The Optometric Billing Spot

Optometric Billing: Digitally Active Contact Lenses!

2012-02-24T17:47:00.000-05:00

Just makes me wonder how we would start billing for this!!!!

"Digitally Active Contact Lenses – Are We Near It's hard to trace the active contact lens' birth date, but the year might be 1973. , researchers at the National Environmental Research Center created a contact lens with a thermocouple built in. The sensor-cum-contact was arguably the first digitally active design to be realized. As the electronics revolution commenced in the 1970s and 1980s, though, little work was done to expand on this precocious design. Interest revived in the late 1990s, but it was not until 2001 that the device began to step from concept into commercial reality. Researchers used micro-electro-mechanic sensors (MEMS) to create a contact lens that monitored ocular pressure -- an important indicator of Glaucoma. The research was presented at the New Directions in Cellular and Tissue Biomechanics conference in Les Diablerets, Switzerland. In 2009, a company Sensimed AG launched the world's first commercial digitally active contact lens. The design, dubbed "Triggerfish", used an embedded a MEMS strain gauge sensor and microprocessor inside a soft silicone contact lens. The circuit elements were exocentric, out of the line of sight. The device received power from and ferried signals via a circular antenna around the eye socket. In the last decade several devising and even more ambitious designs were introduced in this hot field. Among the most noteworthy is Professor Babak Parviz of Seattle's Washington University, who added pixel displays to the mix. Perhaps inspired by Triggerfish - medical sensors, such as a glucose sensor (monitoring tear glucose, an indicator of blood sugar in diabetics), are also inculcated into the design. But creating a contact lens display has been a major obstacle for focusing the image. In short, we need miniature lenses to focus the image on the eye. Ultimately the digitally active contact lens of the future aims to be a high resolution display, which can assert an augmented reality, including text and images over human vision. Such a design would work for business (work displayed right in your eyes), communications (text messages, emails), and pleasure (imagine watching movies or "tripping" without drugs via in-eye vision). The lens will also likely optionally incorporate glucose, occular pressure, and possibly other sensors to monitor eye health and overall body health. , it may be a few decades before the perfected contact lens product is released commercially, but in just 10 years we may have crude commercial contact lens text displays, if you're willing to wearing a bulky wireless power device around your eye socket." (full article here)

Talk Back! Let us Know What You Think!

OpticXpress Handles Optometrists’ Billing

2012-02-24T17:41:00.002-05:00

From Elaine Rose at "Press Of Atlantic City"
Full Article Here

OpticXpress provides medical billing services and office software for optometrists. We give them the software to help comply with records requirements and to connect with patients as part of doing the billing.

We have multiple clients nationwide that use our service and our software.

I work with companies in Vineland for developing software, creativity and for printing forms. I try to work with local companies when practical.

Optometry is an underserved specialty in the medical billing world. There are a lot of nuances in the codes that most generic medical billers are not familiar with.

Entry: Until the early 1990s, optometrists weren't considered to be providing medical services, and dealt with vision insurance. But then the government opened the opportunity for them to provide medical services, which are covered by Medicare and Medicaid.

We were able to capitalize on the change, and could educate doctors. We post a lot of information we get from our community and various articles[ to our blog ] as a resource to help in their practice.

We specialize in post-operative cataract billing. It's an issue that's very hot among optometrists. A lot of them have patients who go to ophthalmologists for the surgery, and then come to optometrists for after care. We can virtually guarantee that an optometrist will get paid for those services.

The average optometrist's practice is small, about $500,000 to [$1.5] million a year in revenue. The biggest challenge is to educate practitioners that it's better to outsource their billing, so they don't have to do it anymore. They often can't afford to hire a billing department, so they rely on untrained staff to bill patients and deal with insurance companies.

The future: We want to become synonymous with optometric medical billing nationwide. We want optometrists seeking to take their practice to the next level to think of OpticXpress.

Staff writer Elaine Rose

RELATED ARTICLES:

WHAT OPTICXPRESS BELIEVES

ANOTHER OPTOMETRIC BILLING NO-NO!

