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Florida Optometry Practices observe 30 percent growth in their revenue after partnering with MedicalBillersandCoders.com

Florida, labeled as the "Sunshine State", is one of the most densely populated of the US states. Due to its refusal to participate in providing coverage for the uninsured under the ACA, popularly called Obama Care, not just patients but also many Florida physicians have been facing a financial crisis – not being paid for services rendered to patients who may not have had insurance coverage for their ailments. Florida has around just under 25 percent uninsured i.e 3.8 million people, which can be disadvantageous to both healthcare improvement and physician reimbursement.

Further, compounding the already complex claims process, recently, a Florida-based physician practice specializing in pain management was ordered to pay the Federal Government $7.4 million after it was determined that the group's physicians were ordering medically unnecessary drug screens and billing Medicare for those tests. Dr. Scott stated, "Documentation is the need of the hour and the patient medical records did not even reflect the need for more extensive testing". Another physician Dr.Richard, working at one of the hospitals in Florida, stated that, "There are disagreements with respect to "balance billing' and blamed balance billing disputes on payers that demand allegedly unsustainable reimbursement rates".

Sunshine State's blinding problems

Physician reimbursement rates are thus dropping, and specialty healthcare providers like optometrists in Florida too were an unhappy lot. Many Optometrists have pointed out that, "Many people have difficulties accessing optometry services because they can't physically get to the places where optometrists see their patients and medical care for conditions related to eyes should be legally included in healthcare".

According to optometrist, Dr.John Day, "The insurance access to care is a big issue & percentage of patients that have health conditions, such as diabetes and hypertension, often have secondary effects for the eye. The leading cause of blindness can be from diabetic retinopathy for certain individuals. Glaucoma is undetected by just a screening".

Many such optometrists approached MBC services to help streamline not just their billing & claims process but also for help in the verification and eligibility of insurance coverage of their patients. According to Dr.John Meyers, "Even a small spelling mistake in the name of a patient, and another who changed their address, led to our claims being denied. Half of our staff then gets busy in the follow up appeals, causing a backlog of claims and more denials. Keeping up with Medicare compliance rules & regulations and changes in coding is taking a stress on our practice".

MBC spokesperson, Darci Hess stated, "We got calls from a number of optometrists and the discussions usually centered around not just our depth and breadth of knowledge but how we could improve their revenues. Part of their worry centered around A/R collection rates and if we could comply with the less than 30 days rule. What was our success rate in handling claim denials and errors, and what was our follow-up practice was their main concern".

Insurance coverage and payers demands, coding problems, healthcare reforms, all add up and tracking such changes on a daily or even monthly basis leaves no time for most Florida physicians to focus on the health of the patients. And given their unique status from not accepting Federal funding can cause a hitch on the kind of patients they can treat- causing more of a health problem in the state than anticipated. Moreover as Baby Boomers get older, and the need to reduce their exposure to UV rays and their effects in the Sunshine state, optometrists will soon have many more such patients to deal with. Streamlining their billing process becomes crucial against this scenario of healthcare reforms and complex operational processes.

There is thus an urgent need to focus more on the patient needs and let the operations such as coding & billing, insurance verification & eligibility & Claims & denial management be handled by professionals who have the expertise and knowledge with respect to knowing the rules, what codes to be employed and when, and especially have a trained and professional staff to handle any queries by both patients as well as physicians and conduct checks. Meeting compliance and avoiding audits also helps ensure a healthy RCM process when you let experts handle certain operations within your specialty practice.

MBC expertise

MBC has been practicing in Florida for many years and understanding of the state and its local rules & regulations is something they can handle and navigate, keeping in balance with the Medicare requirements. MBC tailors solutions to suit its clients, analyzing the problem areas that enable the core team to offer precise responses and action to take in order to not just increase reimbursements, but ensure proper documentation of medical records & diagnosis in case of denials.

MBC is best placed to handle Optometry billing services because they are known to implement strategically tested workflows and processes to reduce errors and thereby shorten A/R days. Their commitment to boost profitability, ensure timely and accurate documentation for coding and billing cases, and adequate revenue cycle staffing, and manage denial management is something to be reckoned with in Florida.

About MBC

MBC has a vast experience of over 16 years, and is one of the leading billing and coding service providers in US. Focusing on integrated revenue flow and fixing revenue leakages for physicians in US, MBC has achieved success in the venture. With a presence in all 50 states, and possessing expertise in more than 40 specialties, MBC has been able to assist physicians across US, irrespective of the location and specialty. This has given MBC leverage over other medical billing services, making them one of the foremost Billing & Coding & Denial management services in the country.

We would love to hear from you and offer tailor made solutions to the whole gamut of RCM issues faced by your practice.