Optometric Billing Tips to Avoid Claim Denials

Your practice relies on insurance claims to generate revenue. However, common errors are resulting in denied claims, wasted time, and lost revenue. It’s time to be proactive about your claim management and maximize reimbursements for your patient visits.

Having to rework denied claims and resubmit them is only adding to the claims that your optometric billing manager has to submit. With a few adjustments to the office workflow and the right technology, you can focus less on reworking denials and more on submitting your claims right the first time. Read on to see what steps you can take today to stop being denied.

3 Proactive Steps to Avoid Claim Denials

Review Patient Eligibility Before the ExamDiscover 3 optometric billing tips to maximize your claims reimbursements

A lot of things can go wrong when you don’t review the insurance eligibility before the exam. By checking a patient’s eligibility using an automated eligibility system, you can immediately reduce denied claims by making sure the patient has insurance, the payer covers the services, and the payer supports the frequency.

More importantly, when you check the benefit eligibility prior to the exam, you can notify the patient up front what their financial responsibilities will be. This will help you avoid angering the patient with a bill they weren’t prepared for. 

Prioritize Your Claims

Prioritizing your claims will help you focus on submitting the claims with the shortest claim filing timeline to reduce the chances of receiving a denied claim. It’s important for your optometric billing manager to continually review rejected claims and payers’ timely filing guidelines to help determine what claims need to be worked first.

Review Your Reports

Reports on your claim submissions may be offered by your clearinghouse provider or by your revenue cycle management provider, however, if you’re not regularly reviewing the reports, then you don’t know where common pain points in your claims process are. Review your claims reports to identify the time it takes for a payer to accept a claim and your monthly denial rate. With these reports, you can adjust your timely filing guidelines and discover ways to improve and correct common denial reasons.

For more tips on how to avoid claim denials, download the "Top 7 Reasons for Denied Claims" ebook.

Get Your Guide to Common Claim Filing Denials

Editor's Note: This post was originally published on October 25, 2016. It has been updated for relevance and richness of content on January 15, 2019
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