Improve Optometry Medical Billing Collections

1
(No Transcript)
2
Improve Optometry Medical Billing Collections
An optometry practice has also the same agenda
as other small businesses you want to succeed.
To achieve success in business is one that
focuses on growing revenue while providing
excellent experiences to their customers. Here,
customers are patients. Improving optometry
medical billing collections is a vital strategy
to achieve financial stability.   Suggestions to
Improve Optometry Medical Billing
Collection Verification with the Insurance
Payer One of the initial steps in optometric
medical billing is to ensure that the provider
has been credentialed by the insurance
company. You need to make sure to submit and
track credentialing applications based on the
insurance plan requirement. Take your application
one step further and follow up with insurance
payers regularly to ensure that the providers are
enrolled in the network whenever enrolment is
open. Read more The time has come to get
credentialed first!
3
Improve Optometry Medical Billing Collections
Correct use of Modifiers Many optometrists use
to bill a CPT code 92133/92134 and fundus
photography CPT code 92250 on the same visit.
If you do not code this correctly then Medicare
may deny both codes or only allow payment on the
code with the lowest reimbursement. 92133 and
92134 are subject to Medicares Multiple
Procedure Payment Reduction (MPPR). This reduces
the allowable for the technical component of the
lesser-valued test when more than one test is
performed on the same day. CPT Code
92133 SCANNING COMPUTERIZED OPHTHALMIC
DIAGNOSTIC IMAGING, POSTERIOR SEGMENT, WITH.
INTERPRETATION AND REPORT, UNILATERAL OR
BILATERAL OPTIC NERVE. 92134. SCANNING
COMPUTERIZED OPHTHALMIC DIAGNOSTIC IMAGING,
POSTERIOR SEGMENT, WITH.   CPT codes are
published by the American Medical Association
and consist of three types or categories of
five-character codes and two-character modifiers
to describe any changes to the procedure.
4
Improve Optometry Medical Billing Collections
NCCI edits prevent bundling/unbundling due to
incorrectly using CPT procedure codes
and HCPCS billing codes, including combining
inappropriate code combinations. A revised annual
version of the National Correct Coding Initiative
Policy Manual for Medicare effective January 1,
2021, was posted December 18, 2020.   While the
NCCI edits do permit the use of a modifier for
OCT/GDX and fundus photography, be cautious and
use a modifier properly, or it may result in a
denial or rejection. It depends on local
policies, if tests are necessary due to 2
separately recognizable conditions, you may be
able to link the suitable diagnosis code to each
CPT and addition of modifier 59 to the second
procedure. Stay Updated To make sure you are
coding your eye care claims properly and
error-free, you must remain careful with Local
Coverage Determinations (LCD) and Medicare
Administrative Contractors (MAC) in your area and
sign up to receive payer listserv updates.
5
Improve Optometry Medical Billing Collections
Doctors of optometry and their staff need to be
prepared for substantial changes in 2021 to
optometry coding and documentation for evaluation
and management (E/M) services. Starting Jan. 1,
2021, E/M codes will need to be selected based on
what is more appropriate medical decision-making
or total time, not a patients history and
physical. Use an ABN for Non-Covered
Services If you are unsure that the procedure or
service you will provide to the patient may not
be covered by commercial non-Medicare plans or
original Medicare and the patient may be
responsible for out-of-pocket costs, get an
Advance Beneficiary Notice of Noncoverage (ABN),
Form CMS-R-131. In this case, the patient must
sign the ABN before you provide the procedure or
service to the patient. Do you have a lot of
paperwork burden? Keeping up to date with
confusing and never-ending optometry and
ophthalmology billing rules and regulations,
payer requirements and complicated EDI processes,
and managing denials and rejections is
time-consuming. Ready to outsource to a leading
medical billing company?
6
Improve Optometry Medical Billing Collections
You will see increased ROI when you outsource
eye care billing to Medical Billers and Coders
(MBC). We will help you to get started. Reach out
to us today, we are just one form submission
away.