Tips To Improve Ophthalmology Billing And Collections
How
would you explain the word 'efficient'? It can be defined as giving minimum
expense or effort to achieve maximum productivity. In the field of
ophthalmology, having an efficient ophthalmology billing and collections
practice will help the facility enhance the patient's experience. It would mean
reducing the wait time for the patients, having easy claim policies, and not
having to repeat the information to the patients, staff, doctors, or other staff
members. Though an efficient practice is
vital for the successful running of the hospital, effective ophthalmology
billing services are essential for your practice and the patients.
If
you are wondering why efficient ophthalmology billing and collections are
essential for your practice, consider the following:
Ø You
would not want patients to churn due to claim rejection or denial because there
have been reporting errors on your part.
Ø Frustrated
and dissatisfied patients would give negative reviews, which would mean a
decrease in practice and loss of revenue.
Ø Delayed
claim approval means slowing down the revenue flow
Ø Missed
claim file deadlines mean unrecoverable claims, thus not getting paid for the
services rendered.
Unless
you have an efficient ophthalmology billing and coding system in your practice,
you are moving toward revenue loss.
So,
what can be done to improve your ophthalmology billing and coding along with
100% collections? Here are some tips that can make your practice efficient with
proper ophthalmology billing and collections:
1.
Check with the insurance company
When
a patient contacts you for services, the first step is to verify whether the
provider has a license from an insurance company. You must check the file and
follow the guidelines given by the insurance company for the plan for the
provider. Take a step further, i.e., contact the insurance company to check
whether the provider is covered within the network to ensure you get paid for
the ophthalmology services on time.
2.
Using the Right Modifiers
Often
by mistake or just to get paid more, ophthalmology practices use CPT codes such
as 92133 - 92134 and the CPT 99250 - the fundus photography code used for a
single visit billing. All this would result in denying the codes and the claims
or paying for the code with the lowest reimbursement rate by Medicare or other
insurance companies.
Since
there are three categories of codes, which have five characters and modifiers
with two characters that describe the changes in CPT codes procedures as
published by AMA (American Medical Association), it
is essential to use them correctly. While under-coding will cause a loss of
revenue, over-coding can bring in the medical governing bodies to investigate your
practice for fraud. Hence, the importance of using correct codes and modifiers
for ophthalmology billing and coding cannot be over-emphasized.
3.
Stay Updated
Monitoring
the Medicare Administrative Contractors (MACs) and Local Coverage Determinations
(LCDs) updates should be closely monitored when it comes to coding the claims
for ophthalmology. It would ensure no errors in the coding, as it will help you
stay up-to-date with the payers' list.
Staying
prepared for the changes in the ophthalmology coding and documentation rules
and regulations for evaluation and management (E/M) is vital for every ophthalmologist
and the staff of a facility. In fact, part of the ophthalmology billing and
coding would require you to select the E/M codes that are appropriate instead
of the physical examination of the patient's history.
4.
Practice on-time Settlement
Checking
whether the patient's insurance plan is based on deductibles or co-payments is
a must. Using an online form for the payment option for the patient at the time
of enrolling would allow you to incorporate on-time payment settlement. The
process will help in speeding the admission process and enhance the patient's
experience. It will also warrant timely payment without hassle for the services
rendered, thus improving the revenue flow.
5.
Choosing the Right Billing Plan
In
ophthalmology, it is common to come across patients with an insurance plan with
both health and vision insurance. The process of selecting the right plan for a
patient can be challenging. An efficient ophthalmology practice would
understand both the plans when the patient makes an appointment and before
their visit. Next, select the plan and bill it based on the medical diagnosis
of the patient and their chief complaint.
6.
Better Collection Process
Any
ophthalmology practice should have a well-established and defined collection
procedure. It would require the practice to collect the patient's information correctly
and verify it. Training the staff to conduct every step correctly and confirm
it is essential. It will also allow you to identify if there are any
deductibles or co-pays upfront, which will save time in collection and create a
maximum reimbursement.
7.
Finding the Right Billing and Collection Partner
It
can be challenging to go through the collection of patient information, verify
them, keep up-to-date with the codes, and train the staff with the latest rules
and regulations. The best way to ensure efficient ophthalmology
billing and collection for practice is by partnering with the correct ophthalmology
billing and collection partner. 24/7 Medical Billing Services is one such outsourcing
ophthalmology billing services that guarantees maximum reimbursement for the
services rendered.
About
24/7 Medical Billing Services:
We
are a medical billing company that offers ‘24/7 Medical Billing
Services’ and support physicians, hospitals, medical institutions and
group practices with our end to end medical billing solutions. We help you earn
more revenue with our quick and affordable services. Our customized Revenue
Cycle Management (RCM) solutions allow physicians to attract additional revenue
and reduce administrative burden or losses.
Contact:
24/7
Medical Billing Services
Tel:
+1 888-502-0537
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