To our loyal subscribers:
This blog has been moved to a new home at opticXpress.com. We thank you for your years of dedicated reading and all the positive feedback we've received from you as well as all the help we've been able to provide you with. Please follow the links below to continue being a part of us and allow us to continue share with you. With you we are nothing!
Sincerely,
The Optometric Billing Spot Team
NEW PERMANENT HOME:
http://www.opticxpress.com/opticxpress-optometric-billing-blog
RSS FEED FOR THOSE OF YOU THAT WISH TO SUBSCRIBE:
http://opticxpress.com/feed/rss2
opticXpress is an optometric billing company that provides a clearinghouse, billing service and software strictly for optometrists.
Tuesday, January 26, 2016
Friday, September 11, 2015
OPTOMETRY BILLING-A VIEW ON VSP
I was talking to one of my clients last night about VSP. He, like EVERY OD I HAVE EVER MET OR WORK WITH, was lamenting about the fees and reimbursement from VSP vs. our local Medicaid. Here is what I said about that:
"As for VSP, I'm staunchly against their hold on the industry. I've personally watched some of the media they propagate into the optometric community, specifically to OD students on college campuses. It's quite brilliant, but it's dangerous. VSP was started by a group of OD's with the goal of creating a guaranteed method for their "brethren" to be paid for their services and to make it easier for patients to afford you [and obtain needed vision services]. Since their merging with Eyefinity, however, they have become just like every other major corporation....more interested in their bottom line than in serving their clientele. I believe that a government payer should NEVER pay more than a private one . This propagates in-equality in the marketplace and it is the exact opposite of the capitalistic society were intended to operate as.
SIDE NOTE: you can actually make ALOT of money on VSP if you have your own edger as they will pay you as a lab. Suddenly, it is only costing you a few dollars to produce glasses in house rather than pay VSP's exorbitant lab fees. One of my clients makes roughly 800%-1000% on each pair of glasses he produces for a VSP patient and he is usually FASTER than lens crafters and pearl vision when it comes to serving his patients' needs. Something to think about. I hope it begins to catch on among the doctors in AOA, it's the only way to fight VSP in this current climate. "
"As for VSP, I'm staunchly against their hold on the industry. I've personally watched some of the media they propagate into the optometric community, specifically to OD students on college campuses. It's quite brilliant, but it's dangerous. VSP was started by a group of OD's with the goal of creating a guaranteed method for their "brethren" to be paid for their services and to make it easier for patients to afford you [and obtain needed vision services]. Since their merging with Eyefinity, however, they have become just like every other major corporation....more interested in their bottom line than in serving their clientele. I believe that a government payer should NEVER pay more than a private one . This propagates in-equality in the marketplace and it is the exact opposite of the capitalistic society were intended to operate as.
SIDE NOTE: you can actually make ALOT of money on VSP if you have your own edger as they will pay you as a lab. Suddenly, it is only costing you a few dollars to produce glasses in house rather than pay VSP's exorbitant lab fees. One of my clients makes roughly 800%-1000% on each pair of glasses he produces for a VSP patient and he is usually FASTER than lens crafters and pearl vision when it comes to serving his patients' needs. Something to think about. I hope it begins to catch on among the doctors in AOA, it's the only way to fight VSP in this current climate. "
Just as an example of VT Medicaid vs. VSP: VT medicaid pays about $130 for a comprehensive eye exam and refraction. This is offered YEARLY to Juvenile patients and bi-annually to adults. An OD can perform multiple refraction on a patient after the eye exam and get paid for them. VSP caps its Eye Exam reimbursement at about $75. Not every patient qualifies for a refraction and there is no such thing as going to the doctor between covered exams for a followup refraction. In fact, you have to really fight to even be in the $75 reimbursement teer, something our office negotiated with VSP for 3 years before it finally came to fruition. A covered VSP refraction will usually not net you more than $25 (not including patient-out-of-pocet) and VSP includes out-of-pocket fees in their reimbursement rate, medicaid patients don't pay a dime out of pocket for eye exams.
