The Optometric Billing Spot

Optometric Billing-Aetna and Coventry; Now One!

2013-05-08T13:55:00.001-04:00

Hopefully this merger will create more opportunities for Optometrists to generate revenue from qualified patients. Remember, many Aetna plans provide for 1 Routine eye exam per year and I've seen full reimbursements of up to $220.00 for one of these exams including full refraction reimbursement and payment of contacts or other supplies.

Remember, opticXpress is your one-stop for all your optometric billing, and revenue cycle management needs, check out our website today!

Optometric Billing-Expanded Job Decription for OD's

2013-04-09T18:10:00.000-04:00

According to Holly Lafferty at The William's Way, optometrists may soon be required to diagnose and manage other health issues rather than just issues dealing with vision. Though the practice is starting in California, it could quickly spread to other states if the program is successful. This is because, like in California, "Obamacare" is requiring expanded healthcare services and coverage to millions of Americans nationwide and as a result there is a shortage of qualified doctors in many of these areas to fill what would be an explosive need.

If you think that your medical and vision billing can be a headache now, imagine how much different it will be when you or your staff has to code, not only for vision care services, but for other MEDICAL services as well!

Not to fear...opticXpress is always here to help you with your optometric billing needs, CONTACT US TODAY and never worry about issues like this again!

For more info about the bill, please click the links below and don't forget to add your two cents...Comment and tell us what you think!

Original News Paper Article Published in Med City News

Article Posted by Holly Lafferty at The Williams Way

What problems face today's OD's in regards to medical, vision and patient billing?"

2013-03-28T17:22:00.000-04:00

The Meeting is Set!

opticXpress is pleased to announce our first ever webinar! The event will be a Q&A session featuring the president of opticXpress and special presenter, Arnaldo Martinez, O.D. of True Vision Optical in Miramar, Fl.

Taking place at 8pm on May 12th, 2013, the meeting will last for one hour and will be an opportunity for you, as an optometrist or office manager, to present to us the challenges you face on a daily basis in regards to medical insurance billing, vision insurance billing and patient billing. Not only will you be able to post questions to us on how to better manage these challenges, but we hope you will take this opportunity to share ways that you handle these challenges in your office as well.

We invite you to click the link below to register for this unique opportunity today!

SEE YOU SOON!

CLICK HERE TO REGISTER. SEATS ARE FREE AND GOING FAST, SO RESERVE YOUR SPOT TODAY!

Optometric Billing-Choose Your Billing Company Wisely!!

2013-03-26T17:56:00.003-04:00

It is no secret that we live in a world where the complexities of the insurance billing process leaves upon the door for fraud to run amok. Let me give you a personal example of just one such instance.

In August of last year, my wife was seen by an emergency room physician who was a member of larger group that was contracted with her insurance company, Aetna, but they were not contracted to accept Aetna's HMO. However, given the fact that it was emergency care, my wife's out-of-network benefits dictated that the group must accept her and send them the bill. Without fail, the bill was submitted to Aetna within 72 hours for which they received payment in the amount of $413.12. Upon receiving this payment, the billing company for this ER group, changed the original procedure code and re-billed Aetna using the new procedure code. (Now, unless you bill a corrected claim to Aetna using their central fax number, you cannot bill corrected claims to Aetna. They are not set-up to accept corrected claims into their automated electronic adjudication system used to process normal claims. ) After receiving two denials for my wife's "corrected" claim, they then billed her for the difference in charge between the new procedure code, $605.22, and what they were paid for the original procedure code, $413.12,a total sum of $192.10!
My wife, being the diligent and honest woman she is, paid the bill and then handed it to me to file away. Upon reviewing it I noticed that she was being balance billed, a practice that is not necessarily illegal. I decided to listen to my "sixth sense", as she would call it, and look at her EOB to make sure the charges were legitimate. Sure enough, the EOB clearly stated that she was, under no circumstance, to be balance billed for this procedure! So I promptly called them and demanded a refund. After being on hold for quite some time, I was finally allowed to speak to a nice young girl who informed me that a mistake had been made and that a refund would be processed promptly. She told me that my wife could expect to see the refund posted to her account within 30 days.
31 days later, the refund had still not been received. Another phone call to the billing company and another hour long wait turned up another representative who refused to let me speak to a supervisor but informed me that the refund had in-fact been processed and that it was pending a deposit to my wife's bank account. After getting off the phone with the billing company my wife decided to call her bank and follow up on the supposed deposit. Surprise, surprise: a refund was not pending, AT ALL!
At this point my wife decided to try and get her bank involved. She opened an investigation, and the bank did its due-diligence and tried to resolve the matter with the billing company. After another 30 days, she was informed by the bank that there was nothing they could do to help.
So now, just a couple of days before this writing took place, we were back at square 1. I decided to get involved again and sure enough, after another hour-long-wait, I was allowed to speak to Benjamin R. Oh Benjie, poor Benjie, he didn't know what he was running into when he started spewing off at the mouth to me that day! You see, Benjamin told me, again, that no supervisor could speak to me. He informed me further, that not only was my wife's refund not processed but that AETNA HAD REQUESTED A REFUND OF THE ORIGINAL PAID AMOUNT OF $413.12 AND NOW MY WIFE WOULD BE RESPONSIBLE TO PAY THAT BALANCE! This is where I went into "thermo-nuclear" mode against the billing company.
I promptly hung up with Benjamin R. and called Aetna's member services. I detailed the events to aetna and sent them copies of everything, it was then that they discovered the billing company had tried to double bill Aetna for the emergency procedure and billed my wife instead when they had recorded 2 denials of the claim. Aetna took it upon themselves to call the billing company at this point and then conferenced me into the conversation at which time we were told, " A refund has been processed to your wife's account but it can take up to 90 days for it complete"!
One word was my reply to them, "Unacceptable"!
Promptly, I filed a complaint with Aetna's Fraud unit, the FTC and the Better Business Bureau. I then sent a copy of the complaints to the owner of Physicians group in hope that he would see who he is allowing to represent him and that he would do something about it.

