Optometric Billing-Certified Paraoptometric Coders-What the AOA Says and What You Really Should Do

     Last Month, The American Optometric Association (AOA) published their 2012-2013 Annual Report. On pages 14 and 15 of the report, under the section titled "Practice Management", an excerpt piece was written concerning the growing problem of coding and claim errors and how they affect the bottom line. The AOA, by way of this article, suggests that you should have your entire staff trained as Certified Paraoptometric Coders (through AOA's Commision on Paraoptometric Certification, coincidentally) in order to help reduce the costs associated with coding and claim errors. Though I fully agree that coding errors are an issue for many practices, I am vehemently against training EVERY staff member in the area of coding and allowing THAT MANY hands to touch your claims.

     First, some background information on my self. Yes, I am a medical biller that runs a medical billing company dedicated solely to the practice of optometry. However, my business is also part of a growing eye-care clinic located in Stowe, VT. Second, this article is not a result of my fear of loosing business because more staff members will be able to perform the same tasks that are outsourced to my business as a result of becoming Certified Paraoptometric Coders. On the contrary, I am all for a clinic choosing to keep their billing in house, if they can afford to do so. We are blessed in that the Dr. here in Stowe Eyecare CAN afford that expense.  What this article is meant to address is why you don't want to train everyone in your clinic to become coders and why that is a bad business decision.

     Now, some background information on the CPC program. A little research on the Google Machine turned up the AOA's website referring to the CPC program (actually, it is referred to as the CPOC program on the site not "CPC" as contained in the Annual Report). The CPC program is designed for professionals who not only have a minimum of a high school diploma or its equivalent but also " a Minimum of two (2) years' experience in the medical coding and billing field". So off the bat, this program IS NOT FOR EVERY member of your staff as the excerpt suggests. Next, there is, obviously, a charge associated with sending this employee through the program. The minimum cost is $265.00 to register the person for the test on top of which you, or the employee, may purchase study materials for a minimum cost of $500 if you are an AOA member or $750 if you are not a member. From what I can garner from the site alone, this is a completely self directed course, covered by a minimum investment of $765.00, that culminates in a 125 question multiple choice exam certifying the employee as a Paraoptometric Coder...not exactly a professional certification in billing and coding if you ask me. I agree, it is probably very helpful in terms of useful knowledge to a billing person but it is not what I would pin my hopes on if I was hoping to transform my ENTIRE staff into knowledgeable billing personnel like the AOA's article suggests it could. 

     So, with that background knowledge out of the way, and you can look at the AOA's website concerning the CPOC program and all their other programs by CLICKING HERE, why shouldn't you train every member of your staff as Certified Paraoptometric Coders? First, and probably most important, what business does every member of your staff have being involved with a patient's financial information? This is a very important question you should ask yourself if you are even considering this program. 

     Second, The programs calls for minimum requirements of a diploma or GED and 2 years experience in the medical coding and billing field. Let me ask you, and this is totally based on the size and amount of business you do each day, how many of your normal, every-day, non-management personnel have been or normally would be with you long enough to justify the investment of $765.00 into those employees' Paraoptometric Coding Certfication? 1 maybe 2 or none at all? Do they even have 2 years experience in billing and coding if they have been with you long enough to justify this expense or would this be throwing them into a completely foreign field of knowledge?

     Third, and this question is probably just as important as the first question, why would you want to place the additional responsibility of coding and billing on regular support staff when they are most-likely maxed out in terms of their daily responsibilities to begin with? Don't you think that it is more important that they be focused on providing customer service to patients and potential patients when they walk through the door and not be bogged down with worrying about the billing also?

     Here's what I believe you really should do. Do I think that the CPC program has some merit? I do. I think that it is a very beneficial thing for members of your billing staff. If you have a dedicated billing department, and any of them have experience and have been with you past a probationary period (IE 60, 90 or 120 days) then by all means, GO AHEAD AND MAKE THE INVESTMENT IN YOUR BILLING DEPARTMENT, ESPESCIALLY IF THAT BILLER DOESN'T HAVE AN EXTENSIVE BACKGROUND IN OPTOMETRIC MEDICAL BILLING. I also believe that you should also make this same investment in yourself and all other members of your medical team as well as in your office manager as these, along with your billing personnel, are the ONLY people that should be involved in the billing of patients and insurance. By doing this, you will be making sure that the coding is correct from the moment it leaves the OD's office to the moment it makes it into the biller's hand.  Look closely at that last sentence; I am not suggesting you make these investements so that ALL THESE PEOPLE can be billers, I am suggesting you make this investment so that you can ultimately SUPPORT YOUR BILLING DEPARTMENT!

    Let's face it, billing and coding errors have been around since the invention of insurance. THEY ARE NOT GOING TO DISAPPEAR, in fact, they may increase due to changes in the industry like The Affordable Care Act, ICD-10 implementations and changes in CPT requirements. Training your entire staff to handle billing is NOT the answer to minimizing these errors. On the contrary, having a dedicated billing department (whether that be in-house or outsourced) and training yourself, your management staff and and your support staff to properly record  patient demographics is THE ONLY ANSWER to reducing errors as it is demographic errors that cause the most claim rejections, not coding errors. By providing your billing department with correct patient demographics and proper ICD-9/10 and CPT codes on YOUR PART, you will be arming them with the tools they need to get you paid correctly, the first time. 

   Don't waste your money on training the wrong people to do jobs they don't have any business doing like the AOA suggests you should, instead spend your money wisely on educating yourself and your billing department then train the rest of your office to get your billers the best information they possibly can. You will thank me if you do and you will see your bottom line increase exponentially as a result. I guarantee it.

"Anything you spend money on to save time, SAVES PEOPLE! People-time is the most expensive part of any practice."

If you would like help with your optometric medical billing, call opticXpress today and we will do whatever we can to help you. 

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