Improved RCM process for better insights and efficiencies in Optometry Billing

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Improved RCM process for better insights and
efficiencies in Optometry Billing
With a number of changes occurring in the
healthcare industry, revenue cycle management
(RCM) is getting more and more unorganized and
confusing. The Affordable Care Act and
upcoming ICD-10 codes will add yet another series
of steps to an already confusing RCM process,
thus affecting the reimbursements of medical
practices. Optometry Billing is no different to
other medical billings and any loose end may
result in greater denials, lost claims, or
underpayments. The following practices will give
an insight in your existing RCM processes and
guide you in making your billing system
efficient Patient Information and Appointment
Scheduling This is the very first step of a
revenue cycle. A checklist of required
information would ensure that no important
patient details are missed. Additional
information related to the registration process,
co-pays, documents required like medical history,
etc. should be informed to the patient prior to
the first scheduling. Patient Registration
Process
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Improved RCM process for better insights and
efficiencies in Optometry Billing
Once a record is set in the database, on every
following visit, the patients and insurance
details should be confirmed and changes made, if
any. The billing staff should review the forms
for completeness and ensure there are no
mistakes. Pre-Authorization and Claim
Submission There are distinctive claim
submission and reimbursement cycles
for Medicare, Medicaid, and other insurers.
Ensure that your optometry billing service is
aware of its payer mix and can plan for
pre-authorization and documentation
accordingly. Policies and Guidelines for Records
Documentation Using Optometry templates,
responsibility matrix, policies related to date
entry, timelines for completing a patients
record, signing, diagnosis, performed procedures,
and approvals are all good practices which should
be included in maintaining records (electronic or
handwritten) in a systematic way.
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Improved RCM process for better insights and
efficiencies in Optometry Billing
Staff training Training your medical staff on
regular procedures and operating routine machines
can improve the overall efficiency of your
Optometry practice. Customer Satisfaction This
is the key to any service. With the increase in
optometry consultants and the online eyewear
market, optometrists should focus on their
customer service and satisfaction to ensure
consistent profitability. Audits Regular
audits of your medical billing services will help
in focusing on your strengths and weaknesses,
thus giving an opportunity to tighten weak links,
improve efficiency and increase
profitability. Adopt EMR (Electronic Medical
Record)
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Improved RCM process for better insights and
efficiencies in Optometry Billing
Adopt an EMR system that can be customized as
per your optometry service. This will not only
reduce manual efforts but will also help in
updating any coding changes in your Optometry
billing directly. Monitoring and Follow-up of
Claim Follow up your claims regularly and
monitor the reasons behind claim denials. A
constant focus and improvement on the medical
billing and claim process will directly improve
the profitability of your OD practice. For
attaining short-term as well as long-term
profitability, its important for Optometrists to
adopt and follow effective data collection,
billing, and coding practices. Medical Billers
and Coders (MBC) is a leading medical billing
company providing complete revenue cycle
services. To know more about our Optometry
billing and coding services, contact us
at info_at_medicalbillersandcoders.com/888-357-3226.