Whether Optometry or any other medical discipline, billing and coding need to be handled well in order to improve revenues. Hence, optometric medical billing services are no exception when it comes to accuracy in billing and coding, which needs one to be an expert in coding guidelines, use of modifiers, conventions and well versed with several difficult terminologies related to optometry. Being well informed in all these areas makes one handle medical coverage, justifying the need for a particular service provided, or diagnosis and course of treatment prescribed.
With new technologies being introduced for various optometric tests, it is indeed challenging when it comes to interpreting and reporting the need or justification for such a test. In order to fulfill such a requirement, every minute detail that starts from the prescription to the plan of treatment the test indicates need to be meticulously documented in a patient's treatment records. Important points to note here include:
It is important to optimize revenue management system so that it is geared to handle the challenges present in today's coding and billing scenario. The process needs to be scrutinized and assessed to locate revenue leakages, if any.
It is important to implement a system that is driven by medical protocol, which can be achieved through development of clinical paths that generate maximum revenues for every single diagnosis. Keeping abreast of the latest submission guidelines and requirements or various carriers is equally important. Initiatives taken for eliminating denials helps with enhanced and uninterrupted revenues.
There may be instances where the primary insurance of a patient may not cover the entire cost of the service extended. The logical step then would be to bill the secondary or tertiary insurance of the patient, and it is important to understand the difference.