Medicare Expands MPPR Policy to TC Ophthalmology Procedures

Just in case you missed it on the VisionWeb Blog: Medicare has expanded the Multiple Procedure Payment Reduction (MPPR) policy and, effective January 1, 2013, will implement cuts to concurrent diagnostic eye services. If more than one test is performed on the same day, the payment for the technical component (TC) of the less expensive service … [Read more...]

8% Of Insurance Claims Denied?

A great article from VisionWeb on Best Billing Practices:   We all know that rejected insurance claims cost your practice, but how much exactly? An average sized eyecare practice generates 200 claims a month and with an average denial rate of 8%, 16 claims are rejected monthly.  It costs up to $40 per appealed denial, which can run your practice … [Read more...]

Ophthalmic Coding Resources for Electronic Claims Processing

If you are an ophthalmology professional, it is important to keep your coding knowledge up to date! Whether you are a physician, coding/billing staff, office manager, administrator, consultant, ophthalmic medical personnel, or para-professional, taking the Ophthalmic Coding Specialist (OCS) Exam will benefit you. Here are a few frequently asked … [Read more...]

Vision Plan Calculator

We just ran across a Vision Plan Calculator from VPquote.   This is what they say: The vpQuote Vision Plan Calculator was developed to assist Optical Dispensaries in determining the patient-due balance on optical sales given the selected frame, lenses, and lens enhancements.  With the proliferation of Vision Plans and the multitude of benefit … [Read more...]

Billing Bytes; Fundus Photography with Interpretation and Report

Fundus Photography—CPT Code 92250: Fundus photography with interpretation and report You should always note the performance of this test and any findings. You only bill once even if the test is performed on both eyes. The billing might be split into a professional component (using modifier -26) and a technical component (using modifier –TC) if … [Read more...]

Eye-fographic: Lifestyle of A Claim

From Visionweb Blog . All that work, just to get paid, don't you miss the old days sometimes? … [Read more...]

Billing Bytes: Don’t Ignore Electronic Billing Reports

If you're like most eyecare practices, you're up to your ears in claim filing work, so it seems like there's no time to take on anything "extra". Unfortunately, a lot of practices treat their electronic billing reports as something extra when it isn't. In fact, we think it's one of the most important parts of the billing cycle. That's right, PART … [Read more...]

Billing Bytes: File Your DME Claims to the Correct DME MAC

Electronic claim submission can be tedious. Check out our latest coding tip to help you stay efficient in your claim filing processes! When filing a Medicare claim to a Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) for spectacle lenses after a recent cataract surgery, the claim must then be processed by the DME MAC … [Read more...]

Billing Bytes: Advance Beneficiary Notice of Non-Coverage Form

Check out our newest coding tip to help out with your electonic claims processing! Are you familiar with when and how to use the Advance Beneficiary Notice of Noncoverage (ABN) form? The ABN form is provided to Medicare beneficiaries as a way to advise them that a specific service or item may not be covered by Medicare. It also makes them aware … [Read more...]

Flexible Spending -FSA-HRA-HSA Reimbursement Update

The Vision Council Update: Flexible Spending Arrangements / Health Reimbursement Arrangements / Health Savings Accounts (FSA/HRA/HSA) With the ongoing debate regarding the Patient Protection and Affordable Care Act (PPACA) that Congress passed in 2010, consumers are becoming more aware of how they pay for their eye care and what their insurance … [Read more...]

Billing Bytes: Medical Claims Clearinghouses: Should You Commit?

Selecting a clearinghouse is an important decision for any eyecare practice. You need to make sure you are picking the service that is right for you, so we've put together some important things that we think you shoud consider... Before committing to a clearinghouse, ask yourself: What is the enrollment and set up process going to … [Read more...]

What vision insurance do you have? Comments Wanted-Needed!

How many times in a day do we ask this question?  How many times is the answer "I don't know"? It seems that most patients know their medical insurance carrier, but have no clue who holds their vision policy.  Sometimes you can get the information by the employer name or school, but a lot of times the information is elusive.  Do you have a … [Read more...]

Billing Bytes; 3 CPT Codes That Should No Longer Be Used

From the VisionWeb Blog: There are a few CPT codes that have been deleted, and it is recommended that they no longer be used.  Some deleted codes include: 92070 (Fitting of contact lens for treatment of disease, including supply of lens); 92120 (Tonography with interpretations and report, recording indentation tonometer method or perilimbal … [Read more...]

Billing Bytes: First Pair Of Glasses After Cataract Surgery

Medicare normally pays toward the first pair of eyeglasses after cataract surgery.  But some patients do not qualify for Medicare because of the patient's age or their spouse is still working under a qualified benefit plan, and billing needs to be made to their medical insurance carrier.  Of course, the medical insurance would cover it, right?  … [Read more...]

VisionWeb’s First ebook on Claims Filing

eye gotta tell ya, we love VisionWeb. They just published their first ebook on Claim Filing: Fantasy vs Fact. It is easy reading, fun and chock full of good advice. Check it out and download here  We also recommend, that you keep this on file for any new billers and coders. A brief example … [Read more...]