Optometric Billing-Californa Optometric Association Integrates VSP

2012-02-14T16:21:00.000-05:00

Recently the California Optometric Association voted to support the inclusion of VSP in the California Health Insurance Exchange.

Read the Letter Below and tell us what you think by using the comment section to talk back! We want to know what you feel!

Optometric Billing- What opticXpress Believes

2012-02-14T16:01:00.000-05:00

In this day and age it is hard to find a person, let alone a company, that acts in a moral and ethical manner. Yesterday, for example, it was released that Apple is ordering the investigation of it's manufacturing partners plants in China so as to eliminate harsh working conditions and become the first "fair trade" manufacturing company in the world. However, though this looks great on the outside, a deeper look at the company's profit margins will show that though this is a benevolent undertaking, the roots of this effort have their taps in the lore of marketing. Apple stands to make billions off this approach to becomming "fair trade" as it will undoubtedly give them just the marketing edge they need to justify their higher than average prices on their product. Can't you see the waves of "Apple Nerds" now, wearing their "Apple Fair Trade" t-shirts shouting at you from the top of their lungs while they stand in line waiting to fork over their hard earned cash for the iPad 4?!?!

This being said, I want to tell you exactly what we stand for here at opticXpress. opticXpress is a Christian company. We are a second generation Medical Billing Company owned solely by family members since 1991. Though we are not perfect in all that we undertake, we strive to be honest and loyal; not just to our customer but to The Lord from whom we believe our company has been made possible. We want every single one of our clients, readers and potential clients to know that 10% of our gross revenue is donated Monthly in the form of Tithe and offerings to the local Spanish Seventh Day Adventist Church in Vineland, NJ. With this money, the NJ Conference of Seventh Day Adventists helps fund schools and mission work throughout the state. Specifically, one of the newer and more successful of these schools is the Vineland Regional Adventist School for which we have been a supporter of since its inception just a few short years ago.

"We are God's stewards, entrusted by Him with time and opportunities, abilities and possessions, and the blessings of the earth and its resources. We are responsible to Him for their proper use. We acknowledge God's ownership by faithful service to Him and our fellow men, and by returning tithes and giving offerings for the proclamation of His gospel and the support and growth of His church. Stewardship is a privilege given to us by God for nurture in love and the victory over selfishness and covetousness. The steward rejoices in the blessings that come to others as a result of his faithfulness. (Gen. 1:26-28; 2:15; 1 Chron. 29:14; Haggai 1:3-11; Mal. 3:8-12; 1 Cor. 9:9-14; Matt. 23:23; 2 Cor. 8:1-15; Rom. 15:26, 27.)" (Entire Quote Here)

Though we do not advocate forcing one's religion or beliefs upon another human being it is our goal to be a beacon of light to our customers. To minister to them by our actions so that they can see we truly are moral and ethical.

If you feel that you too would like to make a donation in the form of tithe, contact your local church and ask them how to go about doing it. If you would like to become a supporter of the Vineland Regional Adventist School, Please click here and contact Carlos Torres. Maybe your donation will help to train future optometrists!

Optometric Billing-The State Of Optometry

2012-02-14T15:07:00.001-05:00

In her "State of Optometry" Address, President of the American Optometric Association, Dori Carlson, discusses, among other things, :

The Affordable Health Care Act (Obama Care)
Children's Eye and Vision Benefits
Mandatory Vision Care being included in the AHCA
How organized healthcare resisted these efforts by the AOA and lost
The American Recovery and Reinvestment Act
How the AOA has fought for increases in reimbursements from Medicare for Vision Care Providers while reimbursements for other specialties have been lowered.

Take a look at the video below and use the comment section to talk back and tell us what you think. How will these advances affect you as a vision care provider?

REMEMBER, opticXpress IS HERE TO HELP YOU WITH ALL YOUR OPTOMETRIC BILLING NEEDS. CONTACT US TODAY!

Optometric Billing-Do Your Patients Suffer From Lens "Sticker Shock"?

