The 7 Most Frequently Asked Billing Questions in Eye Care Answered

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The 7 Most Frequently Asked Billing Questions in Eye Care Answered

Running a successful eye care practice means more than delivering excellent care–it also means getting paid accurately and on time. Revenue cycle management (RCM) can be challenging, especially when insurance requirements shift and staffing is tight.

Billing services and solutions should help support your practice in everything from claim submission to denial resolution.

Here are the top 7 billing questions we hear most often from optometry and ophthalmology practices.

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Mastering Denied Eye Care Insurance Claim Appeals

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Mastering Denied Eye Care Insurance Claim Appeals

Are you frustrated with eye care insurance and vision plan claims being denied? Dealing with denied claims is a common part of running a practice. However, knowing how to appeal a claim can protect your revenue and ensure patients get the care they need.

Do not despair; there are ways to appeal and win your claim. In this blog, we'll share tips to help you successfully navigate the denied claim appeal process.

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Insurance Billing Codes and Modifiers: What's the Difference and Why It Matters

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Insurance Billing Codes and Modifiers: What's the Difference and Why It Matters

Lost insurance revenue can devastate an eye care practice. Navigating the complexities of insurance coding can be challenging. That’s why assigning the correct diagnosis codes, procedure codes, and modifiers is critical before you file a vision plan or medical insurance claim.

In this blog, we’ll review the difference between billing codes and modifiers.

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12 Ways to Optimize Cash Flow Through Revenue Cycle Management

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12 Ways to Optimize Cash Flow Through Revenue Cycle Management

When you're not bogged down by repetitive revenue cycle management (RCM) tasks, such as verifying insurance coverage and meticulously filing claims, you can dedicate your energy to what truly matters—enhancing the quality of patient care.

An efficient RCM process is crucial for a thriving optometry or ophthalmology practice. Here are a few key areas to focus on.

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Preparing for a Vision Plan and Medical Insurance Billing Audit

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Preparing for a Vision Plan and Medical Insurance Billing Audit

Medical insurance and managed vision care (MVC) billing audits can be stressful, time-consuming, and costly for eye care practices. That’s why it’s critical to have a process in place to protect your practice (and sanity) before you get the dreaded audit request letter, or the auditor shows up at your door.

In this blog, we will review what triggers a vision plan and medical insurance audit, how to prevent audits, and what to do if you get audited.

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7 Medicare Billing Dos and Don'ts to Guide Your Eye Care Practice

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7 Medicare Billing Dos and Don'ts to Guide Your Eye Care Practice

Your eye care practice faces numerous challenges every day. You’re keeping up with constant Medicare regulatory and coding changes, declining reimbursements, or worse, getting Medicare to pay claims at all.

Are you noticing more Medicare claim rejections or denials appearing in your inbox? Review a few common Medicare billing dos and don’ts to guide your practice toward healthier revenue.

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Mastering Claim Denial Reason Codes Expedites Cash Flow

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Mastering Claim Denial Reason Codes Expedites Cash Flow

Researching and resubmitting denied claims can lead to long, frustrating hours trying to figure out what claim denial and claim adjustment reason codes mean, and what action to take. The good news is that almost 90% of claim denials are avoidable with a proactive revenue cycle management and optometric billing solution.

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12 Optometric Billing Tips for Positive Cash Flow

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12 Optometric Billing Tips for Positive Cash Flow

Every time you think your optometric billing is under control, new reimbursement, coding, or staffing roadblocks appear. Increasing collections and improving out-of-control accounts receivable (AR) is critical for revenue growth. Follow these optometric billing tips to help your eye care business thrive.


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How to Avoid 3 Common Optometric Billing Rejections and Denials

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How to Avoid 3 Common Optometric Billing Rejections and Denials

Optometric billing rejections and denials can be a nightmare for eye care providers. They delay payments and affect cash flow. This blog will explore three common reasons for medical billing rejections and denials and offer actionable insights on how to avoid them.

