Billing errors can be the cause of various financial problems at medical offices. If the errors are not caught ahead of time, providers can face issues like delayed payments, loss of revenue, costly fines and even uncalled for audits. Similar to other medical specialties, optometrists also need to review medical claims in a periodic manner for identifying common billing mistakes. For instance, up-coding patient visit is one of the most common billing errors that can lead to an audit.
Medicare / Medicaid Audits more likely
Apart from preparing for the ICD-10 coding system, optometrists also need to adapt to a series of activities for avoiding Medicare audits. This is because around 60% of patients walking in in an optometry clinic for availing medical services rely on Medicare coverage.
Since incorrect billing is considered fraudulent billing in case of Medicare / Medicaid audits, providers need to spruce up their optometry medical billing services. In such cases they are required to reimburse the insurance companies with additional paid amount which can pose serious threats to their revenue cycle. At times the said amount (if penalized) puts extra financial pressure on optometrists. Therefore, in order to avoid audits and re-payments, it has become important for providers to streamline their optometry medical billing services.
How Can Optometrists Avoid Audits?
Due to the rise in billing scrutiny, optometry practitioners need to ensure that their billers are not billing high, even if it is accidental. It has become important for the billing departments to take a methodical approach towards coding and billing.
Many optometry practices lack the time to train in-house billing staff or lack resources for hiring experienced coders and billers. Conducting periodical reviews also become a challenge as they have to keep attending patients and also comply with the other healthcare reforms. In such cases, they prefer outsourcing their optometry medical billing services to a third party such as MedicalBillersandCoders.com. Companies like MBC have a team of certified and experienced billers and coders who are well-trained in offering effective RCM solutions to different medical specialties.