2012-02-11T19:08:00.000-05:00

Do your patients buy designer frames from you but cringe when they find out how much the lenses are? Check out what Micheal Block has to say about this. Don't forget to talk back to us and tell us what it's like around your office!

Optometric Billing-What Tasks Should My Staff Do?

2012-02-11T11:36:00.001-05:00

What should your staff be in charge of ?

In short, the answer to that question is everything but insurance billing, credentialing and A/R. Micheal Sutton of Bloomfield, NJ said it best when he said " Anything you spend money on to save time saves people, and people are the most important part of any practice."

Dr Sutton was smart when he said this. He realized that his budget was limited, his practice was small and he looked hard to find the people that he had working for him. Why would he want to risk loosing them by tasking them with work they had no business or time to be doing?

Apply this to your optometric practices when it comes to your insurance billing, patient invoicing and patient collections. Most optometry practices don't have the budgets it requires to hire a full time billing department so they hire an office manager thinking that person can not only run the office and deal with patients all day but also bill insurance, invoice patients and take the time out of thier busy days to work insurance denials and speak to patients who have questions about thier invoices or account status. STUPID THING FOR ANY PRACTICE OWNER TO DO! The funny thing is that these optometrists sit back and wonder why they are not getting paid the amount of money they feel they should be getting paid by insurance companies and why thier A/R is so high!

IT DOESN'T MATTER IF YOUR OFFICE SECRETARY HAS EXPERIENCE IN BILLING INSURANCE! SHE DOESN'T HAVE THE TIME TO DO THE JOB PROPERLY, DON'T ASK HER TO DO IT!

IT DOESN'T MATTER IF YOUR OFFICE MANAGER HAS A MEDICAL BILLING DEGREE! IF YOUR MANAGER HAS A BILLING DEGREE WHY ISN'T HE/SHE YOUR FULL TIME BILLER INSTEAD OF YOUR OFFICE MANAGER?

IT DOESN'T EVEN MATTER IF YOU CAN AFFORD A FULL TIME BILLING DEPARTMENT! WHY PAY TWO OR THREE PEOPLE A FULL TIME SALARY PLUS BENEFITS THE MONEY THAT IT REQUIRES WHEN YOU COULD OUTSOURCE THIS WORK TO A COMPANY LIKE opticXpress FOR A FRACTION OF THE COST AND ENJOY A HIGHER RETURN ON YOUR INVESTMENT?

The bottom line is this: your staff in office should have one job and one job only, TAKE CARE OF PATIENTS. Leave insurance and patient invoicing to people that don't need to put patient care first, leave it to opticXpress!

Call opticXpress today and let your staff take care of your patients...we'll take care of insurance!

Optometric Billing-All About Vision Plans

2012-02-10T16:24:00.000-05:00

I stumbled across this blog post by Al Clenimann. This is a wonderful write up on the evils of Vision Plans. I sincerely do not advocate an optometrist's use of vision plans. I believe that optometrists are legitimate doctors that need to provide legitimate medical care to their patients and vision plans are not the way to go about it.

Read Al Clenimann's article,The Dealer and the Junkie. I guarantee you will agree with every word he says.

Optometric Billing-Retain Customers and Broadcast Legitimacy

2012-02-10T15:55:00.001-05:00

One of the most important aspects of owning an optometry practice is customer service. This is ever more important to those optometrists that rent space from a franchise store. The more customers you bring in, the more the franchise benefits. It also helps to cement your "legitimacy" as a primary vision care provider which can be hard to do under this business model because patients tend to view you as more of a provider of "screening" services, rather than medical care providers.

My esteemed colleague at Mirro, Inc. wrote a piece about motivating your employees in order to motivate your customers...which is the essence of customer service. Take a look at his article below.

Motivated Employees Create Motivated Customers!

"The best way to ensure everyone around you is motivated is to get rid of the people who aren't motivated." ~ Lou Holtz

This statement couldn't be truer! Have you ever walked into a restaurant or retail store and talked to an employee who wasn't excited to be at work? I have. It sucks. The only thing I can ever think about is why is that person here and how fast can I leave. If you have employees working for you that could qualify as "not motivated" I have to ask you one question: How many of your patients feel the same way I do in the example above when they encounter that employee? Probably most. Employees who are motivated to be at work create a positive environment, for other employees and most importantly, PATIENTS.

