3 Best practices in optometry billing

There are huge benefits to applying best optometry billing practices, including the savings that come from efficient management, ensuring a steady income stream to allow for growth, and expanding and improving customer service.

And it’s important to remember that small billing errors can have a big impact, including financial losses.

At CECOP USA we offer members the tools and guidance to implement best optometry billing practices and get the best results for their practice.

And, as experts on the subject, today we’re going to analyze some of those best practices in optometry billing.

Person calculating the optometry billing

Use the right coding practices

To improve results at an optometry practice, it’s essential to use the right coding processes and it’s very helpful to have a tool like Weave for this purpose. It will help prevent billing errors and inconsistencies, which are some of the main reasons claims can be denied.

That can lead to fines and penalties, which can come at a hefty price. Plus, coding inconsistencies tend to be one of the main reasons insurance companies deny claims.

To use coding right, it’s essential to keep precise records on the specific Evaluation and Management (E/M) services the patient received.

Be careful with the modifiers

Someone at your practice needs to understand the CPT codes in-depth and stay up to date, being familiar with the latest editions of the National Correct Coding Initiative (NCCI).

It’s important to understand this system because, as we mentioned before, small errors in applying codes can lead to extra work that is a waste of time and can also lead to financial losses and unsatisfied customers.

And, speaking of claims, it’s also important to code them right, stay up to date and be very diligent with the local coverage determinations (LCD) of CMS and the Medicare Administrative Contractors (MAC) in the area. So it’s also a good idea to sign up for the payers Listserv.

In any case, at CECOP USA we advise our members on any coding doubts they may have. On average, we resolve 95% of issues within 48 hours.

Guarantee prompt payment

A highly recommended practice is to charge customers when they come into your practice, or even before, online. This gives customers clear, immediate information on how much they owe and what deductibles, coinsurance and copays apply. And, at the same time, it will put your clinic in a better financial situation and boost cashflow.

It’s also a good idea to send bills out well in advance of when they come due, in order to cut down on late payments.

Following up on claims denied

Payment denials, although common, are also an important problem for a clinic, as they are a waste of time and resources and a bother to customers.

Although most of these claims tend to work out in favor of the clinic and the payment is received in the end, the process is tiresome and best avoided.

As we’ve mentioned, it’s important to know how to use billing codes right so you don’t make these mistakes, but it’s also important to have staff that can follow up and keep an eye on claims in order to accelerate the process and limit any negative effects.

Checking suppliers

In addition to using the right codes, another highly useful practice to prevent denied claims is to closely check the insurance credentials of any suppliers you work with.

It is important to send and follow up on all supplier credentialing applications under the insurance plan requirements.

Regularly checking with insurance payers will help you make sure suppliers are credentialed and everything is in order.

These are some of the best practices in optometry billing. We hope they were useful and we invite you to keep reading our blog, where you’ll find more interesting information to help manage your practice.

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