Only with time can one become successful in optometry coding and billing. The optometry biller needs to know the difference between medical plans and routine check-ups. They must understand what is applicable in co-pays during a patient visit or how the deductibles will affect the fees. A successful optometrist service is only possible when the practice has efficient optometrist billing and coding services in place to ensure the revenue cycle management is flawless.
However, with the complex optometry billing and coding system, many practices have started losing money, eventually affecting patient satisfaction. But here is a brief guide on what your practice needs in optometry billing services to warrant uninterrupted revenue flow to improve such services:
1. Efficient Communication
Almost 90 percent of the claims denied in optometry billing can be avoided with a robust billing strategy, preventing common errors and mistakes. The practice needs to have an efficient and proactive billing team at the top of the game with the help of adequate training on the latest billing software and changing coding rules and regulations. The way to move forward is by establishing an easy-to-access communication platform for the staff across every space.
The platform should allow the staff members of the practice and the optometry biller to ask questions and get prompt replies. A chat app for the team can be put in place to share every announcement, update, and news to keep every practice member up-to-date with the latest optometry care, insurance, and billing developments and changes.
2. Use Common Modifiers
Many optometry practices come under the CMS radar and lose out on revenue because of misusing the optometry billing modifiers. The billing service in optometry must learn to use the correct modifiers, so they do not trigger an audit. If an audit finds fault with the optometry billing and coding, the practice can face a hefty fine, which can run up to $10,000 for every offense. Apart from that, mistakes will also result in claims getting denied, and the bottom line is a loss of revenue. The optometry coder must learn the correct modifiers and when to use them during the procedures.
3. Digitizing the System
In most cases, claim rejections and denials occur due to the mistakes made during the data entry. In the traditional method, the medical forms are filled out by the patients and given to the staff, who later transcribes them to the computer for sending to the insurance company for claim submission. Often when transcribing the details of the patients are entered wrong, the result is claim rejection and denials.
Digitizing the system where digital forms are used eliminated the possibility of wrong entry from paper to computer. Also, the repetition of the task is gone, and a single entry on the digital form can be used for prompt optometry claim submission.
4. Instant Messaging to Patients
Getting clarification about the insurance or scheduling from the patient can be tricky, mainly when the individual doesn’t receive the call and it goes to voicemail. Investing in software that allows messaging with the patient can be an easy way to clarify any queries about their insurance and remind them about appointments and other details. The messaging service also reduced billing errors while enhancing the patient experience.
5. Insurance Verification
Before the patient comes in for a visit, the optometry billing service needs to get the details about their insurance when they make the appointment. The optometry biller needs to get up-to-date information on the insurance status, verify the details and understand the covered services. Hence, there are no anomalies when claims are submitted. Suppose any issues arise during the insurance verification. In that case, the optometrist billing service can leave a message with the patient so the problem can be resolved before the visit to the optometrist.
6. Understand Common Mistakes
Even the experienced optometrist biller can get their claims rejected or denied, but understanding what caused the denial is the way to ensure the payment is received. Typically, the claims are dismissed under three categories – clinical, administrative, and policy. It has been estimated that while 90 percent of claims are preventable, 63 percent are recoverable. By focusing on the mistakes that cause the denials, one can rectify them by using the latest software and ensure faster payment.
Partner with an Experienced Optometry Billing Service Provider!
The easiest way to ensure that your optometry practice is never losing money and can give the hundred percent care it wants to provide to the patients is by warranting there is no revenue loss. When you partner with an optometry medical billing team like 24/7 Medical Billing Services, your staff will be free to take care of the patient and not get overwhelmed with the coding and reimbursement issues. The optometry billing team will take care of it while establishing a smooth revenue cycle management.