This is a huge problem. I believe that VSP is the country's largest private vision insurance in the country. Serving the majority of employer groups nationwide as well as being part of government networks, providing out-sourced vision benefits to medicaid patients in California and other states as well (this was something the VT optometric Assc fought against and won). Yet they are one of the worst reimbursing insurances for vision services; BCBS, by comparison, has an excellent vision reimbursement AND THEY ARE NOT FOR PROFIT, UNLIKE VSP!!!!
Thursday, August 13, 2015
OPTOMETRY MEDICAL BILLING-Less than 80 days to ICD-10 - CMS and AMA Announce Efforts to Help Providers
Many offices have contacted us regarding ICD-10 over the last few years. Lately these requests for help have become more ernest. While I have traditionally told people that I didn't believe it was the year for ICD-10 to FINALLY become mandatory, all signs are currently pointing to "yes" for this year. I will still hold out till Oct 1 to be certain BUT it is still good to be prepared.
In July Medicare announced that It will not deny claims coded with ICD-10 that don't use high specificity...at least not at first. That means that if you have the ability to translate an icd-9 code to an icd-10 code directly, not highly specific in terms of ICD-10, you will likely not receive a denial for that. However, this is a temporary solution so you shouldn't rest on your laurels.
Here is an excerpt of the original announcement put out by Office Ally:
"According to the CMS, for one year after Oct. 1, 2015, Medicare will not deny physicians or other practitioners Part B claims based solely on the specificity of the ICD-10 diagnosis code as long as the provider used a valid ICD-10 code from the right family. In addition, quality reporting will also receive a grace period, as long as a valid ICD-10 code from the correct family of codes is used. Moreover, if a Part B MAC is unable to process claims within established time limits because of administrative problems, an advance payment may be available. CMS will also have an ICD-10 Ombudsman to help receive and triage provider issues. "
I still do not believe that it is in our best interest to implement ICD-10 while the rest of the world is already moving to ICD-11 but that is a different argument for a different day.
Click here to learn more about the CMS/AMA announcement.
Click here for the guidance/FAQ from CMS.
In July Medicare announced that It will not deny claims coded with ICD-10 that don't use high specificity...at least not at first. That means that if you have the ability to translate an icd-9 code to an icd-10 code directly, not highly specific in terms of ICD-10, you will likely not receive a denial for that. However, this is a temporary solution so you shouldn't rest on your laurels.
Here is an excerpt of the original announcement put out by Office Ally:
"According to the CMS, for one year after Oct. 1, 2015, Medicare will not deny physicians or other practitioners Part B claims based solely on the specificity of the ICD-10 diagnosis code as long as the provider used a valid ICD-10 code from the right family. In addition, quality reporting will also receive a grace period, as long as a valid ICD-10 code from the correct family of codes is used. Moreover, if a Part B MAC is unable to process claims within established time limits because of administrative problems, an advance payment may be available. CMS will also have an ICD-10 Ombudsman to help receive and triage provider issues. "
I still do not believe that it is in our best interest to implement ICD-10 while the rest of the world is already moving to ICD-11 but that is a different argument for a different day.
Click here to learn more about the CMS/AMA announcement.
Click here for the guidance/FAQ from CMS.
Wednesday, April 15, 2015
Optometric Billing-Medicare Id Number Suffixes
Ever Wonder what the letters at the end of a patient's Medicare ID# mean? I always did too at one time so I decided to share it with all of you.
As originally published by the Council of Nephrology Social Workers:
*A = retired worker
B = wife of retired worker
B1 = husband of retired worker
B6 = divorced wife
B9 = divorced second wife
C = child of retired or deceased worker; numbers after C denote order of children claiming benefit
D = widow
D1 = widower
D6 = surviving divorced wife
E = mother of a child of a deceased worker
E1 = divorced mother of a child of a deceased worker
F1 = aged dependent father
F2 = aged dependent mother
*HA = disabled worker HB = wife of disabled worker
HC = child of disabled worker
*J1 = special “over 72” benefit, has A and B
K1 = wife of “over 72” benefit, has A and B
*M = has Part B Medicare only, no SSA benefit
*T = has A and B Medicare, no SSA benefit
W = disabled widow
WA = railroad retirement
*denotes the recipient’s own social security number.
