Wednesday, January 4, 2012

Optometric Billing-Are these really the best America has to offer? (Campaign 2012)

Ok so we here at opticXpress don't make it a habit to go around playing politics. However, we do feel that it is important for everyone to pay attention to what's going on in the world. Why? Because it is important to understand how our leaders, or potential leaders in this case, will affect our businesses. With that in mind, read the following article by David Gewirtz of ZDnet and take stock of what he says. One of these people could be making the policies that affect the way you run your practice in the near future...do you want any of them making those decisions?




"Are these really the best America has to offer? (Campaign 2012)

By David Gewirtz | January 3, 2012, 5:00am PST

Summary: Seriously? This is it? This is the best of America? These are the best possible leaders we can field when America so critically needs leadership?

Wow. Romney, Gingrich, Paul, Bachmann, Perry, Huntsman, Santorum — and Obama. Are these really the best America has to offer?

Seriously? This is it? This is the best of America? These are the best possible leaders we can field when America so critically needs leadership?

Look, don’t get me wrong. When one of these people walks into the White House on January 20, 2013, I will support him or her. I believe Americans need to stand behind their President. But wow. How demoralizing is this bunch?

What got me thinking about this, beyond today’s Iowa caucuses, was a deeply depressing editorial out of the UK’s Mail Online. In it, Dominic Sandbrook writes:

Today, American voters looking for alternatives are confronted only with a bizarre gaggle of has-beens, inadequates and weirdos, otherwise known as the Republican presidential field. And to anybody who cares about the future of the Western world, the prospect of President Ron Paul or President Newt Gingrich is frankly spine-chilling.

Has-beens. Inadequates. Weirdos. Wow. What’s sad is it’s hard to refute his biting words.

Mitt Romney

Take Mitt Romney, for example. Romney may seem the most sane of the bunch, and he certainly looks like someone in Hollywood pulled him out of central casting for the role of president. But Romney has changed his position on everything he possibly could, in order to appeal to certain groups of GOP voters.

After just two years as governor of Massachusetts, and after failing to be elected for anything else, Romney decided he wanted to become President. He’s been wanting to become President ever since — and that, apparently, is his greatest qualification.

Newt Gingrich

Or, take Newt Gingrich. I like Newt. He and I both appeared on the History Channel special The President’s Book of Secrets, and he’s undoubtedly a very smart man. But shortly after becoming the first Republican Speaker of the House in decades and architecting the Contract With America, Newt got drummed out of Congress on ethics charges. And this was after screwing around on his wife, while making political hay out of investigating a President who was also screwing around on his wife.

Newt’s a visionary, but if you listen to him for too long, you’ll start to think he’s just a little out there. And I don’t mean left-wing wacko out there, or right-wing religious out there. I mean little green men out there. I have a lot of affection for Newt, but I’m not sure America really wants to hand him the world’s largest nuclear arsenal.

Ron Paul

Then there’s Ron Paul. I want to give Ron Paul a bear hug. I do. I often want to stand up and applaud what he says. I agree with his non-interventionist stance, I agree with his belief in the Constitution.

But… once you start reading what he’s written in the past, you start to get the shudders. Now, to be fair, if I were running for office and all my writing had to represent me, you probably wouldn’t give me the keys to the nukes.

The difference is, I commit my writing sins wearing sweatpants and a T-shirt on a couch in Florida (and I mock Apple fanbois on alternate Tuesdays), and Ron Paul wants to be the leader of the free world and has published blatantly racist statements in his newsletters.

Michelle Bachmann

Most of the time, Michelle Bachmann sounds completely loopy. The weird thing is that there’s also something there, there. For example, back after President Obama’s State of the Union address, Michelle Bachmann was the only person of either party to mention how important it was for America to rebuild its manufacturing prowess.

But then she starts going on about something weird here or something strange there. I honestly think she’s sincere (unlike Romney, who does not appear to have a single sincere bone in his body), but I can’t see Michelle Bachmann as Commander-in-Chief.

Speaking of someone no one should want to see as Commander-in-Chief, there’s …

Rick Perry

Seriously? Have you listened to this guy for more than five minutes? The reason he fails the debates is he can’t even seem to remember his own talking points. Then there’s the campground he leases, named something so racially charged I won’t even repeat it.

Rick Santorum

Proving you can’t have enough Ricks in a presidential campaign, there’s Rick Santorum. Yeah, I keep forgetting he’s running, too.

The most interesting thing about the former senator is the friends he made while senator. All you have to do is Google the word “Santorum” to see just how much certain members of the population like him. In 2002, he equated Democrats debating in Congress to Nazis (proving that Godwin’s law applies to Congress-critters as much as to bloggers).

Jon Huntsman

It’s a shame that the most qualified man in the current crop is the guy we never talk about. Jon Huntsman may actually be qualified to be president, is a centrist, has served two successful terms as a governor, and has been ambassador to China — arguably the most important nation we’ll be dealing with this century.

He’s also a successful businessman, and understands making payroll, making compromises, and doing deals. The only problem with Huntsman is that this dog won’t hunt. He’s managed to inspire absolutely nobody, and it’s unlikely he’ll make it past February.

