Optometry billing can be a fast-paced and complex role that can seem intimidating at first. However, with a bit of preparation and homework, you can make a successful career out of managing an optometric practice’s electronic claims.
This post provides four tips to help a new insurance billing manager in the eyecare industry get up and running smoothly.
4 Tips For The New Optometry Billing Manager
Know The Lingo
Do you know the difference between a rejected claim and a denied claim? The first step in getting more confident in your new role as a billing manager is to get the vocabulary down. Knowing these important insurance and billing definitions can help you be more successful in the position and help you find what you’re looking for.
Stay On Top of Rejections
In the demanding role of being a billing manager, it’s common to let claim rejections pile up while you work to submit new ones through the clearinghouse. Unfortunately, as the rejected claims go unworked, the chance of them turning to denials increases, damaging the practice’s bottom line.
While managing the day-to-day of your insurance claims, prioritize the rejected claims so you can quickly rework them and resubmit them for payment.
Avoid Common Denial Reasons
There are many reasons why a claim can get denied by the payer. Fortunately, some of the more common reasons for a claim denial are avoidable. Getting familiar with the common reasons for a claim denial and knowing how to avoid them can help you become more successful in this role and will make your job less stressful.
Track Metrics
One of the downsides of optometry billing is that there’s often a lack of visibility into claim performance. This lack of visibility is bad for you as the biller because you’re unable to show your progress, and bad for OD trying to maximize practice profits through claim reimbursements.
Reports on your billing performance can reveal important information about the practice’s financial health and can be used to make meaningful decisions that grow the practice.
Read the ebook, “OD Growth Guide: 5 Essential Insurance Reports” to learn how to monitor these essential insurance reports to increase practice revenue and prevent denied claims:
- Denial Rate by Service Line
- Denial Count by Adjustment
- Processing Time Analysis
- Utilization Report
- Patient Responsibility