Overview of Medical Billing for Ophthalmology

Overview of Medical Billing for Ophthalmology

The financial health of your ophthalmology practice is related to timely billing and account reimbursement. Our medical billing company has years of experience with ophthalmology billing. Hiring a billing service will be the best decision you ever make. Find out more about outsourcing your medical billing for ophthalmology.

What are the Benefits of Outsourcing Medical Billing

An ophthalmology practice will enjoy many benefits from outsourcing their billing services. These include:

  • 24/7 accessibility to financial information and patient datacanstockphoto6237462
  • Improved income and collections
  • Accelerated payments
  • Full practice management and financial reporting
  • Transparency throughout the revenue cycle
  • Professionals who are specially trained in billing and coding
  • Clean claims with fewer denials
  • Readily available reports and frequent quality assurance checks
  • Customized turnaround time
  • 24/7 customer support
  • Encryption technology and firewalls to protect data
  • No long-term contracts

How a Billing Company can Increase Reimbursements

An ophthalmology billing company is more effective and efficient at billing than in-house personnel. These professionals work with your staff to assure that you get maximum reimbursement. Based on industry statistics, a claims adjustment rate between 20-35% is acceptable and reasonable. Our adjustment rate is much lower, around 10-15%, which means more money for you.

Our clients can reduce office expenses when they use our services. All your office needs is a computer and access to the internet. We have all-inclusive practice management software, which eliminates costly software updates and support fees. We offer a percentage payment option, so you pay according to what we collect. In addition, you can save money when you do not have to pay billing staff and employee benefits.

We do Complex Ophthalmology Medical Coding

Ophthalmology medical coding is quite complex, and this is due to the various documentation requirements for E/M, intermediate, and comprehensive eye codes, as well as large number of bundling edits, differing fee schedules, varying coverages policies, and need to use modifiers to ensure compliance.

Our billing company are aware that rules for payment and coding guidelines often change, so therefore, we continuously educate and train our billers regarding medical coding. Our AAPC-certified coders report preventive and routine eye care treatments correctly, as well as know how and when to use required modifiers. Accurate medical codes are used for:

  • Conditions – Includes eye tumors, retinopathy, eye injuries, hyperopia, myopia, macular degeneration, glaucoma, and Graves’ disease.
  • Treatments – Includes comprehensive eye exams, cataract care, low vision services, and laser eye surgery.

With our ophthalmology billing company, the coders are AAPC-certified, having knowledge of the latest CPT, ICD-10, and HCPCS codes. We understand how to code for office visits, surgical procedures, consultations, and drug administration. In addition, we remain up to date with many reimbursement policies, such as Medicaid, Medicare, Workers’ Compensation, commercial plans, and personal injury plans. To make billing streamlined, we use advanced coding software, such as Flashcode, CodeLink, and EncoderPro.

What we Offer

We provide comprehensive medical billing solutions for your ophthalmology practice including billing, coding, and practice management consulting. We can remotely access your database, work in real-time with your office personnel, and provide many services. The services we offer include:

  • Data entry – Obtaining information from the physician and entering it into the system.
  • Claim filing – Transmission of electronic claims, which are filed without adding postage expense to you or an additional clearinghouse.
  • Mailing statements – Statements are sent from our office on behalf of your ophthalmology facility.
  • Collecting payments – When payments come in from insurance companies, we post these into the practice management system.
  • Filing appeals – We handle incorrect payments and denials, which are challenged or appealed with the insurance companies to ensure adequate reimbursement for the office.
  • Handling aged accounts – We manage accounts receivable to make sure monies are recovered that are due to the office.
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