Owning an eye care clinic comes with challenges, and one of the most significant tasks is managing billing effectively. It’s crucial to find the right mix of methods, tools, and technology to ensure that your billing processes are streamlined and efficient. By improving how your practice operates, you can set the stage for lasting financial success.
Implementing effective billing strategies can make a significant difference in the overall success of your clinic. From accurately documenting patient visits and procedures to promptly submitting claims to insurance companies, every aspect of the billing process plays a role in the financial health of your practice.
One key tip for better billing management is to invest in modern billing software or outsource to a specialized medical billing service in Downers Grove. These solutions can help automate many aspects of the billing process, reducing errors and speeding up reimbursement times.
Identify Challenges And Analyze Anomalies In The Healthcare System
Let’s examine the problems and fix them to make more money and keep your eye care business healthy.
First, figure out what’s not working well in your billing. Are you slow with billing? Do appointments change a lot? Maybe you’re not checking if patients’ insurance covers their treatment, leading to unpaid bills.
Keeping track of patients’ insurance and benefits is crucial. It’s easy to do but often forgotten.
Is your money owed from patients getting out of hand? If you don’t send bills every day and handle payments quickly, your money reports won’t be right.
Do your staff know enough about billing terms? We can help with a list of words and tips to improve how you get paid.
Talk to your team about what needs fixing. Make a plan together and decide when to make changes. If needed, get help from a team that knows about eye care billing.
Discover the Right and Wrong Ways to Use Medical Billing Modifiers
Many optometry practices make errors with medical billing modifiers, which result in payments being sent back to insurance companies and other payers.
Using these modifiers incorrectly could lead to an audit and hefty fines. For example, Medicare audits can result in fines of up to $10,000 for each mistake, which can become expensive fast.
These mistakes will eventually impact your profits, costing you more money than you want to lose. Our guide on common medical billing modifiers will assist you in avoiding these errors in the future.
Ensure the Provider is Credentialed
Before you get medical or vision care, you must check if the provider accepts your insurance. This simple step can help you avoid potential financial surprises later on. If the provider is not on your insurance network, it may lead to higher out-of-pocket costs or even a surprise medical bill. Being in-network means that the provider has agreed to accept the negotiated rates from your insurance company, which typically results in lower costs for you as the patient.
One way to verify if a provider is credentialed with your insurance is to contact your insurance company directly or use their online provider directory. These directories are regularly updated to reflect changes in network status, ensuring that you have access to accurate information when making healthcare decisions. Additionally, some healthcare providers’ offices may also be able to assist you in determining if they accept your insurance plan.
If you discover that the provider you had planned to visit is not in-network with your insurance, don’t hesitate to explore alternative options. While it may require a bit more effort to find a different provider who accepts your insurance, doing so can ultimately save you money and prevent any unexpected billing issues.
Verifying that your provider is credentialed with your insurance before receiving care is a proactive measure to help you avoid financial headaches later on. By confirming network status and exploring alternative options if necessary, you can ensure a smoother and more cost-effective healthcare experience.
Know why claims get denied.
Sometimes, insurance won’t pay for a claim. This happens for different reasons, such as mistakes or rules. Many times, these denials can be fixed. But many times, they’re not even tried to be fixed.
Claims get denied for three main reasons: mistakes, medical reasons, and insurance rules. Most of the time, it’s because of mistakes. On average, about 5–10% of claims don’t get paid. But many of these can be fixed.
The good thing is most of these denials could have been stopped before they happened.
Focus on stopping problems before they start. This will help you get paid faster and avoid stress. This blog has tips to help you fix these issues and get paid quicker.
Outsource Optometric Billing To Third-Party Medical billing services
Is managing your optometry billing and revenue cycle becoming too much for your staff? It might be time to outsource.
Are claims submissions, payment postings, and other tasks overwhelming your team?
To help you understand the true costs, check out our blog post, “Calculating ROI for Outsourcing Optometric Billing and RCM.”
Outsourcing means experts handle your billing, freeing up time for patient care.