As originally published by the Council of Nephrology Social Workers:
*A = retired worker
B = wife of retired worker
B1 = husband of retired worker
B6 = divorced wife
B9 = divorced second wife
C = child of retired or deceased worker; numbers after C denote order of children claiming benefit
D = widow
D1 = widower
D6 = surviving divorced wife
E = mother of a child of a deceased worker
E1 = divorced mother of a child of a deceased worker
F1 = aged dependent father
F2 = aged dependent mother
*HA = disabled worker HB = wife of disabled worker
HC = child of disabled worker
*J1 = special “over 72” benefit, has A and B
K1 = wife of “over 72” benefit, has A and B
*M = has Part B Medicare only, no SSA benefit
*T = has A and B Medicare, no SSA benefit
W = disabled widow
WA = railroad retirement
*denotes the recipient’s own social security number.
If you ever have any questions about Optometric Medical Billing (also known as Optometry Billing), click here to contact us today or call 866-688-3335.
Thursday, March 12, 2015
OPTOMETRY BILLING-BCBS OF VT-TIMELY FILING
Just as an FYI to all Vermont BCBS providers:
After a brief phone consultation with Provider Services at BCBS of VT, it is confirmed that ALL CONTRACTED providers with BCBS VT have a timely filing limit of 6 months. There is one known exception: patients who went under VT Healthconnect to purchase insurance that became active Jan 1 of 2014 and DID NOT update their insurance info with their provider could have their claim re-opened in the event of a timely filing incident.
After a brief phone consultation with Provider Services at BCBS of VT, it is confirmed that ALL CONTRACTED providers with BCBS VT have a timely filing limit of 6 months. There is one known exception: patients who went under VT Healthconnect to purchase insurance that became active Jan 1 of 2014 and DID NOT update their insurance info with their provider could have their claim re-opened in the event of a timely filing incident.
For help with optometric billing contact opticXpress today by CLICKING HERE or calling (866)688-3335.
Thursday, March 5, 2015
OPTOMETRY BILLING-SPECTERA ELECTRONIC CLAIMS SUBMISSIONS
opticXpress is pleased to announce that we are now online with Spectera as an approved clearinghouse to submit claims to them electronically. Providers will still have to sign up with optum-payments to receive Electronic Remittance Advices and request EFT however, which is a let down, but this is a step in the right direction for an insurance company that is arguably one of the most archaic and backwards thinking insurance companies in the market (most vision plans are similar, as well all know!).
Contact opticXpress today by CLICKING HERE or calling (866)688-3335 and let us be your go-to optometry billing service!
Wednesday, January 28, 2015
Optometry Billing-Medicare, VSP and Others Increase Audits
* "Medicare, Blue Cross, VSP and ALL other payers have increased their audits. They know that most practice's documentation is NOT COMPLIANT! Typical Penalties are between $100,000 and $200,000 ! Most practices fail these audits. "
*This came from our friends at Eyecor. opticXpress is a re-seller of Eyecor coding software you can contact us by clicking here to get more info about this ground breaking software. For help with a pending insurance Audit, a Past Insurance Audit or to protect yourself from a possible future audit please contact Eyecor's Nteon Practice consultants by clicking here.
Nteon Practice Consultants are experienced in what auditors are looking for. They have conducted many audits throughout the country and these audits include a review of compliant documentation, reports, HIPPA and lost reimbursements just to name a few.
*This came from our friends at Eyecor. opticXpress is a re-seller of Eyecor coding software you can contact us by clicking here to get more info about this ground breaking software. For help with a pending insurance Audit, a Past Insurance Audit or to protect yourself from a possible future audit please contact Eyecor's Nteon Practice consultants by clicking here.
Nteon Practice Consultants are experienced in what auditors are looking for. They have conducted many audits throughout the country and these audits include a review of compliant documentation, reports, HIPPA and lost reimbursements just to name a few.
Wednesday, January 7, 2015
opticXpress Provides 835 ERA File Interpretation and Translation Services
Dear Medical Biller,
One of the most important aspects of your job, if not THE MOST IMPORTANT, is posting and reconciling payments. However, without expensive software, it is near impossible to do this automatically costing you valuable time, money on salary and worse, CLERICAL ERRORS.
opticXpress has a solution that you may be eager to learn about. WE NOW PROVIDE 835 ERA INTERPRETATION AND TRANSLATION SERVICES! Simply put, you receive an 835 file from your payers or clearinghouse, pass that file along to us in its original format and we translate it and send it back to you in ANY FILE FORMAT you wish! Using our service, the possibilities are endless, your clients will benefit and so will your bottom line.
