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Designing Medical Coding and Billing Practices to Improve Profitability of Your Optometry Practice

December 12, 2013

Profitability is often a much desired yet elusive state which most medical practitioners strive towards yet fail to arrive at without conscious planning. In alternate medicine like Optometry, where majority of procedures demand practitioners’ time, deriving a financially viable revenue cycle becomes an even bigger cycle. Therefore, it becomes even more important for Optometry practitioners to adopt effective coding and billing practices to attain short term and long term profitability. Following billing and medical coding practices can enhance the revenue generation capacity as well as profitability of your Optometry practice –

  • Adopting EMR – Electronic record of patient information and various billing practices makes the basis of an efficient billing system. Designing your Optometry medical billing on the strong foundation of EMR not only makes you eligible for Medicare rewards for meaningful use of EMR but also improves your billing efficiency too.
  • Updating coding changes – ICD-9, ICD-10 and HSPC coding in both primary and alternate healthcare are going continuous changes. Especially in Optometry, where recent reforms have included surgical procedures into the scope of Optometry, keeping track of CPT 9900 and 9200 codes are not enough to ensure correct medical coding. Thus to avoid any Medicare audits or malpractice claims, you must regularly update coding changes in your Optometry medical billing.
  • HIPAA compliance – Eye care records of patients are to be protected while storing and transferring as per HIPAA guidelines. In addition to assigning correct codes for diagnoses, evacuation and minor surgeries performed by an OD, medical staff must also pay attention to HIPAA compliance of all medical records maintained at the practice.
  • Conducting regular audits – Regular medical audits of your Optometry medical billing practices bring to focus errors as well as strengths of the system. These review audits also prepare your OD practice for surviving actual audits and avoid unwarranted costs.
  • Claim submission and follow-up – Medicare, Medicaid and other insurers follow distinctive claim submission and reimbursement cycles. Your Optometry practice must be aware of its payer mix and plan claim filing processes in line with pre-authorization and documentation processes of its insurance carriers.
  • Monitoring claim denials – Much of your financial losses can be reduced by effective monitoring of reasons behind claim denials and addressing them instantly. A profitable OD practice should not have a claim denial ratio of more than 4% and acquiring such stats requires constant focus on billing and claim filing procedures.
  • Customer service – Most malpractice claims in Optometry are triggered by customer dissatisfaction. With internet offering the ease of obtaining prescription glasses, OD practices have to start focusing on their services and customer satisfaction for ensuring long term profitability.
  • Staff training for billing – Lastly, training your medical staff to operate routine machines and administer regular procedures in addition to billing correctly, can save you a lot of time and improve overall efficiency of your Optometry practice.

Medicalbillersandcoders.com is an Optometry medical billing expert that can offer complete revenue cycle management services to your OD practice. RCM is an all comprehensive coding and billing practice that develops a system of generating consistent profitability for your practice.


Category : Best Billing and Coding Practices