There is a recurring theme above. If you, as a medical practitioner, have a billing agency, staff-member, department or other entity in your employ, the words "unacceptable, hour-long-wait, it's the insurance company's fault, refused to let me speak to a manager, and fraud" had better never be used in the same sentence with them...EVER!!! These people represent your business, YOUR LIVELIHOOD on a daily basis, THEY REPRESENT YOU! These are the people you trust to provide CUSTOMER SERVICE to your patients and like it or not your patients are YOUR CUSTOMERS and without your customers, you have no practice.
What does this all mean? Choose your billing company or billing personnel wisely! If you outsource, stay on top of them, audit them from time to time or enter a fake person with your address into your management system and have them send you a bill and see how they handle the situation when you call in; do whatever you have to do to make sure that your name and your practice are being represented fairly. Trust me, even though the FTC and BBB don't do anything about a claim 99% of the time, the complaint gets logged in a searchable online database that patients, potential patients AND INSURANCE COMPANIES all check on a regular basis. The database may not cause you to loose many patients but if one of your top insurance payers decides to check up on you and sees one of those complaints, kiss your contract with them goodbye.

We live in the digital age and word of mouth is everything. Make sure the words being used to represent you are the right ones.

opticXpress is a reputable optometric billing company. We treat everyone fairly and we always make sure that your practice is represented in the best possible manner! Contact us today.

Optometric Billing-The Future of Optometry

2013-02-13T14:34:00.001-05:00

All the time I am confronted with OD's who complain or fear the rise of the prominence of Vision plans, decreases in reimbursements from Medicare and other Insurance companies and so forth. However, when I say to these docs "What are you going to do about it?" the answer is usually...SILENCE.

In my opinion, the only way to effect change is to be change. Speak up for what you believe, fight for what you want/need and find a way to be seen and heard. The funny part is that in today's world, it is so much easier to be heard AND seen than ever before if for no other reason than Google (blogger) and Youtube.

Below is a video I found on You Tube. Many of you may have seen this, many may have not. What is most important about this clip is that the people that you will see in it may be very prominent members of the optometric community while others are just getting started. What they all have in common...THEY ARE SPEAKING OUT IN DEFENSE OF THEIR PROFESSION AND MAKING THEMSELVES SEEN AND HEARD.

What will you do going forward? Will you speak out about your profession too? Talk back below and let us know and remember, opticXpress is always here to help...contact us today.

Optometric Billing-Billing Medicare for 92250 CPT

2013-02-05T20:53:00.002-05:00

Due to recent experiences with Certain Medicare Contractors and the post from Palmetto GBA posted below we are going to officially say that Billing for Fundus photos is now inherently Bilateral and you cannot append with proc. codes 50, LT or RT.

Yay Medicare for your wonderful attention to detail (pun intended)!

I submitted numerous claims for fundus photography with the bilateral procedure modifier to indicate that the procedure was performed on both eyes, but the services were rejected. Why?

Answer:In the Medicare Physician Fee Schedule Database (MPFSDB), fundus photography (CPT code 92250) is designated as a Bilateral Indicator 2 code, which means that payment is already based upon it being performed bilaterally. Therefore, CPT modifier 50 should not be submitted with CPT code 92250. When CPT code 92250 is performed bilaterally, simply submit it as CPT code 92250 (one unit) without CPT modifier 50.

