May 02, 2016
The best way to augment output and revenue in any healthcare profession is to handle billing and coding proficiently. This holds true with Optometry Revenue Cycle Management (RCM) as well. Optometry billing services should be able to transition into revenues earned. It is in the top five independent professions in the US. Increasing revenues in optometry implies complete and thorough knowledge of billing and coding structures like modifiers, codes, principles, guidelines, and optometric terminologies. The demand for optometry services is increasing by the day with locations in more than 6500 communities in the US. Due to this geographical spread, there are more optometrists than other eye care professionals and people wearing lenses or requiring eye care almost takes up half the population of US.
Optometry billing is diverse and deals with intricacies. It requires billing professionals as Medicare has separate guidelines which they should be aware of. For appropriate Optometry billing, a number of questions are taken into account such as services provided and the amount collected per year, number of providers and insurances, fee structure to be followed, and codes used (local or standard CPT). It also ascertains the medical necessity of the service provided to the patient which should be in line with the medical issue stated by the patient, along with conducting tests after the complete diagnosis and not just on the basis of symptoms. The complexity of the patient's history, the illness and the diagnosis is denoted by the last number of the codes. As the claims are based on documentation, it has to be aptly recorded.
Importance of EHR & EMR-
A great way of optimizing optometry RCM is to embrace EHR and EMR systems as part of the optometry practice. Specially designed Electronic Health Records (EHR) systems simplify workflow by means of lesser paper work, enhance patient flows with higher concentration on their care and improvement, and encourage a healthy expansion in the practice. These EHR systems include ePrescribing, scheduling, optical point of sale and billing. EHR should also include PQRS codes and make an addition to each visit automatically. PQRS codes are the finest ways to report all documented measures.
Other practice management solutions like EMR (Electronic Medical Records) augment profitability and enhance services like integrated eye exams codes and vision testing device, digital pen solution for eye exams, financial systems integration, automated reminders through emails and calls, incorporation of vision testing devices, optometry forms, quick charts and optometry models, along with ensuring an assimilated optical point-of-sale system for glasses and contact lenses selling.
Increasing Demand of Eye wear-
Eye care and eye wear demand shall continue to grow in the future and are the most essential drivers of optometry practice. Increase in efficient services will enhance patient satisfaction, accurately capture the increase in rate of product sales and augment monetary returns. This plays a role in the RCM of the optometry practice.
Revenue Cycle Management