Using Revenue Cycle Management Reports To Prevent Audits

Posted by Jeff Rezabek on Thu, Aug 03, 2017 @ 15:08 PM

The eyecare industry is heavily regulated with rules that help improve the quality of care a patient receives from your optometric practice. While these rules are in place to protect a patient, they can also cut into your revenue. Even worse, the stress of choosing the right procedure code, avoiding an audit, and the frustration of an audit could affect your decision-making and impact the quality of care you administer to patients.

In this post, we explore how a utilization chart, available with the Insurance Revenue Cycle Management service offered by VisionWeb, could affect your optometric practice.

How Utilization Charts Can Improve Your Revenue Cycle Management

What Are Utilization Charts?Using a revenue cycle management service to provide utilization reports to prevent audits and increase payment.

Many times, the optometric billing manager in your practice doesn’t have the tools, data, and time required to create revenue reports based on claims management activities. However, gaining this insight could make it easy for you to avoid an insurance audit, help you earn more money, and give you the information you need to grow an effective optometric practice.

One important report to focus on your optometric practice is the utilization chart. Utilization charts inform ODs the frequency they perform a test compared to their peers across their state and nation. This is valuable because insurance companies use this information to identify test frequency that’s higher than normal to trigger audits.

Using Utilization Charts To Avoid Audits

Being able to read the data in a utilization report is important because it could help you prepare for an audit if your chart indicates that you’re performing tests more frequently than your peers across the nation. It could also help you identify issues in documenting procedure codes and using the guidelines for the code. If there is a problem in your documentation, you can work to correct the issue before an audit is triggered to improve your claims reporting process and enhance patient care.

Using Utilization Charts To Increase Revenue

The utilization chart could also reveal if you’re performing a test less than the national or state average. If you’re performing a particular test less often than the average, it could be a signal that you’re under utilizing some of the instruments in your optometric practice and could potentially use them more often to enrich patient care and increase revenue.

Discover other ways reports could help you increase your revenue by downloading "The Definitive Guide To Making More Money On Claim Reimbursements."

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Tags: Tips & Tools, Electronic Claim Filing, Revenue Cycle Management