Everything About Optometry Billing Services

Maintaining the revenue cycle and striving to maximize it can be a struggle for optometrists.

Medical billing is complex and requires effective handling to improve the workflow and bottom line.

Just like any other medical specialty, optometry medical billing also suffers errors in coding and denial of claims.

Even though medical billing is a systematic process, the scope for mistakes and missing details is high. As a result, healthcare providers need expert optometry billing services to deal with all the challenges effectively.

For optometrists, understanding the nuances of medical billing is vital to further handle the administrative process.

That is why in this blog we will go through optometry medical billing and learn how optometrists can improve their revenue cycle management.

Shortcoming in Optometry Medical Billing that Cause Denials

Medical billing and coding are not simple, and this is the reason that healthcare providers opt for optometry billing services.

From manual errors to denials and faulty management, the list of shortcomings is long. Other than that, there are frequent changes in rules and guidelines that require attention as well.

Let’s go through some significant drawbacks that cause denials in optometry medical billing:

Insurance Coverage Expiration

Usually, there are medical services that are not included in a patient's coverage. However, there are times when a patient’s insurance expires.

Both cases are not ideal for healthcare providers as they lead to denials. This highlights the need to thoroughly verify insurance coverage for ensuring accurate claim filing and zero claim denials.

Absence of Prior Authorization

Taking prior authorization from insurance companies is a way to determine a patient’s benefits.

If healthcare providers fail to carry out this step, then the repercussions can be revenue-damaging. Prevention of denials due to the absence of prior authorization is not advisable for optometrists.

Errors in Patient Information

Patient information is a major part of claim filing, even the slightest mistake can lead to denials.

First, the patient information is recorded and then documented for medical billing. After that, this data is converted to appropriate codes and pushed further.

Apart from this, healthcare providers must also ensure the safety of patient information and protect it from misuse. For this, they must follow regulatory HIPAA compliance for the protection of patient data from unauthorized use.

All this brings attention to errors in patient information and healthcare providers must make sure that the data is correct.

Different Provider Network

Healthcare providers fall under different provider networks of insurance companies. It may happen that the healthcare provider doesn't come under the provider network like that of the patient.

To tackle this, healthcare providers must communicate with insurance providers and understand the terms and conditions.

However, a failure to take this step can hamper the reimbursement as it can lead to denials. That is why healthcare providers must not miss such a vital part of the process.

Duplicate Claim Submissions

Sending a single claim twice makes them duplicate and this results in the denial of claims. This happens due to negligence and is often caused by human error.

Healthcare providers must understand that such mistakes are a major drawback that leads to revenue leakage. Manual errors are common and a simple solution to prevent such mistakes is outsourcing optometry billing services.

Void Codes/Modifiers

It is undeniable that coding is vital to ensure that healthcare providers receive their revenue. Errors in coding are also a major issue that medical specialties face while pursuing their administrative tasks.

In optometry, precision is required in mentioning modifiers too. Accurate codes and modifiers lead to acceptance of claims otherwise there is a claim rejection. This is vital to avoid denials and get complete remuneration.

Flawed Bundling

Bundling is a part of optometry medical billing as various medical treatments must be mentioned together.

As the medical billing for many procedures cannot be done individually, issues may arise in the claim management process.

Healthcare providers must know this detail and implement the same while carrying out the medical billing and coding process.

The above points are a testament to the fact that optometry medical billing is indeed very complex. Healthcare providers have a hard time dealing with the challenges and most of the time they face financial strain.

However, optometry billing services can solve these struggles and make the medical billing process effortless for optometrists.

They offer a range of medical billing solutions to all the hassles and improve the revenue cycle. With professional help, there is a significant shift in the results and healthcare providers achieve a sound revenue.

If you are an optometrist and medical billing is too complex for you then Eminence RCM can take your burden and maximize your revenue.

Optometry Billing Services – Eminence RCM

Eminence RCM is a medical billing company in USA, and we offer world-class medical billing services. Optometry billing services is one of our specialties and we provide customized solutions for your unique needs.

We work with a team of expert billers and coders, who make sure to not miss any details. We believe in precision and implement the same in the medical billing process. Our team takes care of every step in the medical billing process and optimizes for the best results.

Partner with Eminence RCM and get:

• Accurate Patient Registration
• Complete Insurance Verification
• Efficient Scheduling of Appointments
• Correct Coding
• Timely Claim Submissions
• Dedicated Denial Management
• Proper AR Follow Up
• Regular Analytical Reporting

Switch to medical billing expert and boost your bottom line while maintaining operational efficiency!