When patients are having a good time or enjoy their environment, they spend more money! If in 2012, one of your practice's goals is to increase your profits (which should be a goal every year), than you need to take a detailed audit of your staff and follow Lou Holtz's advice. You just might see immediate results!

Remember, in this economic environment, fire fast and hire slow!

(Mike Rolih is the President of MIRRO, Inc. a cutting edge consulting firm focused on providing eyecare professionals with training, marketing, and human resource solutions. For more information, you can visit MIRRO at www.mirroinc.com. )

Are there any techniques that you employ in your office that helps you provider top customer service? Talk back in the comment section below and let us know!

Remember, opticXpress is your one stop for all your medical billing needs. We provide full revenue cycle management and excellent customer service to your patients. Please, CALL US TODAY!

Optometric Billing-Funny Photo For The Day!

2012-02-07T14:38:00.002-05:00

Here is a great photo to lighten the mood around your office!

Remember, optometric billing is serious work...we have to post this stuff to lighten the mood sometimes!

CALL opticXpress today!

What Is Optometric Billing? Pt 1

2012-02-07T14:26:00.001-05:00

There are allot of companies out there that provide medical billing services. Many of these companies are large, some are small. Some are handled completely in India or the Phililpines while others handle their work right here in the U.S. Some are corporations and others are simply "Mom and Pop" business'; people that work right from home. Whatever the case may be, these entities all have one thing in common; THEY PROVIDE BILLING SERVICES TO ALL TYPES OF PRACTITIONERS.

Quite simply,OPTOMETRIC BILLING is, medical billing for optometrists. This is an important differentiation that any optometrist should take the time to sit and ponder when trying to decide the best way billing insurance and patients.

There are not currently many differentiated sects in the billing world. Most medical billers provide services to all types of practitioners and the most common specialized billers are only specialized because they are going after hopsitals (hospital billing) or dental practices (dental billing). Consequently, many optometrists that begin the search for a billing agent find themselves confronted with an entity that handles many specialties, and though this may work well for an internal practitioner or a cardiologist this does not translate into a good experience for an optometrist.

Until the early 90's optometrists were not recognized in the insurance world as "medical providers". That meant that optometrists practiced under a limited set of codes and were generally limited to billing a patient for services expecting a payment in the form of cash or relying on routine vision insurances (VSP, Eyemed, etc) to fill the gap. This was not and continues to not be a reliable method of building a large and successful practice, especially since the average routine vision insurance reimburses only about $45.00 for a standard eye exam including refraction. This changed ,however, in the early 90's when optometrists were officially allowed to begin billing medical insurance for "medical procedures" some of which include eye exams when coded properly.

This change not only opened up new streams of potential revenue for optometrists but it also created a headache for medical billers. Many insurance companies, such as BCBS, accept "s"level codes as well as standard medical CPT codes such as "92004" and "92015" or "92225"; codes that were previously only reserved for "Medical Practitioners" such as opthalmologists. Optometrists can also bill HCPCS codes which in effect creates 3 levels of potential or necessary codes billing staff need be aware and proficient of in order to correctly process an insurance claim.

As a result of these conditions, a biller working for an optometrist needs to be familiar with this in order to not only properly bill an insurance company but to help the optometrist provide the highest level of service possible to his/her patients. Unfortunately, most medical billers do not possess this knowledge. They apply standard "Medical Billing" rules to their optometric clientele and consequently can cause an optometrist to leave lots of money on the table not to mention cause undue headaches to patients who's medical insurance should cover most if not all of the procedures his Dr. needs to provide to him in order to ensure not only adequate eye health but adequate overall physical health as well.

Do you have any past experiences with hiring a medical biller to fulfill your optometric billing needs? Did you hire this individual as an outsource venture or was it to fill a role in your office? Use the comment section below to talk back to us and let us know!