(Link for original post found here)

last updated on 01/24/2013 "

As always, contact opticXpress for help with your Optometric Billing!

Optometric Billing- Using 92002,92004,92012 and 92014 When Billing Medicare

2012-10-06T22:29:00.000-04:00

Attention Optometric Billing Personnel. There have been changes this year to CPT coding guidelines that affect how you are reimbursed by Medicare and other insurance companies for Comprehensive Eye exams. Check them out below:

92002 and 92004 are now the only Comp. Ex. codes for new patients and 92012 and 92014 correspond for returning patients.
If using a 92002 or 92012 it is important that the DX code you report as #1 is one for which you plan to see this patient only 1 time in a calendar year. EX: If it is a new pt and they present with Dry Eyes (375.15) as the primary DX then you will most likely see that patient multiple times in the coming months and subsequently should use a 92004 or 92014 rather than a 92002 or 92012. If a patient present with Conjunctivitis as the primary DX then you will most likely only see that patient 1 time in the coming calendar year for that condition and it is therefore appropriate to use 92002 or 92012 to report the comprehensive exam to the insurance company.

For your claims, I have changed and resubmitted where possible. Please keep this in mind going forward so that you do not leave money one the table.

If you have a 2012 coding manual (paper-back) you can refer to page 329 for detailed descriptions of these services.

Click here to let opticXpress handle your optometric billing and begin tracking these changes for you today!

Optometric Billing-Some Coding Tips, OCT, GDX, Fundus Photos, ETC

2012-09-25T15:24:00.000-04:00

Optometric Billing-Billing for an Exam on the Same Day as a Surgical Procedure Such as Dry Eyes or Epilation

2012-09-07T00:26:00.000-04:00

It has always been my opinion that in order to bill for an exam on the same day as providing a surgical procedure, such as dry eyes, that one would have to have notated evidence that the examination portion of the encounter was not in fact related to the surgical procedure. It turns out that after some further research into my coding guidelines this is not just my opinion, it is fact. Let's take a look at how this should be handled.

IE: The patient came into the office for a routine exam or yearly check-up and at that time it was decided that the patient qualified for punctal plugs or epilation. (The plugs would be rare in this instance as it is now necessary to try every other treatment possible BEFORE proceeding with inserting the plugs).

So, in the example above, the physician would note that "the patient was in for a yearly check up and during the course of exam the patient described to the physician that though the drops he has been using for his dry eye syndrome help somewhat, they are still relatively ineffective at times and he would like to know if there is anything else he could try. At this time the physician offers the option of punctal plugs as they have been shown to be a very effective, though minimally invasive, method of treating the patient's condition. "

If the condition above, or any other combination of supporting evidence, is present you now have a justifiable basis for billing the insurance company for 1) A comprehensive examination 2) Punctal Plugs. The example above would be billed in a manner similar to the following:

1) 92014-25 (25 modifier means the exam is a separate service from the actual plugs themselves)

2) 68761 (one plug in either eye) or 68761-50 (1 plug in both eyes) or 68761-51 (2 plugs in the same eye) or better still 68761 E1 (E1 meaning it was the upper left lacrimal duct E3 would be upper right and E2E4 are lower left and right respectively). SEE BELOW

If the condition in the above example is not met, by no means should you bill an insurance company for an exam AND a surgical procedure.At this point, it is understood that the procedure for plugs or epilation etc. includes any examination that need be done. Furthermore, UNLESS a patient comes into the office for an exam during the 10 DAYS subsequent to the punctal plug procedure for something UNRELATED to the previous procedure you cannot bill the patient's insurance for any further items. In this case, you would bill the proper examination procedure code, followed with a -24 modifier (unrelated E/M procedure during post-op period) SEE BELOW

CLICK HERE TO VIEW THE OFFICIAL MEDICARE COVERAGE INFORMATION FOR BILLING PUNCTAL PLUGS.

If you would like to make your billing easier and more effective, try contacting opticXpress today by clicking here!

Optometric Billing-Billing For Punctal Plugs

2012-09-06T19:06:00.000-04:00

This was burried in our internal notes and is article written by John Rumpakis, O.D., M.B.A., Clinical Coding Editor. You can find the original text for this article by clicking here.

"Signs and symptoms of dry eye syndrome are often discovered during a comprehensive exam. When further testing is indicated, this may be best done as a follow-up evaluation. This evaluation for dry eye syndrome most likely involves several examination techniques and ancillary tests. These tests, which do not have separate procedure codes, include:

• Patient history (dry eye surveys, symptoms, circumstances, etc.)

