Optometric Billing Solution Showdown: Clearinghouse vs Revenue Cycle Management

Posted by Jeff Rezabek on Tue, Dec 06, 2016 @ 14:12 PM

A lot goes into generating revenue from insurance claims. The tasks required for an optometric practice to stay on top of their claims and guide each claim through the claim management lifecycle is a long, tedious, and error-prone process. However, even the best optometric billing manager can fall behind if they don’t have the right software or guidance. A small hurdle in the claim management lifecycle can snowball into more problems, a larger stack of unfiled claims, and more denials due to missed deadlines.

To assist in your claim management process, your practice needs to find the optometric billing solution that will help you maximize your reimbursements to make more money faster. To effectively work your claims, you have two options, selecting a clearinghouse solution or working with a Revenue Cycle Management service.

Identifying Your Optometric Billing SolutionbOptometric Billing Solution Showdown: Clearinghouse Solution vs Revenue Cycle Management

Clearinghouse

When it comes to claims management, most practices have ditched paper claims in response to submitting electronic claims in the insurance payers’ portal. But, even this can get cumbersome if you have to go to multiple payer sites throughout the day to submit and track claims. With claims management software, also known as a clearinghouse solution, you gain access to thousands of payers all within one dashboard and obtain the ability to submit, track, and work claims. Additionally, most clearinghouse solutions come with claim scrubbing and code checks to minimize the likelihood of denied claims.

The benefits of a clearinghouse solution include:

  • Control the billing cycle in house
  • Access thousands of payers from one location
  • Minimize claim rejections with claim scrubbing features
Revenue Cycle Management

If your optometric practice is struggling to effectively collect reimbursements due to challenges like high biller turnover rates, lack of transparency, and lack of capacity, you can hire a billing service to handle your Revenue Cycle Management. Revenue Cycle Management is the practice of completing all of the steps necessary to process a claim quickly and correctly, and there are services out there who will handle all of these steps for your practice.

The advantages of Revenue Cycle Management include:

  • The ability to scale quickly during season increases
  • A team of experts that is up to date on the latest claim filing trends and regulations
  • No payroll expenses or dependency on one person
  • Rejections, denials, and appeals worked quickly
  • Comprehensive reports available for transparency and insight into your reimbursement revenue stream
Are your claim management practices struggling to generate the revenue you expect? Download the ebook, Top 7 Reasons for Denied Claims, and learn what each denial means and how to fix it. 

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Tags: Electronic Claim Filing, Optical Software, Revenue Cycle Management