How Opticore Optometry Group Tackles Optometric Billing Challenges
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Opticore Optometry Group faced several optometric billing and revenue cycle management (RCM) challenges that affected its revenue stream and efficiency. Four main hurdles were straining staff resources.
Errors in submitting claims to insurance providers.
Arduous tasks in finding and fixing rejected and denied claims.
Prolonged delays in receiving payments from insurance providers.
Challenges in managing time effectively while maintaining billing efficiency processes.
Dr. Taylor Tedder, President of Opticore Optometry Group, shares his success story on how a tailored optometric billing and RCM service resulted in positive solutions and a return on investment in a few months.
What challenges were you experiencing with provider credentialing?
As a new business startup (8 doctors, 4 locations), we consistently juggle to scale our operations to accelerate growth and manage day-to-day tasks.
Before partnering with Fast Pay Health, we encountered many challenges navigating the complex and time-consuming provider credentialing process. Ensuring our providers are credentialed and re-credentialed with third-party managed care organizations demands significant administrative efforts, time, and expertise.
Outsourcing provider credentialing allows us to focus on driving business growth initiatives. We no longer have to divert valuable time and resources from our primary business objective–our patients.
How has Fast Pay Health helped reduce accounts receivable and improve cash flow?
An optometric billing service is pivotal in reducing accounts receivable (AR) and improving cash flow stability. Before we outsourced billing to Fast Pay Health, we were experiencing a concerning trend: a substantial number of outstanding claims were aging beyond 120 days.
Aging claims pose a significant challenge to our cash flow, as delayed reimbursements impede our ability to maintain consistent revenue streams and meet financial obligations.
Implementing a proactive approach to review AR and aging claims has substantially reduced the number of outstanding claims, particularly those exceeding the 120-day threshold.
Claims are now processed faster, which means we get paid more quickly. Our net collections increased by over 90% in the first few months.
How important is verifying a patient’s benefits and eligibility?
One of the standout services we highly value is prior authorization and verifying a patient's benefits and eligibility. Knowing what is covered beforehand makes claims submissions accurate and ensures a smoother patient experience. Now, our staff redirects their focus towards delivering high-quality patient care.
Automating the benefits and eligibility verification process minimizes the need for manual data entry and reduces the likelihood of errors. Receiving notifications when coverage changes allows us to address any issues promptly and avoid billing errors.
How have medical coding reviews helped maximize reimbursement and prevent claim denials and potential audits?
Knowing the correct diagnosis/procedure codes and medical billing modifiers ensures that our claims match the services we provide and follow the rules of each insurance payer.
By incorporating Fast Pay Health’s recommendations into our coding processes, we've improved the accuracy of our claims submissions. Accurate claims minimize the risk of delays or denials due to coding errors. Insurance reimbursements have also increased without triggering audits or claim rejections.
Why do you analyze optometric billing trends?
Analyzing billing trends allows us to identify inefficiencies or bottlenecks in our billing and RCM process. We pinpoint areas where improvements can be made to reduce claim rejections and denials and accelerate cash flow.
Most importantly, Fast Pay Health helps us anticipate potential issues before they escalate into significant problems. This proactive approach helps us address billing challenges promptly and deliver better outcomes for our practice and patients.
How would you rate your Fast Pay health billing team?
Our practice gives the Fast Pay Health billing team a solid 10/10. I've enjoyed working with my account executive, Arthur, who has been fantastic. His professionalism, expertise, and commitment to exceptional service have stood out.
Arthur's knowledge of the eye care industry and attention to detail are exemplary. He consistently demonstrates impeccable follow-through and follow-up, ensuring that any concerns or questions are addressed promptly and thoroughly. Arthur’s proactive approach to problem-solving has been instrumental in our success.
Why is posting payments directly into your practice management software critical?
Fast Pay Health automated many billing processes that integrate with our practice management software. Implementation was pain-free. For example:
Accuracy: Ensures accurate recording of all financial transactions related to patient payments, insurance reimbursements, and other sources of revenue.
Efficiency: Eliminates manual data entry tasks and reduces the likelihood of errors. This streamlines the payment posting process, saving time and resources that can be allocated to other critical tasks.
Real-Time Reporting: Access to financial reports leads to timely insights into revenue trends, outstanding balances, and financial performance.
Compliance: Ensures compliance with regulatory requirements and industry standards for financial record-keeping and reporting.
Patient Satisfaction: We get accurate and up-to-date information about patient’s account balances, payment history, and insurance coverage.
What priorities are you focusing on now that your optometric billing is under control?
By outsourcing our billing, we focus more on growth-driven functions that strengthen our competitive edge, attract new patients, build long-term loyalty among our existing patient base, and expand service offerings.
For instance, we’re implementing a new customer relationship management program to optimize patient communication and engagement by leveraging mobile technology. Patients receive timely reminders about their appointments and can easily confirm or reschedule them through their mobile devices. We’re also investing more in staff training and development.
What tips would you share with other practices challenged with their optometric billing?
Partnering with a reputable billing service like Fast Pay Health will significantly improve your billing processes. Their unwavering commitment to excellence has made them an invaluable partner in optimizing our revenue cycle management processes.
Whether you outsource optometric billing or not, it’s critical to focus on the following business tasks:
Train your staff.
Monitor key performance indications (KPI) to leverage trends, identify patterns, and make data-driven decisions.
Stay updated on coding changes.
Implement clear billing policies and procedures and regularly review and update them.
Develop positive relationships with vision plans and insurance payers.
Be proactive and resolve issues promptly–don’t procrastinate.
Experience Positive ROI of Outsourcing Optometric Billing & RCM
Managing claims submissions, eligibility and benefits verification, claims rejections and denials, payment posting, collections, and other billing tasks can overwhelm your staff and impact productivity
Request a free practice analysis today and see how Fast Pay Health will help you get paid faster and improve your practice’s financial performance. We work with ANY eye care practice management software.
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About Taylor Tedder, OD: Dr. Taylor Tedder is the founder of Opticore Optometry Group, PC. He is a member of the American Optometric Association (AOA), California Optometric Association (COA), and the Inland Empire Optometric Society. Photos provided by Opticore Optometry Group.