Generating revenue from your claim reimbursements needs to be profitable for your eyecare practice. But, managing the claim lifecycle is a difficult task, and many claim management practices are error-prone and time-consuming. The cause of many of the most common insurance challenges is a lack of tools, processes, insights, and resources. This post explores a few ways your practice can make fewer optometry billing mistakes.

5 Ways to Improve Optometry Billing in Your Practice

Use a Complete Clearinghouse Solution

Filing claims manually creates a lot of extra work and introduces avoidable errors. Errors like duplicate data entry, switching between payer sites, and using incorrect codes will only complicate your claim management process. Using a complete clearinghouse solution gives you access to thousands of payers from one location.

Gather Full Payer Coverage Information

Common reasons claims get denied are due to the payer not covering a service and the payer not supporting the frequency of services. The good news is that you can avoid this type of denial by pulling patient benefits at least two days before the appointment so you can address any issues.

Using an automated, real-time eligibility system from your clearinghouse or practice management system, you can check patient eligibility and review payer specific guidelines before the appointment. When you pull eligibility benefits, check to see if these services are covered, and if so, how frequently the payer allows the service to be performed:

• Routine eye exams
• Special visits and diagnostic testing
• Office surgeries
• Radiology procedures

Stay On Top of Timely Filing Guidelines

Claims can get out of hand quickly. When claims begin to pile up, rejections get neglected, and deadlines get missed. While timely filing deadlines vary between payers, it’s important to submit your claims as soon as possible and check rejections frequently.

Review Reports

Reviewing your claim management reports will give you a better understanding of how your practice is generating revenue compared to other eyecare practices in the nation and in your state. You can use information like monthly denial rates to uncover common billing errors and work with your optometric biller to correct the errors from happening in the future.

Some reports you’ll want to review include:

• Claim acceptance rate
• Monthly denial rate
• Monthly income

Get Help

Optometry can be a seasonal business. With an increase in traffic in the summer months and towards the end of the calendar year, you can expect your claim management practices to be more chaotic than the rest of the year. Although you can bring in more in-house resources to help carry the extra work, you can also outsource a billing service to supplement your revenue cycle management.

Looking to fine tune your claims management process? Download this eBook to learn which claim filing method might be best for your practice.