Optometric Billing-Copays, Co-insurances and Deductibles-To Collect or Not Collect ?

Thanks to our friends at EyeCOR The answer to this question is simple. View below

There you have it, COLLECT CO-PAYS, CO-INSURANCES AND DEDUCTIBLES FROM EVERY PATIENT THAT FALLS INTO THESE CATEGORIES...OR ELSE! (You are not responsible if you bill the patient and the patient doesn't pay, you just have to prove that you billed them!)

Click here to contact opticXpress and we will take care of this for you...then you will never have to worry about a problem like this :)

Optometric Billing-ICD Implementation Delayed....AGAIN!

Senate passes bill which delays ICD-10 implementationPosted on: Tuesday, April 01, 2014

The U.S. Senate passed a House-approved measure (HR-4302) on Monday evening (3/31/2014) that delays the conversion to ICD-10 diagnostic and procedure codes until at least October 1, 2015. 

Oddly enough, the bill wasn't even ICD-10 related....no one even knows how this measure got into the act. Provider groups (likely the AMA to name) are apparently pretty pissed. I know I am, I would like to just get it done already.

You can one of the articles on the topic by clicking here.

If you Click Here, you won't have to worry about ICD-10 cause opticXpress will worry about it for you!

Optometric Billing-Affordable Care Act (Obama Care), Letter From President Obama

I got this letter from the President of The United States earlier today, I just wanted to share it with everyone.

"Hello everyone,

Last night, the first open enrollment period under the Affordable Care Act came to an end.

And this afternoon, we announced that 7.1 million Americans have now signed up for private insurance plans through the new Health Insurance Marketplaces.

7.1 million.

That doesn't count the more than 3 million young adults who have gained insurance under this law by staying on their families' plans. It doesn't count the millions more who have gotten covered through the expansion of Medicaid and the Children's Health Insurance Program. It doesn't include the more than 100 million folks who now have better care -- who are receiving additional benefits, like mammograms and contraceptive care, at no extra cost.

Now, millions of our fellow Americans have the comfort and peace of mind that comes with knowing they're no longer leaving their health and well-being to chance. For many of them, quality health insurance wasn't an option until this year -- maybe because they couldn't afford it, or because a pre-existing condition kept them locked out of a discriminatory system.

Today, that's changed. And while our long-broken health care system may not be completely fixed, it's without question a lot better. That's something to be proud of -- and there's no good reason to go back.

Regardless of your politics, or your feelings about the Affordable Care Act, millions more Americans with health coverage is something that's good for our economy and our country.

At the end of the day, that is what this law -- and the other reforms we're fighting for, from a 21st-century immigration system to a fairer wage for every American who's willing to work for it -- are all about:

Making sure our country lives up to our highest ideals.

I am thankful to be your President today, and every day. And I am proud that this law will continue to make life better for millions of Americans in the years to come.

Thank you.

President Barack Obama"

Somewhere in there he forgot to mention that now, millions of more people will be insured to walk through your optometry practice doors and create an optometric billing nightmare for your billing staff because many, many, many of these newly insured patients, as well as the patient's that have been with you for years, are going to get hit with sky-high deductibles that average anywhere from $3k-$10k per year. 

Patients barely want to pay their co-pays now as it is,do you really think it is gonna be any easier to get them to pay for their entire exam out of pocket due to ridiculously high deductibles and co-insurances? Somewhere, I bet the board members of Care Credit are cracking open bottles of Dom Perignon and cases of Cuban Cigars while they laugh...all the way to the bank.

Avoid hastles. Click here to let opticXpress become your biling department today.

Optometric Billing-Why I Hate Officemate-Part 2

Problem #2: Upgrade Apology

A few days after officemate released its version 11 software, they took the download link off "MyInstall Center" and issued the above apology. The problem is, how could you release a non-working piece of software into the world to people who pay you good money for software knowing it doesn't work properly? (Coincidentally, that in and of itself is the underlying premise to this entire series of articles.) Especially after you told everybody that you had been testing it for months?

What Does This Problem Mean to the Average Office Mate User?
Well the answer here is a simple one. Let's use our office in Stowe as an example. When we upgraded to office mate we had 9 workstations and lap-tops that needed to be updated and a server. Also, the update instructed that from now on, A SERVER IS REQUIRED TO USE OFFICEMATE. Trying to be smart, we updated the server first, then the dr's computer, billing computer and front desk. After those were verified as working, we began to move to the smaller, less important computers. However, after getting our optical computer updated, the updated was removed from the install center, leaving us without the ability to finish the update for several days and rendering our non-updated computers...useless!