To find out more about this invaluable service, give me a call today at (866)688-3335 X1 and ask for more info on our 835 Interpretation and translation service. I guarantee that you will have nothing to lose but the seemingly endless piles of EOB's on your employee's desks!
Sincerely,
Andrew W. Roy
President
opticXpress
One of the most important aspects of your job, if not THE MOST IMPORTANT, is posting and reconciling payments. However, without expensive software, it is near impossible to do this automatically costing you valuable time, money on salary and worse, CLERICAL ERRORS.
opticXpress has a solution that you may be eager to learn about. WE NOW PROVIDE 835 ERA INTERPRETATION AND TRANSLATION SERVICES! Simply put, you receive an 835 file from your payers or clearinghouse, pass that file along to us in its original format and we translate it and send it back to you in ANY FILE FORMAT you wish! Using our service, the possibilities are endless, your clients will benefit and so will your bottom line.
To find out more about this invaluable service, give me a call today at (866)688-3335 X1 and ask for more info on our 835 Interpretation and translation service. I guarantee that you will have nothing to lose but the seemingly endless piles of EOB's on your employee's desks!
Sincerely,
Andrew W. Roy
President
opticXpress
Expanded Optometry Billing Services To Choose From This New Year !
Hi All,
Andrew Roy here, President of OpticXpress. I just wanted to key you in on some of our core services that we offer . As a busy optometric practice, any or all of these services may fit your needs perfectly and I invite you to give me a call and chat with me about them.
We offer:
Andrew Roy here, President of OpticXpress. I just wanted to key you in on some of our core services that we offer . As a busy optometric practice, any or all of these services may fit your needs perfectly and I invite you to give me a call and chat with me about them.
We offer:
- Free practice management software
- Paid practice management software that includes fully accredited EMR allowing your practice to take advantage of meaninful use payments
- Full medical billing services including clearinghouse, claim submission, claim denial resolutions, payment reconciliation, patient invoicing, patient consultations regarding invoice/balance questions, patient access to quick and easy online invoice payments
- Patient recall services including low cost post-card mailing
- Access for your practice to discounted equipment just for being an opticXpress client. This equipment includes retinal cameras and OCT machines as well as all other major equipment.
- Staff training
- Full practice management
You can choose from any or all of the above solutions that best fit your practice. Once you have an idea of where you want to go we will help integrate these services into your office.
Give me a call about these wonderful services today, I can't wait to hear from you. 866-688-3335
HAPPY NEW YEAR!
Sincerely,
Andrew W. Roy
President
opticXpress
Friday, September 12, 2014
Optometric Billing: Why I Hate Officemate, Part 4
In part 4 of this mini-series we will look at Officemate's Automatic Insurance Payment Posting System. The bottom line...IT IS BROKEN and has been since the first generation of the software.
Take a look at the below screen shot:
In the above example, the user imported a remittance advice file into office mate and auto-posted it. It clearly shows that the patient paid their $25.00 co-pay but still transferred a $25.00 copay to the patient's responsibility! As usual, I approached office mate tech support with the issue and they told me what they always tell me : "Works as designed, no plans to fix". Can you believe that?!?!
What this means to your practice:
Quite literally, this means that if you are using auto-post, you will never be able to trust the system when it applies payments to patients' balances. The problem goes deeper as financial errors always snowball (think back to that missing check # in your check book that you can't reconcile for the life of you). If you don't check the work, which literally defeats the purpose of auto-posting, you will not be able to keep accurate financial records or send accurate statements and invoices to patients. This will not only mean that any financial reports you run out of officemate will NEVER be accurate (which again, defeats the purpose of having automated office management software), but you will also cause your patients to either over-pay you or get extremely upset at you causing you to loose customers and receive negative reviews in the community that you serve....all because you chose officemate. I can tell you from experience, having an patient call you due to an officemate-generated statement you sent them is NEVER pleasant experience.
There is good news. There are tons of software solutions you can choose and opticXpress can help you find the right one...