• Tear film break-up time (TFBUT) • Schirmer testing (I&II)

• Cotton thread or phenol red thread testing

• Sodium fluorescein, lissamine green and/or rose bengal staining

• Tear prism evaluation

• Evaluation of lid wiper epitheliopathy

• Biomicroscopy and examination of ocular surface and lid margins

These tests help you formulate the diagnosis. The appropriate diagnosis code is usually dry eye syndrome (375.15) or keratitis sicca (370.33). Sjögren’s syndrome/keratoconjunctivitis sicca (710.2) is also a possibility, although you should be familiar with your carrier’s requirements prior to initiating any therapy.

In general, before contemplating either surgical or prescriptive treatment, you should have a well documented record of palliative therapy with an artificial tear protocol. The failure of the artificial tear treatment is what provides the medical necessity to proceed to more invasive treatment.

Once you’ve made the diagnosis of dry eye and formalized a treatment plan, several subsequent visits are typically necessary to evaluate the treatment plan. Both the diagnostic and treatment visits are billed using the appropriate office visit codes only. Keep in mind that if you perform the diagnostic examination on the same date as the comprehensive exam, it is not billable as a separate/distinct visit in addition to the comprehensive examination. Follow-up visits to assess the effectiveness of treatment, to alter or to add to the treatment plan are billed using 99212, 99213 or 92012.

If you decide the patient requires punctal plugs, the billing is the same for temporary diagnostic plugs and permanent plugs. The supply of the punctal plugs is typically included in the insertion code. The insertion procedure is billed per plug in one of two ways. Here is the first method:

• One plug: 68761

• Two plugs, different eyes: 68761-50 (billed at 200% of one plug)

• Two plugs, same eye: 68761-51 (billed at 200% of one plug)

• Three plugs: 68761-50 (billed at 200% of one plug) and 68761-51 (billed at 100% of one plug)

• Four plugs: 68761-50 (billed at 200% of one plug) and 68761-50-51 (billed at 200% of one plug)

The “multiple surgery rule” applies, so the payment is typically 100% for first plug, 50% for the second plug, and 25% for each of the third and fourth plug. The -50 modifier indicates a bilateral procedure on the same eye and the -51 modifier indicates multiple procedures on the same eye. See Appendix A in your CPT book for further details.

The second method for billing punctal occlusion is adding the E modifiers to the surgical code to designate which puncta are being occluded. Bill for each plug on a separate line using the appropriate E modifier:

• E1: upper left

• E2: lower left

• E3: upper right

• E4: lower right

The global period for punctal occlusion is 10 days. So, if a patient returns within that period for a follow-up visit related to the punctal occlusion, then that visit is included in the insertion fee. However, if a patient returns for an unrelated problem, then that office visit must be billed using a -24 modifier (unrelated evaluation and management during a postoperative period) in order for you to be compensated for that encounter. "

We would like to thank Dr. Rumpakis for his continued contributions to Medical Coding. His work has proved to be very valuable to our cause as well as many OD's around the country.

CHECK OUT OPTICXPRESS TODAY AND TAKE THE NEXT STEP TO MAKING YOUR BILLING MUCH EASIER!

Optometric Billing- Does Medicare Cover Routine Eye Exams?

2012-08-31T14:33:00.000-04:00

I get this question all the time, sometimes doctors even demand that I "respect their authoritah" (Eric Cartman pun intended) and trust them when they tell me that Medicare Pays for Routine Eye Exams.

Simply put, MEDICARE DOES NOT PAY FOR ROUTINE EYE EXAMS, EXCEPT FOR PATIENTS WITH DIABETES.

"Medicare Part B (Medical Insurance) covers a yearly eye exam for diabetic retinopathy by an eye doctor who is legally allowed to do the test in your state." link

That being said, if you try to bill Medicare using a V72.0, 367.21, 367.0, 367.4,367.1 DX Code as your primary DX code, expect not to get paid; and if Medicare doesn't cover it, chances are the patient's secondary may not pick it up either, although this is not a definite rule as it varies by payer and patient plan.

By the way, for those docs and staff out there that think you are being paid for routine work because the EOB says you were paid for a "92004 and 92015"....YOU ARE MISTAKEN AND YOU MUST LEARN TO RESPECT MY "AUTHORITAH" !

OPTOMETRIC BILLING-INCREASE REVENUE, BY 50 PERCENT?!?!

2012-08-13T18:46:00.000-04:00

I recently came across a website that specializes in medical billing for opthalmologists. The owners of the site, and likely the business, claim right on the home page that you can "INCREASE YOUR REVENUE BY 50% WHEN YOU OUTSOURCE YOUR BILLING!" .