Coming in part 2: "WHAT SHOULD AN OPTOMETRIST LOOK FOR WHEN TRYING TO FIND AN OPTOMETRIC BILLER?"

RELATED ARTICLES:
OPTICXPRESS HANDLES OPTOMETRIST'S BILLING

Don't forget to check opticXpress.com for answers to your questions about optometric billing!

Optometric Billing-One More Way to Bill for Contact Lens Bandages

2012-02-02T17:10:00.000-05:00

Here is one more possible way to bill for the contact lens bandage. This was found at the Review of Optometetry and written by Dr. Sorrenson. I would save this method only in the event that 92071 is not covered. Not because I don't think it is good but because it doesn't make great business sense from a Return on Investment (ROI) standpoint...it is just too time consuming. This is definitely a last case scenario in that respect.

"Billing problems can arise in both diagnosing and fitting keratoconus patients. Diagnosis is typically suspected during a routine exam, then confirmed with corneal topography. Medical carriers vary considerably in topography reimbursement. Unfortunately, many wont pay for the procedure, regardless of your appeals.

Once you confirm the diagnosis and counsel the patient, finalize your decision to fit the patient in contact lenses. This is the first step where many offices fail to bill properly. The code for bandage lens fitting and supply [92071] is a poor choice for keratoconus fits because the reimbursement$60 to $85 for the fit and lenses, per eye is a fraction of the proper amount for a case of such complexity.

A better approach: Bill the code for contact lens fitting (92310) and append modifier -22 to alert the carrier to the greater amount of time and complexity for this proceduretriple the usual rate is not uncommon. Expect to submit further documentation to the carrier to justify this higher fee. A letter of explanation including full color topographic maps often fulfills this requirement." Read the Entire Article Here

Do you have any experience trying to bill for Contact Lens Bandages? Have you tried either of the methods listed above? Use the comment section below to talk back and let us know!

CONTACT opticXpress TODAY FOR ALL OF YOUR OPTOMETRIC BILLING NEEDS!

Optometric Billing-Mobile Devices Changing Healthcare

2012-02-02T13:31:00.000-05:00

"As healthcare costs continue to rise, tablet and smartphone apps are steadily entering the mainstream as appealing and less expensive alternatives to non-invasive procedures and tests. People can now test their vision, count calories, send microscopic images, and more, all using mobile devices."

Our Friends at Noble Vision believe it and so do we! Get on board in your office with mobile devices today! (read entire article here)

Are you using mobile technology in your office? Why or Why Not? Tell us below!

Cataract Post-Operative Billing Can Be Easy!

2012-02-02T13:21:00.001-05:00

One of the great things about running a blog is that I get to take a look at data. This data comes from my readers and those they pass us on too. I get to see trends, likes, dislikes and more. The most important piece of data I get to see, however, is exactly which articles my readers love the most.

Over the past few months I have noticed that when we publish a piece relating the billing of insurance companies for cataract post-operative procedures our hits go way up! This, among various Google and Bing searches, leads me to believe that this is a hot button issue for optometrists. In fact, I know it is a hot button issue because we get calls at opticXpress concerning this issue all the time.

What I don't understand is why? Why is it that it is so hard for optometrists to bill for this procedure and get paid for it?

There are just a few steps needed to properly bill and get paid for the procedure.

