Revenue Cycle Management (RCM) Solutions for Optometry Physicians

Streamlined business solutions in the form of revenue cycle management and medical billing are hard to get. Optometry physicians, who run a small-scale business in their locality, are finding it difficult to manage their facility owing to the high costs of the in-house accounts department. However, while choosing RCM solutions is thing stands vital, which is Optometrist need to be observant.

Small to medium Optometry facilities should expect their IT vendors to add new revenue cycle management tools that will improve patient billing, as well as income cycle. However, physicians shouldn’t expect technology alone to solve all their problems.

Become an Observer not a Negligent

As an optometrist, it is your duty to be cautious when vetting RCM software, warn experts dealing in providing IT transformation services to medical facilities.

At the moment many physicians are struggling with disorganized medical billing and coding for Optometry that often contains errors. Doctors are looking for solutions for systems to simplify bridging the patient encounter with administrative data to streamline payment posting.

Implementing quality RCM systems and services are gaining a renewed sense of urgency. Optometry facilities are enrolling in programs like Medicare’s Quality Payment Program, including the Merit-based Incentive Payment System, as well as other pay-for-performance initiatives.  In such an environment, physicians are demanding specialty billing and RCM tools to automate financial processes and medical billing tasks.

Optometrists want a Complete Package

Typically, third-party vendors offer optometrist practices everything beyond the patient encounter. This includes scrubbing the codes, generating and submitting claims, and then posting the payment to the practice. In return, vendors ask for a percentage of the practice’s revenue, and for some practices that’s a very appealing offer.

However, this procedure comes with many challenges. Many times vendors and the facilities don’t communicate effectively and set the right expectations. In some scenarios, practices think if they do nothing beyond the clinical aspect of the patient encounter and leave the Revenue Cycle Management prerequisites to the vendor, they have no role to play. This in our view should not happen and leads to further financial issues.

Do remember that there are best practices that need to be followed to facilitate the billing process. For instance, there are coding processes and specialty billing tasks that need to be streamlined. This is done to ensure practices properly code items prior to the end of the encounter, which with the aid of the medical billing organization and their capabilities can be identified and continuously improved upon.

As an Optometrist, engage more deeply with optometry medical billing companies in an effort to improve efficiency, reduce costs and increase revenues, there are some vital strategies that practices can employ.

  • Learn from, frequently improve on and enhance your RCM solution. Keep in mind that the solution should reduce the amount of time for receiving payments on the services rendered.
  • Stay observant during an RCM implementation project. At the time of rendering RCM software, there may be minor areas or issues that could lead to catastrophic results.
  • Aggressively evaluate Revenue Cycle Management tools as there is a wide range of RCM systems in the market. Some RCM service providers are involved in mergers and acquisitions to enhance their RCM solutions.
  • If a vendor touts himself as having the ability to outsource a practice’s RCM system, the optometrist should find out exactly what processes the RCM service provider will address and take an informed decision about it.
  • Lastly remember, the revenue cycle is a multifaceted and multi-step process. It includes everything right from pre-registration and registration to charge capture and claim submission, collections, as well as an evaluation of the utilization of optometry billing guidelines.