{"id":13949,"date":"2021-07-19T14:08:22","date_gmt":"2021-07-19T14:08:22","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=13949"},"modified":"2024-09-12T12:11:30","modified_gmt":"2024-09-12T12:11:30","slug":"how-to-increase-your-optometry-practice-collection","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/how-to-increase-your-optometry-practice-collection\/","title":{"rendered":"How to Increase Your Optometry Practice Collection?"},"content":{"rendered":"

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. <\/span><\/p>\n

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.<\/span><\/p>\n

Optometry Practice Collection Tips:<\/strong><\/h2>\n

Prior Benefits Verification<\/strong><\/h3>\n

Many patients have both vision and medical insurance plans. While the best billing practice is to select which plan to bill based on the patient\u2019s chief complaint and medical diagnosis, sometimes it\u2019s more complicated. It is critical to verify both vision and medical plans before the office visit. <\/span><\/p>\n

One of the fastest ways to increase your practice cash flow is to develop an upfront collection process.\u00a0<\/span>During check-in or check-out, if the patient\u2019s insurance plan includes a co-pay, coinsurance, or deductible, always collect before they leave the office. <\/span><\/p>\n

Sending invoices before the due date reduces Accounts Receivable (AR)<\/a> delays, helps avoid late payments, and increases your chances of getting paid on time. Open balances also create a false image of your AR.<\/span><\/p>\n

\"Legacy<\/a><\/p>\n

Obtain an Advance Beneficiary Notice<\/strong><\/h3>\n

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. <\/span><\/p>\n

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.<\/span><\/p>\n

Get Credentialed<\/strong><\/h3>\n

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. <\/span><\/p>\n

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.<\/span><\/p>\n

Use Accurate CPT Codes<\/strong><\/h3>\n

Many offices bill an OCT\/GDX (CPT\u00ae codes 92133\/92134) and fundus photography (CPT\u00ae 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. <\/span><\/p>\n

If you are looking at a single problem, such as glaucoma, both tests cannot be paid according to Medicare\u2019s National Correct Coding Initiative (NCCI) edits; codes 92133\/92134 and 92250 are considered mutually exclusive.\u00a0<\/span><\/p>\n

NCCI edits prevent bundling\/unbundling due to incorrectly using CPT\u00ae procedure codes and HCPCS billing<\/a> 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. <\/span><\/p>\n

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\u00ae and add modifier 59 to the second procedure.<\/span><\/p>\n

Stay Current with LCD Updates<\/strong><\/h3>\n

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.<\/span><\/p>\n

Review on Denied Claims<\/strong><\/h3>\n

A majority of claim denials are due to administrative errors. For example<\/strong>, 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.<\/span><\/p>\n

Follow-up on Claim Denials<\/strong><\/h3>\n

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 for determining what went wrong, the more likely you won\u2019t recover the maximum amount (or any) from the insurance payer.<\/span><\/p>\n

Proper Documentation<\/strong><\/h3>\n

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 patient’s 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). <\/span><\/p>\n

The doctor only has to add a note in the patient\u2019s 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.<\/span><\/p>\n

Perform Interpretation and Report (I&R)<\/strong><\/h3>\n

Every diagnostic test that you perform requires an Interpretation and Report (I&R) which is not optional. The I&R \u2018interprets\u2019 the diagnostic test results and \u2018reports\u2019 how the test affects the patient care plan: clinical findings, comparative data (change in condition), and clinical management. <\/span><\/p>\n

Don\u2019t 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 I&R and you didn\u2019t create one, the payer may audit your practice, which may result in penalties and interest.<\/span><\/p>\n

You\u2019ll 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.<\/span><\/p>\n

Managing an optometry practice is a complicated, demanding job. Give your optometry faculty more patient focus time by outsourcing your billing process. Outsource Optometry’s billing process<\/a> or find a billing solution that suits your practice best. <\/span><\/p>\n

We can help you increase your Optometry practice collection.<\/span><\/p>\n

\"Our<\/p>\n

To learn more about our optometry billing and coding services, get in touch with us at: 888-357-3226<\/strong><\/a>\u00a0 or email us at: info@medicalbillersandcoders.com<\/a>.\u00a0<\/span><\/p>\n

FAQs:<\/strong><\/h2>\n

1. Why is verifying benefits before a patient visit important?<\/h3>\n

Verifying benefits ensures you know what insurance covers and what patients owe, which helps in collecting payments upfront and reduces billing issues.<\/p>\n

2. What is an Advance Beneficiary Notice (ABN), and when should it be used?<\/h3>\n

An ABN is a form used when a service might not be covered by Medicare or other plans. It informs patients they may need to pay out-of-pocket and must be signed before providing the service.<\/p>\n

3. How does provider credentialing impact billing?<\/h3>\n

Credentialing ensures that providers are recognized by insurance companies, which is essential for getting claims approved and avoiding billing issues.<\/p>\n

4. Why is accurate CPT coding crucial in optometry billing?<\/h3>\n

Correct CPT coding prevents claim denials and ensures proper reimbursement. Incorrect coding, especially with mutually exclusive codes, can lead to rejections or reduced payments.<\/p>\n

5. How can outsourcing optometry billing improve collections?<\/h3>\n

Outsourcing billing ensures accuracy and efficiency in managing claims, reducing errors, and freeing up staff to focus more on patient care, which can improve overall collections.<\/p>\n","protected":false},"excerpt":{"rendered":"

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 […]<\/p>\n","protected":false},"author":2,"featured_media":13951,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[469],"tags":[596,1138,2168,799,1281,1124,759,812,2594,2595],"class_list":["post-13949","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-optometry-billing-services","tag-claim-denials","tag-cpt","tag-evaluation-and-management","tag-hcpcs","tag-modifier-59","tag-ncci","tag-optometry-billing-2","tag-optometry-billing-and-coding-services","tag-optometry-practice-collection","tag-optometry-practice-collection-tips"],"yoast_head":"\r\nHow to Increase Your Optometry Practice Collection?<\/title>\r\n<meta name=\"description\" content=\"Enhance your optometry practice collections with these expert tips. 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