Optometry Medical Billing Collection

Optometry Medical Billing Collection

A successful and profitable optometry practice is not possible without accurate and competent medical billing and collection processes. An optometry practice is also having the same goal as other small practices have. A successful optometry practice can be considered when you are focusing on increasing your revenue with great patient experiences. In current pandemic situation it is more challenging to run practice with great collection of payment from both patients and insurance companies. There is one more reason for this – rising documentation requirements and an increasing co-pay and patients responsibilities for a portion of their medical bill.

Increase Optometry Medical Billing Collection

Increasing collections is an important strategy for your successful eye care business. We tried to collate all questions for you to help your business thrive.

How do you collect patient remaining balance?

As an optometry specialist, you know that any money not collected on the date of service (DOS) will be tough to collect later. It’s important to ensure that all statements that patients receive in the mail are clear and easy to read. These statements should be mailed as soon as possible so that the service is fresh in their minds and they are more likely to pay. Have you ever tried online payment gateway / electronic payments for your optometry specialty? It’s very easy to use and implement. This will be a great option for your patients as it gives them a way to view their bill electronically and pay automatically.

Note: Collect Co-Pays, Coinsurance, and Deductibles Before the Patient Leaves the Office

Do you check that your credentials with insurance payer?

As an optometry medical practice you might already have credentialed with top insurance payers. It also important to check that you are credentialed or at least check that you are credentialed with insurance payer of your patient’s insurance. If you are not credentialed with insurance payer then you can 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.

If you are not credentialed with insurance payer then you can 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.

Do you check average reimbursement from each payer?

Do you think that you are done once you receive payment from insurance company? No, it’s not done yet. Payments can differ patient to patient for same service. You need to make sure that you have received properly for your time and expertise. You need to analyse data to determine your cost per patient that includes the amount for your office rent, front desk wages, etc.

You can analyse average reimbursement from each insurance payer to get the exact profit or loss number. If your EHR reporting package is unable to assist you with this, consider data analytics software or hiring an outside agency like Medisys Data to help you out. Once you finish with this analysis you can come to conclusion that payers who are providing you with a low return on investment should be negotiated with or no longer accepted.

Do you work on your denials?

Working on denials is time consuming and labour intensive work of the revenue cycle. You as a optometry service provider and your front desk staff should implement a proper system to improve accuracy to minimize denials. We at Medisys Data can suggest you proper solution on your existing system to avoid denials. Still you received a denial, no worries our billing expert can guide you whether or not it could’ve been prevented on the front end. After analysis of denials it should be resubmitted to clearinghouse to send claim to the payer. We suggest that denials should be taken care of immediately and try to avoid patient involvement into it unless necessary.

Do you check industry updates?

Stay Current with LCD, MAC, and Listserv Updates. To make sure that 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.

Are you ready to streamline your medical billing process for optometry? Why to wait, we will be in touch with you soon once you fill our contact form. Request a free practice analysis today.

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