Take a look at the below screen shot:
In the above example, the user imported a remittance advice file into office mate and auto-posted it. It clearly shows that the patient paid their $25.00 co-pay but still transferred a $25.00 copay to the patient's responsibility! As usual, I approached office mate tech support with the issue and they told me what they always tell me : "Works as designed, no plans to fix". Can you believe that?!?!
What this means to your practice:
Quite literally, this means that if you are using auto-post, you will never be able to trust the system when it applies payments to patients' balances. The problem goes deeper as financial errors always snowball (think back to that missing check # in your check book that you can't reconcile for the life of you). If you don't check the work, which literally defeats the purpose of auto-posting, you will not be able to keep accurate financial records or send accurate statements and invoices to patients. This will not only mean that any financial reports you run out of officemate will NEVER be accurate (which again, defeats the purpose of having automated office management software), but you will also cause your patients to either over-pay you or get extremely upset at you causing you to loose customers and receive negative reviews in the community that you serve....all because you chose officemate. I can tell you from experience, having an patient call you due to an officemate-generated statement you sent them is NEVER pleasant experience.
There is good news. There are tons of software solutions you can choose and opticXpress can help you find the right one...
Monday, June 2, 2014
Wednesday, May 28, 2014
Optometric Billing-Why I HATE Office Mate- Part 3
The Problem:
In Part 3 of this "mini-series" on reasons not to purchase office mate, or get rid of it if you already have it, we are going to explore Ledger Balances.
In Office Mate, ledger balances are often incorrect, as seen below. (HINT: The picture is quite large so you will need to click on it in order to get a better view. )
What this means to your practice:
This is kind of a no-brainer. As has been my mantra with Office Mate, and ALL Eyefinity produced software for that matter, you purchase office management software to help you MANAGE YOUR PRACTICE which means that you are entrusting it to provide you with accurate financial information. As seen in the example above, however, Office Mate provides you with a balance for the patient, "Alexa" of $54.89 but if you click on the detail you will find that the ACTUAL ACCOUNT BALANCE is zero!!! These in-accurate balances are found throughout the patient ledger in office mate and usually occur after legitimate write offs have been posted to patient accounts. Basically, your staff is writing off these charges but a balance remains. Often, these erroneous balances are left to age and generally end up being billed to patients on statements! To Office Mate's credit, they have created a separate program you can download to "TRY" and fix some of these errors (this program is called "iBal" and will be explored in a subsequent post) but the program does not always work and you have to ask for it if you want it. It is not offered to you by Office Mate when you purchase the program nor can it be found in the Office Mate download center.
As with every other error I have posted about and will post about in the future, Office Mate does not deny the existence of this costly bug and has deemed it to be part of the program "as designed" which means they have no immediate intention of fixing it. When you buy Office Mate, regardless of what price you pay for it, YOU ARE BUYING SOFTWARE THAT DOES NOT WORK PROPERLY AND YOU PAY A YEARLY MAINTENANCE FEE OF UP TO $2,000.00 TO SUPPORT THIS BROKEN SOFTWARE!
Did I mention that not only are these ledger errors reflected on patient statements but on the reports you and your staff generate using Office Mate as well? It's true! This means that if you run an "open balance" report or an "aging report" YOU CAN'T TRUST THE NUMBERS THE SYSTEM IS GIVING YOU WHICH EFFECTIVELY MEANS THAT YOU WILL NEVER HAVE A TRULY BALANCED ACCOUNTING WHEN USING OFFICE MATE! This is truly a COSTLY shame.
In Part 3 of this "mini-series" on reasons not to purchase office mate, or get rid of it if you already have it, we are going to explore Ledger Balances.
In Office Mate, ledger balances are often incorrect, as seen below. (HINT: The picture is quite large so you will need to click on it in order to get a better view. )
This is kind of a no-brainer. As has been my mantra with Office Mate, and ALL Eyefinity produced software for that matter, you purchase office management software to help you MANAGE YOUR PRACTICE which means that you are entrusting it to provide you with accurate financial information. As seen in the example above, however, Office Mate provides you with a balance for the patient, "Alexa" of $54.89 but if you click on the detail you will find that the ACTUAL ACCOUNT BALANCE is zero!!! These in-accurate balances are found throughout the patient ledger in office mate and usually occur after legitimate write offs have been posted to patient accounts. Basically, your staff is writing off these charges but a balance remains. Often, these erroneous balances are left to age and generally end up being billed to patients on statements! To Office Mate's credit, they have created a separate program you can download to "TRY" and fix some of these errors (this program is called "iBal" and will be explored in a subsequent post) but the program does not always work and you have to ask for it if you want it. It is not offered to you by Office Mate when you purchase the program nor can it be found in the Office Mate download center.