Barack Obama

While everyone else on the list aspires to the GOP nomination, President Obama has a lock on being the 2012 Democratic nominee. As a sitting president, the election is his to lose.

Sadly President Obama is no great statesman. He was an incredibly inspiring candidate, but is an equally uninspiring leader. The nation, while not in worse condition than it was when he took office, isn’t much better. Our national malaise is ongoing, unemployment is still too high, we’re far deeper in debt, and we still don’t appear to have either a workable plan or a clue.

While it could be argued that the Republicans got in his way at every turn, that’s not what you want to hear from your President. What you want is for the job to get done (without the “Mission Accomplished” sign, hopefully). With Obama, the job is far from done, and it’s questionable whether he is capable of the heavy lifting necessary to pull us away from the brink.

The best of America

Sure, we’ve had our fair share of disappointments, from old Zachary Taylor to Herbert Hoover to Millard Fillmore. But we’ve also had George Washington, Thomas Jefferson, John Adams, Abraham Lincoln, Teddy Roosevelt, and FDR. We’ve had towering heroes as President, men who embodied all that America was, all that we could be, and all that we dreamed of.

As we begin the election season in earnest, I’d like you to engage in a little exercise. You know how it is with President Obama. If you’re thinking of hiring his replacement, say the following names out loud: President Romney, President Gingrich, President Paul, President Bachmann, President Perry, President Huntsman, or President Santorum.

Now, ask yourself these questions. Do I trust this person with America’s nuclear (or “nucular”) arsenal? Can this person go face-to-face with Vladimir Putin or Mahmoud Ahmadinejad or even Angela Merkel? Will this person put Americans before politics or political gain? Does this person truly understand all the interconnections and implications of governance and policy?

The fact is, we’re stuck with one of these completely unimpressive figures for 2013 through 2016. That’s pretty much a done deal, despite whatever fuss Donald Trump is making this week.

But let’s start thinking towards 2016 and let’s remember the presidency isn’t a prize, and it isn’t something that should be given to the person we all would most like to have a beer with. The presidency is the single most important job on the planet.

It should be a job held by the single most capable person in America. It should be held by someone who can be compared with Lincoln and Washington and Jefferson and Roosevelt, and be someone who would clearly be able to stand in their company.

Let’s start now, looking for someone who doesn’t just look presidential, but someone who is presidential. Maybe, if we make it successfully to 2016, then we’ll be able to choose from the best of the best, and not simply the least worst of the what’s left.

Maybe then, we’ll be able to ask “Are these really the best America has to offer?” and have an answer that doesn’t make us feel sad or embarrassed for our nation.

When the primary comes to your state, vote. It’s all you can do now, so go fulfill your civic duty.

In the meantime, be all you can be."

Tuesday, January 3, 2012

Optometric Billing-Programs Provide the Tools Needed for Practices to Significantly Increase Their Reimbursements.



-Eric Bran, OD

PHOTO COURTESY OF NTEON SOFTWARE LLC.
As EMRs have become mainstream and will be mandated for health care providers within a few years, computerized billing and coding programs are becoming even more valuable. Some of these programs are embedded within the EMR software itself, while others are stand-alone products that assist doctors in setting proper fees, completing medical records properly, and getting the correct reimbursement for their examinations. opticXpress provides just such a program that not only allows a practice to efficiently manage their office(s) but that will help them with EMR and coding as well. Take a look today!

CLICK HERE FOR opticXpress EMR or click the link on the top of the page.

(ORIGINAL LINK TO THIS ARTICLE FOUND HERE)

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!!!

Call opticXpress today...and don't wind up disgruntled like this student!




Optometric Billing-New Glaucoma Codes - THEY ARE REQUIRED!

***Pulled the following article from ODWire. As always, you can contact opticXpress for help with your optometric billing.


Robert E Rebello

EyeCOR

As of Oct 1, 2011 new Glaucoma codes went into effect. The majority of Optometrists and Ophthalmologists are unaware or do not have a complete understanding of these new codes. At three Optometry meetings in October, most doctors and their staffs had not heard about these new codes.

We at EyeCOR have put together this article explaining the new codes and their proper usage.

The new Glaucoma codes are “Stage” codes which specify the level or Stage of Glaucoma severity.

The new Stage codes are:

  • 365.70 – Unspecified Stage Glaucoma
  • 365.71 – Mild or Early Stage Glaucoma
  • 365.72 – Moderate Stage Glaucoma
  • 365.73 – Severe Stage Glaucoma
  • 365.74 – Indeterminate Stage Glaucoma

Use the appropriate Stage code for the patient’s worst eye.

These Stage codes are secondary and coded immediately after the actual Glaucoma Diagnosis code. Stage codes cannot be used without the primary Glaucoma Diagnosis.

Note: These new codes are in effect for Medicare. Other payers are required to use the new codes beginning January 1, 2012. At this time other payers may not recognize them.

