OpticXpress Handles Optometrists’ Billing

From Elaine Rose at "Press Of Atlantic City"
Full Article Here

OpticXpress provides medical billing services and office software for optometrists. We give them the software to help comply with records requirements and to connect with patients as part of doing the billing.

We have multiple clients nationwide that use our service and our software.

I work with companies in Vineland for developing software, creativity and for printing forms. I try to work with local companies when practical.

Optometry is an underserved specialty in the medical billing world. There are a lot of nuances in the codes that most generic medical billers are not familiar with.

Entry: Until the early 1990s, optometrists weren't considered to be providing medical services, and dealt with vision insurance. But then the government opened the opportunity for them to provide medical services, which are covered by Medicare and Medicaid.

We were able to capitalize on the change, and could educate doctors. We post a lot of information we get from our community and various articles[ to our blog ] as a resource to help in their practice.

We specialize in post-operative cataract billing. It's an issue that's very hot among optometrists. A lot of them have patients who go to ophthalmologists for the surgery, and then come to optometrists for after care. We can virtually guarantee that an optometrist will get paid for those services.

The average optometrist's practice is small, about $500,000 to [$1.5] million a year in revenue. The biggest challenge is to educate practitioners that it's better to outsource their billing, so they don't have to do it anymore. They often can't afford to hire a billing department, so they rely on untrained staff to bill patients and deal with insurance companies.

The future: We want to become synonymous with optometric medical billing nationwide. We want optometrists seeking to take their practice to the next level to think of OpticXpress.

Staff writer Elaine Rose

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WHAT OPTICXPRESS BELIEVES

ANOTHER OPTOMETRIC BILLING NO-NO!

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Optometric Billing-One More Way to Bill for Contact Lens Bandages

Here is one more possible way to bill for the contact lens bandage. This was found at the Review of Optometetry and written by Dr. Sorrenson. I would save this method only in the event that 92071 is not covered. Not because I don't think it is good but because it doesn't make great business sense from a Return on Investment (ROI) standpoint...it is just too time consuming. This is definitely a last case scenario in that respect.

"Billing problems can arise in both diagnosing and fitting keratoconus patients. Diagnosis is typically suspected during a routine exam, then confirmed with corneal topography. Medical carriers vary considerably in topography reimbursement. Unfortunately, many wont pay for the procedure, regardless of your appeals.

Once you confirm the diagnosis and counsel the patient, finalize your decision to fit the patient in contact lenses. This is the first step where many offices fail to bill properly. The code for bandage lens fitting and supply [92071] is a poor choice for keratoconus fits because the reimbursement$60 to $85 for the fit and lenses, per eye is a fraction of the proper amount for a case of such complexity.

A better approach: Bill the code for contact lens fitting (92310) and append modifier -22 to alert the carrier to the greater amount of time and complexity for this proceduretriple the usual rate is not uncommon. Expect to submit further documentation to the carrier to justify this higher fee. A letter of explanation including full color topographic maps often fulfills this requirement." Read the Entire Article Here

Do you have any experience trying to bill for Contact Lens Bandages? Have you tried either of the methods listed above? Use the comment section below to talk back and let us know!

CONTACT opticXpress TODAY FOR ALL OF YOUR OPTOMETRIC BILLING NEEDS!

Optometric Billing-Jump On The iPad Bandwagon!

Thanks to our friends at the Noble Vision Group we finally have some content that reinforces our belief that tablet computers, especially Apple's iPad, are a great tool for any optometrist to use in their office. Not only can you use opticXpress' practice management software on them, but they are an excellent tool to use during an examination to not only record exam information and notes but also to bring up diagrams and other pictures of the eye to help educate patients. You will find that a tablet will not only help you perform essential office functions like optometric billing more efficiently but more importantly, a tablet will help you to engage and involve your patients more during an examination thus giving the patient the impression that you have performed a more thorough and efficient examination.

Read the article below and don't forget to contact opticXpress today to see how we can help you get started using tablets in your office!

More Apps for Eye Care: Orca Health’s EyeDecide MD

Has your medical practice jumped on the iPad bandwagon yet? There are more and more practices adopting the iPad or other tablets every day, utilizing all kinds of healthcare appsdesigned to improve efficiency, educate patients, and share information.

One of the major challenges in healthcare is patient education, and mobile apps are great tools for addressing this issue. It’s important for patients to understand what is going on with their bodies, why they are receiving certain procedures or medications, and how to take care of themselves after they leave their doctor’s office. Studies show that the current lack of health literacy can cost as much as $238 billion a year.

High patient volume, time constraints, and a lack of appropriate visual aids make it difficult for many doctors to effectively educate their patients.

The healthcare software developer Orca Health addresses this problem with their Decide Medical App Series, which features interactive 3D models of several anatomical parts.