As with every other error I have posted about and will post about in the future, Office Mate does not deny the existence of this costly bug and has deemed it to be part of the program "as designed" which means they have no immediate intention of fixing it. When you buy Office Mate, regardless of what price you pay for it, YOU ARE BUYING SOFTWARE THAT DOES NOT WORK PROPERLY AND YOU PAY A YEARLY MAINTENANCE FEE OF UP TO $2,000.00 TO SUPPORT THIS BROKEN SOFTWARE!
Did I mention that not only are these ledger errors reflected on patient statements but on the reports you and your staff generate using Office Mate as well? It's true! This means that if you run an "open balance" report or an "aging report" YOU CAN'T TRUST THE NUMBERS THE SYSTEM IS GIVING YOU WHICH EFFECTIVELY MEANS THAT YOU WILL NEVER HAVE A TRULY BALANCED ACCOUNTING WHEN USING OFFICE MATE! This is truly a COSTLY shame.
For recommendations on the best software for your practice, contact opticXpress today by clicking here. We can point you in the right direction and help you get the best, most cost-effective software for your practice.
Friday, May 9, 2014
Optometric Billing-Patient Payment Expectations...UPFRONT!
For years I have been yelling at the top of my lungs about the need for optometrists to tell patients UPFRONT, THAT YOU EXPECT TO GET PAID IF THE INSURANCE COMPANY DOESN'T and to collect a payment method AT THE TIME OF SERVICE!
But no one listens. You are all to scared to piss off your patients because you are worried you will lose them if you do. None of you stop to think that if you let a patient get away with not paying you, you are not keeping the patient anyway because if they know they owe you money THEY STILL WILL NEVER COME BACK! It all boils down to the same thing...you always think you are right, and you think no one else knows your business. Well guess what, those of us that are actually in charge of your money actually know a great deal about your business and in most cases (except providing actual healthcare) we know MORE THAN YOU DO ABOUT YOUR BUSINESS! That is because we are trained business men, at least I am, and you are a TRAINED DOCTOR. It is my job to count dollars and cents and it is your job to provide healthcare. Stop trying to be superman (or woman). Stop trying to wear so many hats (or capes) in your practice. Entrust those you hire to care for the health of your practice...TO CARE FOR THE HEALTH OF YOUR PRACTICE, while you worry about the health of your patients!
That being said, Instamed has posted on their blog an article outlining this exact problem in health care practices. Unfortunately for optometry, the numbers are even worse than what this article details because of the reason I expressed above. Here it is below:
"When you stay at a hotel, are you able to check in without giving your payment card? Of course not. However, patients receive access to healthcare services with no assurance that they will pay their portion of the bill on time, or at all. As a result, you may spend up to 90 days, send multiple paper statements and even make phone calls to collect payments. And frequently, the payment is written off as bad debt. This is costing your business a lot of money.
Providers have opportunities to use Smart Big Data and technology to accurately estimate patient responsibility and automatically collect payments, which creates a level of payment assurance already happening in consumer-focused industries.
Transforming the Collection Process with Smart Big Data
Here’s how Smart Big Data transforms the collection process:
When providers can leverage Smart Big Data to accurately estimate patient responsibility in real-time, it becomes functional on a day-to-day basis, enabling you to efficiently collect payments and thrive in the evolving healthcare industry."
(https://www.instamed.com/blog/finding-payment-assurance-in-the-healthcare-industry-with-smart-big-data/)
But no one listens. You are all to scared to piss off your patients because you are worried you will lose them if you do. None of you stop to think that if you let a patient get away with not paying you, you are not keeping the patient anyway because if they know they owe you money THEY STILL WILL NEVER COME BACK! It all boils down to the same thing...you always think you are right, and you think no one else knows your business. Well guess what, those of us that are actually in charge of your money actually know a great deal about your business and in most cases (except providing actual healthcare) we know MORE THAN YOU DO ABOUT YOUR BUSINESS! That is because we are trained business men, at least I am, and you are a TRAINED DOCTOR. It is my job to count dollars and cents and it is your job to provide healthcare. Stop trying to be superman (or woman). Stop trying to wear so many hats (or capes) in your practice. Entrust those you hire to care for the health of your practice...TO CARE FOR THE HEALTH OF YOUR PRACTICE, while you worry about the health of your patients!