Establish a set price for cataract post-operative care. Why? Because Medicare and the likes of other insurance companies consider post-op work to be a maximum of 90 days and pay a certain amount for this procedure intended to cover you for ALL visits with this patient in the 90 days following the actual surgery. So then, it stands to reason that you need to bill for a reasonable amount of money that will cover you for EVERY planned visit of the patient within that 90 day period. Billing your usual and customary fee for a standard eye examination is not a good idea cause most likely that is all you will be paid!
Coordinate with the physician that provides the surgery- In other words, require that a patient bring a referral sheet from the surgeon's office. Most opthamological centers have a standard one. This sheet will list the procedure code used to bill medicare by that office for the original surgery as well as an modifiers that may have been used and the ORIGINAL surgery date. IF THE PATIENT DOESN'T HAVE THIS SHEET AND YOU CAN'T GET IT FROM THE SURGEON'S OFFICE, DON'T PERFORM THE EXAM UNTIL YOU DO.
Coordinate with the surgeon's billing staff-make sure that you verify what was billed to Medicare when they originally billed for the surgery. IF THEY HAVEN'T BILLED THE SURGERY YET THEN DON'T BILL FOR THE POST-OP WORK, YOU WILL NOT GET PAID!
Make sure that you are using billing software that allows you to manipulate lines on the 1500 form!-Believe it or not most of the major pieces of software like officemate and maxim eyes either don't support this feature in earlier versions or make it very difficult to do. Sometimes, it is best to just leave off information from the procedure in order to generate a CLEARINGHOUSE denial so that you can manipulate the claim through their web portal. If you are using opticXpress to bill for cataract post-op work then you don't have to worry about this because the software does it for you.
You will need to write in the dates that you saw patient-This means that when you manipulate the claim lines you will have to write a) the date you saw the patient and b) the date, 90 days from the start date, the post-op care will terminate. Also, you need to write 90 days after the dates. This information must be listed in box 19 on the 1500 form and should look like this: assume care date-care end date-90 days (02022012-05022012-90days). IF THIS IS NOT ON THE CLAIM YOU WILL NOT GET PAID!
The date of service IS NOT THE DATE YOU SEE THE PATIENT, IT IS THE SURGERY DATE!
Use proper modifiers
List the surgical provider as your "referring physician".

After looking back at all those steps and how wordy it is I can see why so many doctors don't get paid for these services! It's too bad, it can be very lucrative for your office. However, unless you are handwriting these claim forms, it's most likely not your fault that your getting nothing for these services. The bottom line is that you just spent way too much money on office management software without taking into account the fact that it needs to be able to help you provide these services to your clients! If you had known about or chosen opticXpress software, the 8 steps listed above....GONE! You could have stopped at number 3!

Billing for Cataract Post-Operative care should not be hard. It should be as easy for billing for an eye exam. With opticXpress at your side, billing for these services IS EASY! Watch this 59 second video to see just how easy it can be. Then...

CALL opticXpress AND LET US HANDLE CATARACT POST-OP BILLING FOR YOU!

Is this something that you have experienced in your office? Do you have stories about billing for cataract post-op care? Use the comment section below to let us know.

RELATED POSTS:

CATARACT POST-OPERATIVE BILLING

BILLING FOR CATARACT POST-OPERATIVE CARE

Optometric Billing-Today's Hillarious Video

2012-02-01T14:36:00.002-05:00

Today's Hillarious Video for all to enjoy! Please share this with everyone you know!

Remember, opticXpress doesn't take your optometric billing as a joke!

CONTACT US TODAY!

Optometric Billing-Dry Eye and the Schirmer Test

2012-02-01T14:22:00.000-05:00

Laurie Barber, MD, University of Arkansas Ophthalmology Professor, Interviewed by Sharon Kleyne about the Schirmer Test for Dry Eye, Eye Drop Allergies, Eye Mist, and Water.

You can read the article here.

CONTACT opticXpress TODAY!

Optometric Billing-Billing For Contact Lens Bandage Update for 2012

2012-02-01T12:38:00.001-05:00

Thanks to Dr. Eric Botts of OBC posted an update on Facebook that has answered a question we have long held concerning the billing of Contact Lenses as Bandages.

"92070 (bandage contact lens) has been replaced with 92071 (fitting of bandage contact lens to treat ocular disease) and 92072 (initial fitting for treatment of keratoconus)."

As always opticXpress Strives to be on top of billing and coding procedures in order to best serve the optometric community.

Talk Back! Let us know if this is helpful!

CONTACT opticXpress TODAY!

Optometric Billing-The OpticXpress Facebook Page!

2012-02-01T10:32:00.002-05:00

Take A Look At Our New Facebook Page and Like Us Today!

OpticXpress

Promote Your Page Too

Optometric Billing-Another Hilarious Video!

