Rules to Follow for Advance Beneficiary Notice of Noncoverage

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Rules to Follow for Advance Beneficiary Notice of Noncoverage

URGENT ABN COMPLIANCE ALERT: The version of Form CMS-R-131 currently in your files expires on January 31, 2026.

For all services rendered on or after February 1, 2026, providers MUST use the refreshed Advance Beneficiary Notice of Noncoverage (ABN) form with the updated expiration date. Using the old form after this date will result in an "invalid notice," making your practice financially liable for denied claims.

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Avoid Costly Mistakes: Tips for Medicare and Medicare Advantage Eye Care Billing

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Avoid Costly Mistakes: Tips for Medicare and Medicare Advantage Eye Care Billing

Ophthalmology and optometry practices with a large Medicare and Medicare Advantage patient base face unique billing challenges. However, overlooking key billing processes may lead to costly mistakes and reduced cash flow. In this blog, we discuss a client case study and review critical Medicare and Medicare Advantage billing dos and don’ts to help your eye care practice succeed and boost net collections. collections.


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In-House vs. Outsourced Billing for ODs: How to Choose the Right Model for your Practice

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In-House vs. Outsourced Billing for ODs: How to Choose the Right Model for your Practice

The conversation in optometry offices this fall isn't just about scheduling—it's about cash flow. Every OD knows that providing excellent patient care is your core mission, but securing the revenue for that care is the single most significant factor in your practice's long-term sustainability. This requires a robust Revenue Cycle Management (RCM) strategy.

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Stop Revenue Leaks in Your Eye Care Practice With Fast Pay Health

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Stop Revenue Leaks in Your Eye Care Practice With Fast Pay Health

You can see patients back-to-back, fit them for glasses and contacts, and keep your schedule full. But when you check your financials, the numbers tell a different story. Cash flow feels tight. Bills get paid late. New equipment has to wait. The problem isn't the number of patients you see—it’s hidden revenue leaking out of your practice through poorly managed accounts receivable (AR).

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Insider Tips for Faster Eye Care Payments

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Insider Tips for Faster Eye Care Payments

No one likes to see a denied claim from an insurance or vision plan payer. A denied claim is lost or delayed revenue for your eye care practice.

Researching and resubmitting denied claims can lead to long, frustrating hours trying to figure out why the claim was denied in the first place. That’s why nearly 65% of denied claims are never reworked by providers.

Let’s look closely at common coding denials, reasons, and how you can establish a proactive solution to increase your business revenue.

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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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