Improving Medical Billing Procedures to Avoid Optometry Billing Malpractice Claims


optometry medical billing servicesOptometry has emerged as an alternate medical stream that is fast sharing the burden of primary eye care providers and offering increasingly specialized services. With healthcare industry undergoing consistent reforms aimed at bringing more and more patients under Medicare or Medicaid coverage, Optometry practitioners are experiencing an increasingly diversified payer mix. While this means increased profitability and long term financial sustainability for every Optometry practice, it also means an increased patient liability. Most Optometry practices are prone to malpractice claims because patients can’t perceive the true value of the services offered by an OD. More often than not, patients leave disgruntled due to erroneous diagnosis and dissatisfactory healthcare services. To avoid Optometry malpractice claims, the best way is to improve optometry medical billing services.

Optometry billing practices are based on some fundamentals that can dramatically enhance the productivity of medical billing services if fine tuned properly.

  • Coding and billing correctly – Biggest Optometry billing challenge lies in correctly assigning codes for eye disorders diagnosed. Optometry medical billing primarily deals with 9900 and 9200 CPT codes which pertain to diagnosis alone. As the scope of Optometry is expanding, OD practitioners are likely to employ more and more codes for varied procedure. This is where the chances of error increase as many a times an incorrect code can get assigned to diagnostic procedures. To avoid fraudulent billing charges and malpractice claim, therefore, it is essential to update your EMR database with coding changes regularly.
  • Updating and recording medical data electronically – In addition to coding, recording of patient data in the HIPAA approved format is equally important to save your practice from malpractice claims. Optometry medical billing is a niche and specialized area, wherein regular coding changes are rare and therefore difficult to track. Healthcare industry has adopted ICD-10 coding standards but majority of Optometry coding still happens with ICD-9 codes. Therefore, medical data recording has to be scrutinized and reviewed regularly to maintain proper patient database.
  • Filing reimbursement claims after scrutiny – Many audit actions and malpractice claims are triggered by incorrectly filed reimbursement claims. Hence, it is crucial to file for reimbursement with medical carriers after thorough scrutiny of billing and coding details.
  • Conducting monthly audit reviews – In addition to reviewing reimbursement documents, weekly and monthly audit reviews can dramatically improve the billing efficiency of your Optometry practice. You can not only identify recurrent errors in your Optometry medical billing but can also enhance the productivity of your revenue cycle.
  • Tracking patient satisfaction – Malpractice claims stem from patient dissatisfaction, which in turn arises due to insufficient attention to patient needs. Optometry services are predominantly diagnosis and evacuation based. They rely heavily on the OD’s skill and medical equipments available at the practice. Any gap in the delivery of care due to untrained medical staff or inefficient billing practices results in customer dissatisfaction and can cause malpractice claims at a later date. Therefore, Optometry medical billing should be based on a fee-for-value or a pay-for-performance model to provide best eye care to patients. is an Optometry medical billing expert that helps your OD practice in developing medical billing procedures that are compliant to medical reforms and protect your practice from any malpractice claims.

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