As an optometrist, one of the most important procedures you give your clients is a Visual Field (92081,92082,92083) but it is also one of the most commonly misbilled procedures in the optometric billing field. The biggest reason for this is that it is commonly not paired with a correct diagnosis code which means you loose money because it is denied as "medically unnecessary". You can avoid this by first determining whether or not it is deemed medically necessary to perform a visual field by check the attached chart to see if the diagnosis you are suspecting qualifies for a visual field. If it does not then you need to explain to the patient that you feel it is necessary to perform the procedure and CHARGE THE PATIENT! You would then bill the insurance company with a "-GY" modifier. MAKE SURE THAT YOU INCLUDE THIS INFORMATION IN THE PATIENT'S ADVANCE BENEFICIARY NOTICE (ABN) !
opticXpress is an optometric billing company that provides a clearinghouse, billing service and software strictly for optometrists.
Showing posts with label good optometric bililng practices. Show all posts
Showing posts with label good optometric bililng practices. Show all posts
Friday, March 23, 2012
Optometric Billing-How To Properly Bill For Visual Fields
Using Medicare's Local Coverage Determinations (LCD's) as a guide to billing ALL insurance companies is a good strategy to employ. Though it does not guarantee payment across the board, it is, in my opinion, a key way to increase reimbursements. This is because Medicare is, by far, the most stringent payer in terms of rules for coverage.
As an optometrist, one of the most important procedures you give your clients is a Visual Field (92081,92082,92083) but it is also one of the most commonly misbilled procedures in the optometric billing field. The biggest reason for this is that it is commonly not paired with a correct diagnosis code which means you loose money because it is denied as "medically unnecessary". You can avoid this by first determining whether or not it is deemed medically necessary to perform a visual field by check the attached chart to see if the diagnosis you are suspecting qualifies for a visual field. If it does not then you need to explain to the patient that you feel it is necessary to perform the procedure and CHARGE THE PATIENT! You would then bill the insurance company with a "-GY" modifier. MAKE SURE THAT YOU INCLUDE THIS INFORMATION IN THE PATIENT'S ADVANCE BENEFICIARY NOTICE (ABN) !
As an optometrist, one of the most important procedures you give your clients is a Visual Field (92081,92082,92083) but it is also one of the most commonly misbilled procedures in the optometric billing field. The biggest reason for this is that it is commonly not paired with a correct diagnosis code which means you loose money because it is denied as "medically unnecessary". You can avoid this by first determining whether or not it is deemed medically necessary to perform a visual field by check the attached chart to see if the diagnosis you are suspecting qualifies for a visual field. If it does not then you need to explain to the patient that you feel it is necessary to perform the procedure and CHARGE THE PATIENT! You would then bill the insurance company with a "-GY" modifier. MAKE SURE THAT YOU INCLUDE THIS INFORMATION IN THE PATIENT'S ADVANCE BENEFICIARY NOTICE (ABN) !
Thursday, February 2, 2012
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!
Friday, December 30, 2011
Optometric Billing-Why Good Billing Can Alleviate Your Fears
Watch the clip below. It was apparently posted to you tube by a disgruntled optometry student. If only this student had known about opticXpress!!
Did you know that using opticXpress as your billing service could alleviate over 80% of the problems reported in this video?!?!?!? Espescially diminishing returns!!! In fact, we have references that will prove it!!!
Case In point: One of our doctors billed 13k to insurance this month and we collected over 75% of it before adjustments!!!
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