Some Ophthalmology Billing Tips for Enhancing the Revenue of Your Practice

Your ophthalmology practice stays profitable by submitting clean claims and receiving prompt payment. However, anybody who has ever been engaged in the billing process for ophthalmology knows that it is a complex and complicated task. Ophthalmology billing is prone to mistakes, therefore if you want to streamline your billing procedure, you should consider using ophthalmology billing services. So, keep reading this article to get more information before hiring any ophthalmology billing company for your practice.

5 Ophthalmology Billing Tips You Should Know to grow your practice 

Make the best choice between E/M codes & eye codes

When it comes to billing for ophthalmology services, unlike doctors in other specialties, ophthalmologists can select two different sets of codes. Your billing becomes more flexible as a result, but it also causes uncertainty. Therefore, consider your payer's criteria, your examination components, medical necessity standards, and reimbursement rates for codes you're considering before making your decision. Consider these additional selection considerations to help you choose the optimal code:

For visits that have a medical component, use E/M codes. An eye code is the best option if the examination is solely visual and does not include any medical components.Verify your diagnostic code (s). Eye codes are more limited in terms of what diagnoses classify as medically necessary, and the precise codes might change depending on the payer. These limitations do not apply to E/M codes.Due to frequency modifications in eye codes, look up the patient's medical history. For instance, you can only use the billing code 92014 once per patient every 12 months. These frequency adjustments do not apply to E/M codes.Check payer policies. The paperwork needed for E/M codes is uniform across all payers, however, the documentation needed for eye codes varies.If everything else is equal (and you match the criteria for both an eye code and an E/M code), go with the code that offers the highest degree of reimbursement.

Get familiar with your payers

Ophthalmology billing criteria and coverage assessments differ between commercial payers and Medicare. Even within Medicare, each MAC will have a different preference for the supporting evidence they want and the way you should classify a bill. You must understand and abide by each payer's policies in order to submit clean claims.

For instance, Medicare mandates that you charge bilateral claims by including modifier 50 and a single procedure code on the claim. Other payers request that you list the procedure code once with the LT modifier and once more with the RT modifier on the next line. 

Reevaluate the billing reports for your patients

Even for people with excellent levels of financial knowledge and physical health, medical billing statements are notoriously difficult to understand. If your statements aren't clear, concise, and easy to understand, even people who can pay will "deal with it later." This will result in more days in A/R for you and more frustrated (and less satisfied) clients. 

Try the following strategies for billing statements that pay:

Explain services in simple terms. Avoid using codes and medical terminology. Patients want to be completely aware of what they are paying.The layout should be simple, with lots of white space and a wide sans-serif typeface. Eliminate any extraneous language.Include specific instructions that outline the patient's obligation to pay 

Fix claim errors and rejections as received

Errors do occur, but if they are immediately corrected, they will have far less of an impact. For prompt corrections, adhere to the following guidelines:

Resubmit your claim after responding to any claim denials that you receive.

Establish a mechanism for handling rejected claims as soon as possible; timely submissions may still be relevant.

Know how you'll respond to requests for transmitting medical records or other information. The claim can be processed more quickly the sooner the information is supplied.

Do you want to maximize the revenue of your practice?

If yes, then a professional ophthalmology billing company such as Medcare MSO can assist you. We decrease claim denials and rejections by employing the most effective technological solutions and the latest billing software. Therefore, contact us to learn how we can increase your revenue collection with our excellent ophthalmology billing services.