2012-01-31T14:28:00.001-05:00

Another Hilarious "optifog" video...were gonna have them make us an optometric billing commercial I

think! Enjoy and don't forget what we were all taught as children...SHARE!

DON'T FORGET TO CHECK OPTICXPRESS.COM FOR MORE OPTOMETRIC BILLING INFORMATION TODAY!

Optometric Billing- 25% Of All U.S Physicians Own a Tablet!

2012-01-31T14:08:00.000-05:00

At least twice per month it seems that we bring to light just how important it will be for optometrists to "Jumb on the iPad bandwagon"! Well, today, our friends at Noble Vision have said the same thing. They posted an article today that highlighted just how important these new tools are/can be.

"Today, 25 percent of all US physicians own a tablet device, while average consumers can use mobile devices asdiagnostic tools and share healthcare information via social networking. Mobile devices also provide consumers with the concept of “quantified self,” helping them monitor and improve their health."
Read the entire article here

We believe whole heartedly that tablets are the new "PC" and will become more mainstream this year and into 2013. In fact, it was announced yesterday that Apple is now the leading provider of "PC's" thanks to record sales of the iPad in the last quarter '04 having toppled the once dominant Hewlett Packard.

Here at opticXpress we test our optometric billing software and services on tablet devices regularly and encourage clients and non-clients alike to implement tablets into their office structure whenever possible. We encourage you to do the same if you haven't already.

CONTACT opticXpress TODAY FOR MORE INFORMATION!

Apple Leading the Way In Mobile Computing

More Mobile Platform Information

Optometric Billing-Getting The Most Out of Medicare

2012-01-30T17:37:00.000-05:00

I received a letter from one of my doctors today concerning certain types of Medicare Rejections having to do with patients that have Medicare but are actually covered by another insurance company for vision services. He asked me for some tips as to how to minimize these rejections and get more out of his services to Medicare patients. The following excerpt from my reply letter to him should efficiently help any optometric practice or optometrist who has the same questions regarding the billing of Medicare.

***Please note that you will see references in this excerpt to the opticXpress software system. Though most of you do not use it just know that if you do use it to bill Medicare we can virtually guarantee the payment of your Medicare claims provided you enter the required information into the system correctly.

Call opticXpress today for more information!

TIPS ON GETTING THE MOST OUT OF YOUR MEDICARE BILLING FOR OPTOMETRIC SERVICES

Here are some things that you should follow when performing an exam on a Medicare patient:
1) Medicare does not cover refractions. Make the patient pay for the refraction after you complete
the exam.
2) Make sure your staff collects ALL of the patient's insurance information and scans it into
opticXpress. This includes ID cards, social security cards and driver's liscense. Many times
a staff member sees one insurance card and then stops instead of proceeding forward with finding
out whether the patient has other insurance. If the staff member collects all of this and enters it
into opticXpress then it will be most valuable for us should a claim be denied...it allows us to
work the rejection ASAP.
3) Every medicare patient is required to pay Co-insurance of 20% of the allowed amount of the service.
This means that if your examination fee is $100.00 you should collect $20.00 in addition
to what you are charging for the refraction. If the patient has secondary insurance that will cover
co-insurances and deductibles then Medicare will usually "cross the claim over" to the patient's
secondary if the patient has alerted Medicare of this additional coverage. If the patient has not updated this information with Medicare or they don't have secondary
coverage, than collecting these fees up-front assures cash flow from Medicare while you are
awaiting final payment. Additionally, if your staff has entered all of the patient's insurance
info into the system it allows us to "cross the claim over" to his/her other insurance
on the patient's behalf. You will then receive this additional payment from the patient's secondary
insurance company.
4) Remember that Medicare's deductibles are a yearly payment each patient must pay. That means that
most Medicare patients you serve during the first 4-6 months of the year will owe this deductible
and hence, they will have to pay you for the service out of pocket after Medicare denies or
any secondary (supplemental) coverage will cover it but it will add to the turnaround time on
that claim. Just remember this when working with your Medicare patients and remind them while
they are in the exam room with you or at another designated time. Most Medicare patients are
elderly and it is imperative that you take your time to try and help them understand their
benefits. In the long run, you will profit more.
5) Finally, ask your patients the following before you begin the procedure:
a) "Do you fully understand our policy concerning Medicare patients?"
b) "Are you comfortable or able to pay for a refraction and/or your co-insurance today?"
c) "Do you understand that Medicare requires you to pay a deductible out-of-pocket and
you may owe this if you have not met it for the year and do not have supplemental
coverage to take care of this for you?"

