Optometrist Options for Billing and Coding
While optometry is not a new profession, the industry may not be enjoying the same benefits as larger medical outlets when it comes to receiving their proper dues (in the form of financial reimbursement). This could be attributed in large part to the fact that optometrists are either not aware of the benefits of medical billing and coding, or because they are not utilizing it properly. In either case, there is a lot to be gained from an understanding of the processes and options involved in medical billing a coding and how doctors of any stripe can take advantage of it to make their business run more smoothly and ensure that they are operating at maximum capacity.
1. AOA Coding Today . If the problem is that you are simply not informed about how medical billing and coding can help your business, then you should look to the American Optometric Association for a little help or American Academy of Ophthalmology CodeQuest, their annual lecture tour, will provide optometrists with both the basics of billing and coding as well as up-to-date advances in the field. Or you can simply visit their online forum with any questions you may have.
2. Insurance. Every medical office must deal with a variety of insurance companies, but the main one (and probably the most complex) is Medicare. While it may take some time to learn the ins and outs of what different companies are willing to pay, it would behoove you to find out what they offer as reimbursement for your standard services so that you are getting the most for your time. For example, standard fees are a thing of the past. If a certain insurance company pays more than your regular fee, you may want to ask yourself if you’re charging enough for your services (since payouts are based on what the carrier deems to be fair). There are certainly situations in which you will not be able to recover all costs through insurance, so perhaps you should consider an offset when it comes to items that the coverage exceeds.
3. RBRVS. The Resource-Based Relative Value Scale is a system designed by Medicare to calculate the value of a medical procedure in order to assign it numerical cost (based on the amount of work, overhead, and risk involved). It pays to know what these values are so that you can bill accordingly. You may be able to receive a listing (from Medicare at the very least), but you can also learn to calculate them for other insurance providers who are reticent to release the information.
4. Code correctly. There is no quicker way to lose money than through incorrect coding. If you’re lucky, you will receive a reduced reimbursement, but it’s much more likely that your claim will be rejected altogether. So take the time to incorporate knowledge of coding with your clinical expertise in order to ensure that you get paid correctly. You can do this by attending seminars or getting advice and training from an experienced medical biller and coder (or simply hiring one).
5. Invest in software. It might be next to impossible to do medical billing and coding on your own, especially with the health care industry in flux and changes on the horizon. So consider investing in software that will help you make the right selections, calculate values, and ensure that you are reimbursed fully for your work.