That being said, Instamed has posted on their blog an article outlining this exact problem in health care practices. Unfortunately for optometry, the numbers are even worse than what this article details because of the reason I expressed above. Here it is below:
"When you stay at a hotel, are you able to check in without giving your payment card? Of course not. However, patients receive access to healthcare services with no assurance that they will pay their portion of the bill on time, or at all. As a result, you may spend up to 90 days, send multiple paper statements and even make phone calls to collect payments. And frequently, the payment is written off as bad debt. This is costing your business a lot of money.
Providers have opportunities to use Smart Big Data and technology to accurately estimate patient responsibility and automatically collect payments, which creates a level of payment assurance already happening in consumer-focused industries.
Transforming the Collection Process with Smart Big Data
Here’s how Smart Big Data transforms the collection process:
- Before the patient visit, verify patient eligibility information and generate an estimate of the patient’s payment responsibility, using data stored from payer remittance information.
- Automatically send a communication to the patient to set clear payment expectations upfront.
- Securely save the patient’s payment card on file.
- When the claim is adjudicated, automatically collect the exact amount due, or set up an automated payment plan. As a best practice, send another communication to the patient to remind them of their payment.
- Automatically post the payment to your accounting system.
When providers can leverage Smart Big Data to accurately estimate patient responsibility in real-time, it becomes functional on a day-to-day basis, enabling you to efficiently collect payments and thrive in the evolving healthcare industry."
(https://www.instamed.com/blog/finding-payment-assurance-in-the-healthcare-industry-with-smart-big-data/)
Click here and contact opticXpress today. Let us worry about your business while you worry about your patients.
Monday, May 5, 2014
Optometric Billing-Billing for Contact Lens Training
When doing my usual look up of site stats for The Optometric Billing spot today, I noticed that someone Googled us using the following key word: "can you bill for contact lense training" .
I was a bit baffled by this considering that this is historically considered part of the contact lens fitting but I figured I would look
it up for you cause it piqued my interest. So, here is what I came up with. NO, YOU CAN NOT SPECIFICALLY BILL SEPARATELY FOR
THE TRAINING. The one area where you might be able to get away with it is insurance companies that take "S" codes
as there is an "s" code for Comprehensive Contact Lens Evaluation. However, I doubt the reimbursement is even worth your time.
I also doubt that insurance company would let you bill for both a Contact lens fitting (92310) and the Comprehensive Evaluation
(S0592) for the same patient, but maybe someone better than I can figure that out for you.
Bottom line, as always in the Medical Vs. Insurance world....Play it safe and don't get greedy!
I was a bit baffled by this considering that this is historically considered part of the contact lens fitting but I figured I would look
it up for you cause it piqued my interest. So, here is what I came up with. NO, YOU CAN NOT SPECIFICALLY BILL SEPARATELY FOR
THE TRAINING. The one area where you might be able to get away with it is insurance companies that take "S" codes
as there is an "s" code for Comprehensive Contact Lens Evaluation. However, I doubt the reimbursement is even worth your time.
I also doubt that insurance company would let you bill for both a Contact lens fitting (92310) and the Comprehensive Evaluation
(S0592) for the same patient, but maybe someone better than I can figure that out for you.
Bottom line, as always in the Medical Vs. Insurance world....Play it safe and don't get greedy!
Need help with insurance billing? Want as close to a guarantee as possible that you will get paid for EVERY insurance claim yousubmit to insurance?
Click Here to contact opticXpress today. If you send us your claims, chances are, they will get paid the first time,
WE GUARANTEE IT!*
Thursday, April 17, 2014
Thursday, April 3, 2014
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 :)
Wednesday, April 2, 2014
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.
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.
Sunday, March 30, 2014
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?
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.
Friday, March 28, 2014
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!
Subscribe to:
Posts (Atom)