Optometric Billing-Funny Optical Video!!! Must Read!

2012-01-26T12:39:00.001-05:00

From our friends at McLeish Optometrists comes this hilarious video! Share this with friends, family, colleagues and co-workers!

Don't forget, opticXpress is your one stop for all your optometric medical billing needs!

Optometric Billing-Apple Leading The Way In Mobile Computing

2012-01-25T20:00:00.001-05:00

Take a look at this article from ZDnet. It's just one more reason to choose iOS products as your mobile device
of choice to fuel your optometric practice!

"via ZDNet for iOS
Enterprise iPhone 4S activations spike, highlight Apple's halo effect

Apple sold more than 37 million iPhones in its December quarter and apparently a nice chunk of those went to the enterprise, according to Good Technology. Tim Cook, Apple CEO, gave his quarterly nod to the enterprise and highlighted enterprise accounts and Fortune 500 adoption stats of iPhones and iPads. In a nutshell, Apple is seeing a halo effect in its corporate, consumer and education account...(Read more)

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Optometric Billing-More Mobile Platform Information

Another Optometric Billing NO-NO!

2012-01-25T13:57:00.000-05:00

"A New Whiteland optometrist could retire any time he wanted, but he keeps going because he likes the work and the patients, some of whom he has treated for decades. Joseph Claudy began his practice after graduating from Indiana University School of Optometry in 1968. He began his career working from the New Whiteland home he still shares with his wife, Mary Jo, before moving to the current office a short distance away on U.S. 31.

Claudy, 75, works nearly full time. Patty Towles has worked for him for 23 years, scheduling appointments, billing patients and helping repair glasses. (entire article)"

I want to congratulate Dr. Claudy for finding and doing something he loves, it is a rare thing to be able to do that these days, it seems. However, I want to rebuke him for what he has put poor Patty Towles through for 23 years. Dr. Claudy has given a perfect example of the BIGGEST mistake I find being made in optometrist's office day and day out; USING ONE STAFF MEMBER TO DO TOO MANY THINGS.

When we go to Walmart and ONE cashier is ringing out customers don't we get agitated when no one is sent in to open another line and help relieve the traffic at the check out? WE ALL GET AGITATED AT THIS, so doesn't it stand to reason that when we run our practices shouldn't we provide the best customer service possible by not assigning one staff member too much work?

I understand that alot of times this decision is driven by economics. However, it is a proven fact that medical practices whose billing departments are made up of regular office staff routinely post lower collection amounts from insurance than their out sourced counterparts. So, with this in mind, doesn't it make more financial sense as a BUSINESS OWNER (notice the emphasis on business ower) to pay a few extra dollars in the short term to hire someone that specializes in insurance and patient billing than to loose more money in the long run relying on "Patty Towles" to do it all by herself for 23 years?

CALL opticXpress TODAY. WE WILL BILL INSURANCE AND PATIENTS FOR YOU SO PATTY TOWLES NO LONGER HAS TOO!

Optometric Billing-Programs Provide the Tools Needed for Practices to Significantly Increase Their Reimbursements.

Optometric Billing-Why Good Billing Can Alleviate Your Fears

Optometric Billing-Scientific Fact Of The Day-01/24/2012

2012-01-24T14:35:00.003-05:00

A recent study of business school graduates found that people who are 20% or more overweight make approximately $4,000.00 less per year than thinner graduates!

Also...

On Average, women cry 5.3 times per month while thier male counterparts cry only about 1.4 times per month!