Medicaid & Replacement Glasses

It might be surprising, but Medicaid in most states only covers repairing or replacing glasses for patients 20 and under. If an adult aged 21 or older comes in needing repairs, they must pay out of pocket if they have no other insurance. We sometimes see offices try billing Medicaid for replacement glasses on older patients, only to get a denial and ask us what to do. Read on for more.

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How to Avoid Common Ophthalmic Billing Rejections: Part 3

How to Avoid Common Ophthalmic Billing Rejections: Part 3

Next up in our three-part series on “Common Ophthalmic Billing Rejections” is new vs established patient exams. One surprisingly common rejection seen by Fast Pay is, “This many frequencies is not allowed for procedure code billed.” The cause? Billing a new patient code on an established patient.

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How to Avoid Common Ophthalmic Billing Rejections: Part 2

How to Avoid Common Ophthalmic Billing Rejections: Part 2

Continuing our series on “Common Billing Rejections,” we turn now to ophthalmic testing with Medicare patients. Many codes require a referring or ordering physician in order to process the claim. These include pachymetry, fundus photos and OCT.

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How to Avoid Common Ophthalmic Billing Rejections: Part 1

How to Avoid Common Ophthalmic Billing Rejections: Part 1

Working with eye care providers across the country, our billers at Fast Pay see many common rejections that could have easily been avoided. In this “Common Billing Rejections” series, we will explore some of the top rejection reasons, starting with the OCT/GDX and fundus photography combination.

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