If you’re involved in the eye care field, Orca’s EyeDecide MD is a great tool to use. Recently named one of the top iPhone medical apps of 2011 by Mobihealthnews.com, the app uses a highly detailed 3D model of the eye to illustrate several common conditions. Users can view the 3D model as a whole or as a cross-section, with the ability to toggle on and off layers of skin and bone, or expand the eye to view all the different parts.

You can even view photos and videos to analyze how common conditions affect the eye. If you have one of these conditions, EyeDecide MD will find your geo-location and show you nearby physicians on a map.

EyeDecide MD can be purchased in the iTunes app store for $4.99.

Click here to see some other great apps for the eye care industry.

Optometric Billing-When To Bill Medical Vs. Vision Plans

Here at opticXpress we always council our doctors to do their best to bill a patient's medical insurance vs. the patient's vision insurance whenever possible. Recently, Dr Augustin Gonzalez sent me this article he wrote that explains exactly why a doctor should do this.

"To my amazement, there continues to be plenty of confusion between eye care
professionals and patients about the role of vision plans and medical insurance. It is no wonder our patients are still more confused! Hopefully, the following information will help clear some of the confusion.

The proper usage of Vision Plans is indicated for refractive care. In other words Vision Care Plans are a pre-paid rider of your medical insurance that is intended to provide a service and a durable good at a reduced fee. It is limited to a refractive diagnosis with the doctor (optometrist mainly as ophthalmologist rarely take Vision Care Plans) performing a screening evaluation of the health of the eye and a full refractive evaluation of vision. Vision plans such as VSP, EyeMed, or Comp Benefits cover vision care diagnosis only, which is limited to the icd9 367.XX series of codes or what is commonly known as nearsighted, farsighted, and refractive astigmatism.

Many OD’s and in such many patients do not realize that Medical Insurance is the responsible entity to be used when a medical related eye problem is detected. Problems such as cataracts, dry eyes, infections, inflammation (even those cause by medical devices such as contact lenses), macular degeneration and complications from diabetes or high blood pressure are often found during the course of the eye evaluation. The management and medical decision process of these eye related medical conditions is not reimbursed by your vision plan.

Medical care involves those situations where during the course of the evaluation, a medical condition with a management decision is related to your eyes and there is a need for counseling, documentation, follow-up care, regular monitoring, prescription of medications or referral to a surgeon is indicate"

Call opticXpress today for more information on how we can help you properly use a patient's vision and medical benefits!

Follow Dr. Gonzalez on Twitter!

Check Dr. Gonzalez's Website!

Optometric Billing-Medicare Guidelines

"Medicare Part B provides benefits for ophthalmology/optometry services which are medically necessary for the diagnosis or treatment of an illness or injury. The services must be consistent with the physician’s scope of practice. Where more than one practitioner furnishes concurrent care, services furnished to a beneficiary by both an ophthalmologist and another physician (including an optometrist) may be recognized for payment if it is determined that each practitioner’s services were reasonable and necessary"

This is the link to Medicare's optometric billing guide. As always, you can contact opticXpress for all your optometric billing needs! Call us Today!

Optometric Billing-Customization is key!

Robin yap OD wrote an interesting piece on his blog about customization and how it affects customers. Read his post below:

"I like my customized espresso drink at Starbucks. When I hear a barrista in any coffee shop sigh under their breath because of a complicated drink, I wonder if the training they received that linked their corporate vision to their specific work was clearly articulated.
At a training session in Atlanta this weekend, a colleague of mine, Dr. Carolynn Sweat, and I were swapping customization ideas that we can bring back to our training environments. I showed her Warby Parker and Marvel Create-Your-Own Superhero and she showed me Wizard101.
Warby Parker has a good story to tell, has a clear corporate responsibility program (buy a pair/give a pair) and the glasses can be virtually worn through self-pic upload mechanism – their customization piece. I like it (see the 4 choices I had above – tell me which one you like on me, if any, in the comments). This capability allows individuals to see exactly what they would look like when the classes are worn. Does this create an emotional connection with you? It does to me.
Then there’s Marvel Create-Your-Own Superhero. This is an old favourite as I’ve used this in training classes before. Saves you copyright costs if you build it yourself. Animate a sci-fi comic concept, create a universe, make sure you make money through a point system and voila, you have Wizard101.
Back to Starbucks, there are around 87,000 combinations at Starbucks and when it  connects to an emotional level to a customer, that customer’s loyalty  meter goes up dramatically. At least, it does for me. Does this happen with the comic strip idea? Bring this further up, would this work when you build training materials? How about when you talk with a client or potential client? How about when you connect with your work colleagues? So how many permutations of customization can your company products and services have? What activities should you create to have that emotional connection with your clients?"

How does this relate to optometric billing? Our service is not all things to all people ( see Eyefinity, officemate et al). Our service is designed exclusively for optometry. Each client can then further request custom items based on their particular needs. We feel this is extremely important because as Dr Yap mentioned, it creates a personal and emotional connection with our clients that helps them see we understand and get them!

Give opticXpress a "LOOK" today. Maybe we can customize something for you!