I CALL BULLSHIT!

I know, I know. It is unprofessional of me to curse on a professional blog site but can you honestly blame me? If you stop and think about it for one second, doesn't that make you feel a little bit stupid as a doctor to see someone advertise to you that they can increase your business by 50% if you just outsource your billing!?!? Maybe stupid isn't even the right word. Maybe foolish is better. Maybe you can think of a better word to describe the feeling that that statement evokes and post it in the comment section below. The bottom line, however, is that no matter how you slice it that is just false advertisement, PERIOD.

First of all some simple math. If your business bills $50k per year to medical insurance it's absolute fodder to believe that outsourcing that job will all of a sudden bring you $50k more per year in insurance business, how does that add up? Where is the logic there? Also, let's just say that the claim this advertiser is making means that you will simply just collect 50% more by outsourcing your billing and your current collection rate is 50%, you will now add $12.5k more money to your bottom line bringing your overall collection rate to only 75% which is the industry average, you can do better than that, why settle for less?

No matter what angle you look at it from, insurance just doesn't work that way. Quite simply, insurance is nothing more than a corporate lottery. These companies are in the business of making money and will do whatever they can to keep their reimbursement rates as low as possible meaning you, the provider, and the patient loose big time. Do you really think that outsourcing is going to improve your odds of DRASTICALLY improving your revenue?

Don't get me wrong. Outsourcing is a great thing and will DEFINITELY improve your revenue and your cash flow if you choose the right partner to outsource too. However, there is no way that I or anyone else can guarantee you that you will improve revenue by 50% if you just outsource your billing. The answer to improving your revenue begins and ends with you, the practice owner. You want to increase your current revenue? You should outsource your billing to a company like opticXpress who focuses on increasing your collection percentage AND works with your patients. This frees up your office staff giving them the time and flexibility to focus on what matters most, your patients. Second, you should increase your business which is single handedly the only tried and true method to increase revenue. Last, TRAIN YOUR STAFF! A well trained staff who understands patient satisfaction and insurance eligibility procedure not only keeps your customers (patients) happy but it cuts down on billing errors and keeps you "in the black".

So, the next time someone tells you that you can increase revenue just from outsourcing, pipe up and call bullshit.

CHECK OUT OPTOMETRIC BILLING SERVICES BY opticXpress TODAY!

Optometric Billing-Free Optometric Billing?

2012-07-31T14:27:00.001-04:00

That's right! opticXpress is working on a way to provide optometrists with a FREE* method to perform optometric billing that centers around their office management software. More info is coming soon, but check their software page for more info about how the ground breaking opticXpress software might be a fit for your practice.

You can also CLICK HERE for software info.

RELATED:

What is Optometric Billing?

Optometric Billing-Today Funny Video-Sorry Walmart OD's!

2012-06-05T13:55:00.001-04:00

This goes out to all of the Walmart Vision Center O.D's and their staff...Clearly, you have it rough!

Dont forget: opticXpress for all your optometric billing needs!

Optometric Billing-Today's Funny Video-04/04/2012

2012-04-04T14:57:00.003-04:00

As usual, we here at opticXpress enjoy a good laugh. Watch the video below and remember to clean the glass at your offices regularly!!!!

Contact opticXpress Today For All of Your Optometric Billing Needs!

Optometric Billing-How To Properly Bill For Visual Fields

2012-03-23T15:28:00.003-04:00

Using Medicare's Local Coverage Determinations (LCD's) as a guide to billing ALL insurance companies is a good strategy to employ. Though it does not guarantee payment across the board, it is, in my opinion, a key way to increase reimbursements. This is because Medicare is, by far, the most stringent payer in terms of rules for coverage.

As an optometrist, one of the most important procedures you give your clients is a Visual Field (92081,92082,92083) but it is also one of the most commonly misbilled procedures in the optometric billing field. The biggest reason for this is that it is commonly not paired with a correct diagnosis code which means you loose money because it is denied as "medically unnecessary". You can avoid this by first determining whether or not it is deemed medically necessary to perform a visual field by check the attached chart to see if the diagnosis you are suspecting qualifies for a visual field. If it does not then you need to explain to the patient that you feel it is necessary to perform the procedure and CHARGE THE PATIENT! You would then bill the insurance company with a "-GY" modifier. MAKE SURE THAT YOU INCLUDE THIS INFORMATION IN THE PATIENT'S ADVANCE BENEFICIARY NOTICE (ABN) !

CONTACT opticXpress TODAY FOR HELP WITH YOUR OPTOMETRIC BILLING

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

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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!