An optometry medical practice requires a steady flow of revenue to grow and expand, like any other business. You can determine the success of an optometry practice by the level of patient care provided while still improving the revenue. To achieve this, it’s imperative to manage all optometry billing and coding efficiently.
Bear in mind that any sort of billing errors like wrong code input might lead to financial loss and stunt your billing collections. The most efficient way to avoid such errors is to check the latest optometry billing practices that other optometrists are following and exchange ideas. This will help you learn accurate and optimal practices that will boost your reimbursement rates.
Improving collections is an essential strategy for revenue growth for any business including an optometry practice. Having a healthy bottom line determines a better financial path for an eye care business. If you are also facing issues in billing and want your business to thrive, you’re at the right place. Here are the best optometry billing tips.
Stick to Optimal Coding Procedures
To get the maximum benefit from optometry billing, it’s essential to use appropriate coding. This can be achieved by keeping accurate records of specific Evaluation and Management (E/M) services that the patient received. E/M is a category of CPT codes used for billing.
Errors or inconsistencies in these codings are one of the main reasons for claims getting denied. This can attract penalties and fines, leading to serious financial losses. Following an efficient billing and coding solution will ensure that proper coding procedures are being implemented to get the best returns.
Be Careful with Modifiers
Speaking of codes, some of these cannot be used together on the same day. Medicare might deny reimbursement claims if these codes appear in a claim. Or it may allow payment on the code that has the lowest reimbursement. It’s best to familiarize yourself with the use case of CPT codes to avoid such errors. To do so, it’s best to refer to National Correct Coding Initiative (NCCI) Edits.
If two such codes need to be mentioned for different tests on the same visit, it’s a must to apply a modifier to one of these procedures. A modifier is a tool to help optometry practices describe a procedure more appropriately to ensure payment for it. Without a modifier, the claim might be rejected or denied.
Follow Up on Denied Claims
The worst-case scenario for any optometry practice is to see a claim marked denied in their inbox. The process of tracking down why the claim was denied in the first place is quite cumbersome and not something to look forward to. To prevent denials, optometry businesses must educate themselves on the common factors that cause denials.
The good news is that on average, around 90 percent of denials are avoidable and two-thirds of them are recoverable. While the process of tracking down the reason for denial is frustrating, the longer you sit on it the harder it gets to recover the most amount or any at all from the likes of Medicare or Medicaid.
In case of a denied claim, regular follow-ups with the insurance company will help you maintain an optimal revenue flow. Regular follow-ups help in resolving all outstanding balances efficiently. Thus it’s necessary to keep up with the follow-ups to enhance collections.
Ensure Timely Settlements of Payments
To increase cash flow, it’s best to set up an upfront collection process. Some patients have insurance that includes deductibles, coinsurance, or co-pays. It’s best to leverage online payment from such patients during the check-in itself or before they leave your office. This will not only speed up your collection process but also add to the patient experience you provide.
Thus upfront collection during check-in will simplify it for the patient and also ensure timely payment to maintain a healthy revenue stream for the practice. Also, with a seamless collection process, the practice will save a ton of time and effort. You can also send invoices long before the due date to reduce accounts receivable delays, and late payments.
These are the best tips to improve optometry billing and boost collection for an optometry practice. The bottom line is that for a practice to be financially viable and stable, it’s important to have a strong claim settlement ratio. Therefore ensure that you have an efficient and effective billing process in place.
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