Apply that scenario to a less technically advanced office. What if the server wasn't installed and the update was made hastily, as in the case of many users? What if the update was removed before the office had the opportunity to update the doctor's computer which is vital to charting and other exam information?

All that aside, the bottom line is this: if you are going to charge people $1 or $10,000. for software that you claim is the "greatest thing since sliced bread", shouldn't you make sure it works %100 before you sell it to them?

Issues like this (and crap apologies from your software vendor) lead to losses of precious revenue and time and a lowered standard of care for patients at many practices in the United States, is yours one of them? What are you going to do about it?

Click here to contact opticXpress today for help finding the right software for your practice.

Optometric Billing-Billing Medicare for 92250-Denials Reported

We have seen Medicare denying 92250 in some regions due to not having a referring provider present on the claim form. Putting the attending physician name and NPI in box 17a and 17b on the claim form (old and new) should fix the problem.

Click here to contact opticXpress to become your billing service. Stop worrying about these denials on your own!

Optometric Billing-Claims to Be Held by Medicare per Congressional Request

Information Regarding the Holding of April 2014 Claims for Services Paid Under the 2014 Medicare Physician Fee Schedule
The 2014 Medicare Physician Fee Schedule (MPFS) final rule stipulated a negative update to the MPFS that was to be effective January 1, 2014. That reduction was averted for three months with the passage of the Pathway for SGR Reform Act of 2013, which provided for a 0.5 percent update for services paid under the MPFS through March 31, 2014.

CMS is hopeful that there will be congressional action to prevent the negative update from taking effect on April 1, 2014. CMS has instructed the Medicare Administrative Contractors to hold claims containing services paid under the MPFS for the first 10 business days of April (i.e., through April 14, 2014). This hold would only affect MPFS claims with dates of service of April 1, 2014, and later. The hold should have minimal impact on provider cash flow, because under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 days for paper claims) after the date of receipt. All claims for services delivered on or before March 31, 2014, will be processed and paid under normal procedures, regardless of any Congressional actions.

You can always contact opticXpress for help with your optometric medical billing and avoid having to worry about these things yourself. Please click here for more info.

Optometric Billing-Why I HATE Office Mate-Part 1

I have been meaning to write this for a long time but for some reason, all I have done is just collect evidence on the subject without actually pulling the trigger on the situation. Hell, I even sent the software designers some of the screen shots that I am going to share with you in an effort to get them to fix these important mistakes BEFORE releasing a new version of the software....it didn't work. So, I am here today to begin my attack on Office Mate.

Office Mate is by far, the worst piece of crap that has ever been sold to the optometric community. I can go into a million reasons as to why but for the purpose of these posts, I am only going to highlight the issues that I can explain to you visually. That is, I have photo documented proof of why you shouldn't spend your money on this piece of Sh88, and if you did these photos prove that you should not only stop using office mate, you should fight tooth and nail to get your money back.

Lastly, before I begin, I want to point out that after speaking to various high level technicians and programmers at office mate ( or eyefinity or who ever the hell owns these people), every single one of the issues that I am going to share with you has been acknowledged by office mate as "known of for quite sometime, program works as designed. No Immediate plans to fix." Did you hear that in your mind as you read that last sentence? OFFICE MATE DESIGNED THIS TO WORK WRONG AND HAS NO PLANS TO FIX IT!

Now, without further adue:

PROBLEM #1: FEE SLIPS DON'T CORRECTLY CARRY OVER TO CLAIMS

In the above image, this patient's exam was coded using  Exam Writer and each diagnosis code was correctly pointed to the respective procedure codes as the Dr. here wanted them submitted to the insurance company. However, when the exam was carried over to the fee slip by our secretary, only #2 diagnosis code appeared on the fee slip for her to choose from. When I received the claim in "3rd party processing" at the end of the day, the above is what I got. The Dr. had actually pointed 1,2,3,4 to proc code 1 when she charted that day and used #2 for the PQRS codes, yet how is it that the claim in the picture above was generated? 

WHAT DOES THIS PROBLEM MEAN TO THE AVERAGE OFFICE MATE USER?

The average optometry practice does not have a billing department and may not have an actual biller. The job of batching claims and submitting to the insurance company is usually left to a secretary, office manager, another un-qualified individual in the office or the doctor. None of these named individuals have the time, desire and in many cases, knowledge to properly research and correct the error above on a daily basis. In fact, most offices don't even batch and submit on a daily basis, many do it weekly. What if you had to fix EVERY CLAIM for 10,20,30 or even 50 patients at the end of a long week? The issue above is a primary reason why claims generated by office mate can't be trusted. 

CRAP CLAIMS LIKE THE ONE ABOVE LEAD TO A LOSS OF PRECIOUS REVENUE IN MANY PRACTICES IN THE UNITED STATES.