The following Glaucoma codes require one of the Stage codes:

365.10, 365.11 365.12 365.13, 365.20, 365.23, 365.31, 365.52, 365.62, 365.63 and 365.65

Do not use the Stage codes for Glaucoma Suspect or other glaucoma diagnoses not included above.

Coding Tip: We recommend not using either 365.70 or 365.74 as they are “Unspecified” or “Indeterminate.” Frequently payers deny reimbursement for Unspecified diagnoses. Instead code the specific Stage of Glaucoma.

Coding Tip: Make sure all procedures that point to the Glaucoma diagnosis using the Diagnosis Pointer (Form Locator: 24 E) point to the actual Glaucoma diagnosis not the Stage diagnosis (See Coding Example 1).

Coding Example 1 - Mild - Primary Open Angle Glaucoma:



Coding Example 2 - Glaucoma Suspect (No Stage code):




Other Ramifications when using the New Stage Codes


Most regions restrict certain procedures based on Severity levels. One example is the frequency limitations for Scanning Laser (OCT, GDx and HRT). Previously, for Advanced Glaucoma damage, you could perform up to 4 Scanning Laser procedures per year. Most regions currently do not allow any Scanning Laser for Advanced or Severe Glaucoma damage. Instead payers may allow up to 4 Visual Fields per year in order to track damage.

Therefore, when you code 365.73 – Severe Stage Glaucoma you will likely be denied reimbursement for Scanning laser. In addition, if you now code “Severe” Glaucoma and previously performed Scanning Laser on this patient, the payer may look back at previous claims and demand you return reimbursement for those procedures.

The current frequency limitations for Scanning Laser for most regions are:
Glaucoma Severity Level
Scanning Laser Frequency
Mild or Suspect Glaucoma
1 Time per year
Moderate Glaucoma
2 Times per year
Advanced or Severe Glaucoma
NO Scanning laser. Up to 4 Visual Fields

Avoid the temptation to stay away from the “Severe” glaucoma code. If you are audited and found to be using incorrect Stage codes, you could be in for more trouble.

Glaucoma Suspect Code Changes

In addition to the new Stage codes for Glaucoma, CMS has also changed the descriptions for two Glaucoma Suspect codes (365.01-.02) and adding two new codes (365.05 -.06). The new descriptions and codes are:
  • 365.01 – Open Angle Glaucoma with Borderline Findings – Low Risk
  • 365.02 – Anatomical Narrow Angle – Primary Angle Closure Suspect
  • 365.05 – Open Angle Glaucoma with Borderline Findings – High Risk
  • 365.06 – Primary Angle Closure Without Glaucoma Damage

The differentiation is Low and High Risk and Closure without Glaucoma Damage.

Make sure when coding Glaucoma Suspect, you use the codes with the description matching the patient’s diagnosis.

Glaucoma Severity Definitions

CMS defines Glaucoma severity as follows. Make sure you use the correct Severity Level based on the worst eye:
Glaucoma Suspect or Mild Damage (one or more of the following)
- Intraocular pressure >22 mmHg as measured by applanation.
- Symmetric or vertically elongated cup enlargement, neural rim intact, cup/disc ratio Greater than 0.4.
- Focal optic disc notch.
- Optic disc hemorrhage or history of optic disc hemorrhage.
- Nasal step or small paracentral or arcuate scotoma.
- Mild constriction of visual field isopters.

Moderate Damage (one or more of the following)
- Enlarged optic cup with neural rim remaining but sloped or pale, cup to disc ratio Greater than 0.5 & Less than 0.9
- Definite focal notch with thinning of the neural rim.
- Definite glaucoma visual field defect (arcuate/paracentral scotoma, nasal step, pencil wedge, constriction of isopters

Advanced or Severe Damage (one or more of the following)
- Severe generalized constriction of isopters (i.e., Goldmann I4e <10 degrees of fixation).
- Absolute visual field defects within 10 degrees of fixation.
- Severe generalized reduction of retinal sensitivity
- Loss of central visual acuity, with temporal island remaining
- Diffuse enlargement of optic nerve cup, with cup to disc ratio Greater than 0.8
- Wipeout of all or a portion of the neural retinal rim.

Summary
With the addition of the new Glaucoma Stage codes and new Glaucoma Suspect codes, proper coding can be complex. You need to ensure your practice is coding Glaucoma correctly. Otherwise, you could find your practice receiving unnecessary denials resulting in lost reimbursement.

For additional information contact EyeCOR:
Toll Free: 888-866-5367
Web: www.EyeCOR.com
Email: info@EyeCOR.com Copyright 2011 - Nteon Software LLC
EyeCOR is a register trademark of Nteon Software LLC

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.

Thursday, December 29, 2011

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!

Friday, December 23, 2011

Optometric Billing-Disadvantages Of Optometry

In this video, Dr. Raj Patel describes what he sees as just the few disadvantages of being in the optometric field. The biggest disadvantage he speaks about is the unique way that optometrists interact with insurance companies in order to provide the best possible service to their patients. We here at opticXpress know all about this and we encourage you to give us a call so that we can help you provide your patients with the best possible care!