12 Tips To Increase Cash Flow In Eye Care Practice

Almost 65 percent of denied claims are never reworked and resubmitted to payers. Average cost of reworking a denied claim is $25.20. It may appear very small amount but it also multiply very speedily. It is pertinent to note that 90 percent of claim denials are avoidable with a appropriate revenue cycle management and optometric billing solution.

Here in below are 12 tips which eye care professionals must implement to get faster reimbursement.

1. Provider Credentialing:

Simplify the credentialing process to determine the provider’s participation status in the health plan, then submitting and tracking provider credentialing applications based on insurance plan requirements.

2. Patient Insurance Eligibility and Benefits Verification:

Verification of patient’s insurance eligibility and benefits is utmost necessary prior to submission of insurance claim. Also ensure demographic and insurance data is correct by verification of plan coverage and the co-pays.

3. Accurate Charge Entry:

Charge entry is a process to enter perfect medical billing information and assign diagnosis and procedure codes prior to file vision or medical claim. Accurate charge entry is very necessary to collect maximum reimbursements, reduce payment denials and increase profit.

4. Updated Knowledge of Medical Billing and Coding Changes:

Optometry and ophthalmology medical billing regulations, and code changes are never ending and frustrating. for eye care professionals, it is very time consuming to keep updated with such changes. Therefore, outsourcing medical billing is the only practical option.

5. Accuracy In Electronic and Paper Claims:

High Clean Claim Rate (CCR) maintenance requires well-defined revenue cycle management processes. Clean and accurate claims get paid faster. Educate your staff how to bill the visit and ensure that claims are clean and free from any error prior to submission to vision plans and insurance companies.

6. Clearinghouse Management:

Clearinghouse gives medical billers access from a single location to various insurance payers, across different states. It also expedites reimbursements and increases revenue by electronic claim submissions. To expedite reimbursement, choose a clearinghouse that integrates with eye care practice management software so management of patients and insurance billing can be done with built-in edit checks.

7. Payment Posting:

For accurate and up-to-date accounts, post payments that arrive in through Electronic Remittance Advice and standard paper Explanation of Benefits, directly into practice management system, One can move the balance to secondary insurance and bill that very rapidly, by posting remits within 24 to 48 hours,

8. Secondary Claims:

If optometry billing cycle not running perfectly, it works like a ripple effect. If primary claims not filed, then secondary claims and patient billing are delayed. Many payers require to bill a secondary payer within a specific period after receipt of primary payment. If there is a balance left for the patient co-pay, it becomes very difficult to collect payment. Therefore, file claims promptly.

9. Claim Denials Management:

To increase cash flow, it is most important to review all denied claims and make necessary corrections as early as possible. Most payers have set a deadline for resubmission the denial. Most common denial reasons are invalid insurance information, invalid member ID numbers, invalid insured information, and the patient isn’t eligible on the date of service.

10. AR Cleanup and Insurance Follow-up:

Focus on accounts receivable (AR) and aging claims daily to check why open balances are still outstanding. Accurate data is directly related to reimbursements receipts.

11. Avoid Reimbursement Delays:

Prevention is better than cure. Prevention of denials is the best way to increase cash flow. Therefore, avoid reimbursement delays by submission of clean and error free claims.

12. Use Patient Statement Service:

For busy practices, it is difficult to get time for printing and mailing patient statements. Hiring a complete RCM service, practices can reduce overheads, increase revenue, and eliminate time-consuming work of in-house printing and mailing.


Consider X-Factor Healthcare Solutions LLC as your Medical & Dental Billing Partner

You are at the right place for a Medical & Dental Billing Partner who can focus on your Revenue Cycle Management and make the technology and implementation just as simple.

That’s what the best medical billing company X-Factor Healthcare Solutions LLC can do.

Schedule a meeting with our medical billing manager by filling out schedule appointment form from our website.


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