Some optometric practices seem to have no problem managing their insurance claims and maximizing their claim reimbursements. However, most practices aren’t leveraging their strategies for reducing billing errors and making more money from claim reimbursements.

Below are some of the strategies that a successful optometric practice utilizes to increase revenue from their insurance claims.

How Successful Optometric Practices Make Fewer Billing Mistakes

They Use A Clearinghouse Solution

Duplicate data entry, switching between payer sites, and calling individual payers creates a lot of extra work that complicates the claims management process, which can create costly errors. Successful billing managers take advantage of a complete clearinghouse solution, such as TriZetto, to gain access to thousands of payers from a single location.

They Pull Benefits Early

There are many reasons as to why a payer will deny a claim. Fortunately, most of these reasons can be avoided just by pulling the patient’s eligibility earlier. 

Pulling patient benefits early using your clearinghouse solution or practice management software can give you insights into the patient’s full coverage information and will help you reduce common rejection reasons. Common claim rejection and denial reasons avoided by pulling patient benefits early include:

• The payer doesn’t cover the services
• The patient is uninsured
• The patient’s coverage has been terminated
• The payer doesn’t support the frequency of services

They Review Reports

Running and reviewing your claims management reports will help you make decisions that will earn you more money from your claim reimbursements. Successful optometric practices owners know that if they want to improve, they have to stay on top of their reports to ensure that they aren’t below industry averages. With reports, you can identify your practice’s common claim denial reasons so you can address and avoid them in the future. Some of the common reports a successful optometric practice will run for their claims management efforts include:

• Claim Acceptance Duration
• Monthly Denial Rate
• Monthly Income Comparison

They Leverage Revenue Cycle Management Services

Managing a high-volume of claims in your optometric practice is challenging. The claims lifecycle is complex, and with the other challenges of managing a successful optometric practice, managing claims effectively can seem impossible.

Many successful optometric practices leverage the help of a revenue cycle management service to file claims, work rejections, and track metrics so they can shift their focus to delivering quality care and achieving patient satisfaction.

Download "The Definitive Guide to Making More Money On Claim Reimbursements" for more tips on how you can increase profits from your claims.