a team involved in follow-up with account receivables and responsible for claim management.

Moreover, use resources effectively to deal with denied claims and make note of rejected claims to avoid those circumstances in the future.

If you want a one-stop solution for your optometry billing procedure, then you can get in touch with us. We are team of HIPAA compliant experts who can optimize billing process and help in increasing the top line of the organization.

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