4 Claims Management Lessons Learned

Posted by Madhu Singh on Thu, Jul 05, 2018 @ 10:07 AM

Being in the industry for almost 20 years, you pick up a few great learning lessons from clients, optometrists, software specialists, and other eyecare industry experts. We combed through the common mishaps ODs have with their insurance claims and saw four key bits of information that they learned on the way.

From talented optometric billers to comprehensive software, you can get a handle on your claim management with the right resources. Save yourself money, time, and headaches by reading the lessons we've learned from our claim management mistakes and triumphs. 

Take Control of Your Insurance Claims with These 4 Tips

Claims Management Lessons Learned PictureClaim denials aren't the end of the world.

Experiencing denied claims requires you to examine your claim performance through metrics and reports to see why you're being denied and how you can better optimize your management efforts. Improvement and learning from mistakes is invaluable progress for any eyecare practice. 

Especially if you are seeing the same mistake multiple times, it's good to figure out if it's an error with your claim submissions, the biller, or a case-by-case situation. The most common reasons that claims get denied are lack of insurance, late filing, duplication submissions, the payer doesn't cover he service, bundled payment, termination of coverage, or the payer doesn't support the frequency of service. If you're experiencing these reasons for denial, you can learn why, fix them, and your practice will become more resilient.

Clearinghouse solutions can increase revenue in the long-term.

Are you still managing your claims manually? Put away the paper claims and switch to electronic management. You or your optometric biller could be more productive and less error-prone with a complete clearinghouse solution that gives you access to thousands of medical insurance payers, online claim tracking, and batch claim uploading in one space. Having all your claim management processes in one solution means fewer errors before you submit the claim and more revenue from reimbursements. 

With a clearinghouse solution, your biller can also easily keep an eye on rejections so that no claims go unpaid. Also, streamlining the billing process can give your biller more time to analyze reports and think of ways to innovate their process.

Cheap billers aren't worth it.

A large portion of the claim management responsibility rests on your optometric biller. Although affordable billers are tempting, especially if your optometry practice is new, it almost always pays off to go with a more experienced candidate. Experienced billers will end up paying for themselves through the money they save your practice. They'll have a deeper understanding of insurance companies, coding, and may align better with your practice's goals. They're also well versed on filing guidelines so that you don't have to worry about missing deadlines for each payer.

Always be looking at your reports.

When all is said and done, you'll need to make sure you're on the right track year over year with meeting deadlines, reducing errors, and increasing your monthly income. You should be examining claim reports to see how your claims are progressing and if you need to optimize your process.

If you're using VisionWeb's Revenue Cycle Management service, it will automatically be generating reports for you. These reports can help you increase revenue through successful claim reimbursements.

Check out our eBook below to see how you can use our products to generate more money on your claim reimbursements.

Download Your Guide 

 

Tags: Revenue Cycle Management, Electronic Claim Filing, Practice Management

Looking for tips to grow your eyecare practice business? Read on!