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15 Claim Denial Management Solutions to Improve Cash Flow

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15 Claim Denial Management Solutions to Improve Cash Flow

Claim denial management strategies for optometry and ophthalmology practices are critical to quickly identifying, resolving, recovering from, and preventing denied claims. How can you keep the denial rate below 5% and boost unhealthy cash flow? In this blog, see common reasons for claim denials and solutions to help you improve your cash flow.

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On-Demand Webinar: Boost Your Cash Flow With These Optometric Billing Tips

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On-Demand Webinar: Boost Your Cash Flow With These Optometric Billing Tips

If you’re struggling with delayed payments or billing errors or simply looking to improve the financial health of your eye care practice, this on-demand webinar is for you. It’s packed with advice, solutions, and practice tips you can implement immediately.

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How Opticore Optometry Group Tackles Optometric Billing Challenges

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How Opticore Optometry Group Tackles Optometric Billing Challenges

Opticore Optometry Group faced several optometric billing challenges that affected its revenue stream before transitioning to Fast Pay Health. Dr. Taylor Tedder, President of Opticore Optometry Group, shares how a tailored billing and RCM service resulted in positive solutions and a return on investment in a few months.

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Medicare Advantage Billing Tips That Boost Your Revenue

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Medicare Advantage Billing Tips That Boost Your Revenue

Is your eye care practice struggling with increased Medicare Advantage claim denials? Not sure how to keep up and capitalize on the growing popularity of Medicare Advantage plans versus traditional Medicare? Review trends, requirements, and insurance billing tips to increase cash flow.

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Vision Plans vs. Medical Insurance: When Should You Bill?

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Vision Plans vs. Medical Insurance: When Should You Bill?

Many patients have both medical and vision insurance. It can be confusing and challenging to decide which to bill, especially when patients want to be part of the decision and are concerned with what they will have to pay. This blog will discuss best practices for billing vision plans and medical insurance.

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10 Reasons You Need an Optometric Billing and RCM Service

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10 Reasons You Need an Optometric Billing and RCM Service

Are you getting your money’s worth with your in-house billers or optometric billing service? Is your accounts receivable (AR) becoming unmanageable? If you are considering outsourcing your insurance and vision plan billing and RCM tasks, here are ten reasons to help you decide.

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5 Optometric Billing Tips to Improve Practice Operations

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5 Optometric Billing Tips to Improve Practice Operations

Running an eye care practice comes with a unique set of challenges. Effectively managing optometric billing is a critical aspect. It’s a balance between processes, resources, and technology. These 5 tips will guide your practice toward long-term success.

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Calculating ROI for Outsourcing Optometric Billing and RCM

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Calculating ROI for Outsourcing Optometric Billing and RCM

To help you determine the true costs of your current billing and revenue cycle management (RCM) process, let’s look at four financial and operational questions critical to calculating your return on investment (ROI) for outsourcing to an optometric billing and RCM partner.

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2024 ICD-10-CM Code Updates Guide for Eye Care

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2024 ICD-10-CM Code Updates Guide for Eye Care

Is your office prepared for the fiscal year (FY) 2024 eye-related ICD-10-CM code changes that become effective on October 1, 2023? To help you navigate these FY 2024 code updates, we've prepared a quick guide to the eye-related ICD-10-CM code changes for October 1, 2023 through September 30, 2024.

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Why is Charge Entry Critical to Optometric Billing?

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Why is Charge Entry Critical to Optometric Billing?

Charge entry is one of the most critical steps in the optometric billing cycle—where the claims are created. Even one mistake could lead to a rejected or denied claim, resulting in thousands of dollars in lost revenue. Use these eight tips to help you manage the charge entry process better.


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Rules to Follow for Advance Beneficiary Notice of Noncoverage

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Rules to Follow for Advance Beneficiary Notice of Noncoverage

Insurance payers seem to pay eye care providers less and assign more responsibility to patients. Suppose you suspect Medicare may not cover a procedure or service for a patient. In this blog, we’ll review when, why, and how you should use an Advance Beneficiary Notice of Noncoverage (ABN) form.

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