Optometric Billing-Why I HATE Office Mate-Part 1

I have been meaning to write this for a long time but for some reason, all I have done is just collect evidence on the subject without actually pulling the trigger on the situation. Hell, I even sent the software designers some of the screen shots that I am going to share with you in an effort to get them to fix these important mistakes BEFORE releasing a new version of the software....it didn't work. So, I am here today to begin my attack on Office Mate.

Office Mate is by far, the worst piece of crap that has ever been sold to the optometric community. I can go into a million reasons as to why but for the purpose of these posts, I am only going to highlight the issues that I can explain to you visually. That is, I have photo documented proof of why you shouldn't spend your money on this piece of Sh88, and if you did these photos prove that you should not only stop using office mate, you should fight tooth and nail to get your money back.

Lastly, before I begin, I want to point out that after speaking to various high level technicians and programmers at office mate ( or eyefinity or who ever the hell owns these people), every single one of the issues that I am going to share with you has been acknowledged by office mate as "known of for quite sometime, program works as designed. No Immediate plans to fix." Did you hear that in your mind as you read that last sentence? OFFICE MATE DESIGNED THIS TO WORK WRONG AND HAS NO PLANS TO FIX IT!

Now, without further adue:

PROBLEM #1: FEE SLIPS DON'T CORRECTLY CARRY OVER TO CLAIMS

In the above image, this patient's exam was coded using  Exam Writer and each diagnosis code was correctly pointed to the respective procedure codes as the Dr. here wanted them submitted to the insurance company. However, when the exam was carried over to the fee slip by our secretary, only #2 diagnosis code appeared on the fee slip for her to choose from. When I received the claim in "3rd party processing" at the end of the day, the above is what I got. The Dr. had actually pointed 1,2,3,4 to proc code 1 when she charted that day and used #2 for the PQRS codes, yet how is it that the claim in the picture above was generated? 

WHAT DOES THIS PROBLEM MEAN TO THE AVERAGE OFFICE MATE USER?

The average optometry practice does not have a billing department and may not have an actual biller. The job of batching claims and submitting to the insurance company is usually left to a secretary, office manager, another un-qualified individual in the office or the doctor. None of these named individuals have the time, desire and in many cases, knowledge to properly research and correct the error above on a daily basis. In fact, most offices don't even batch and submit on a daily basis, many do it weekly. What if you had to fix EVERY CLAIM for 10,20,30 or even 50 patients at the end of a long week? The issue above is a primary reason why claims generated by office mate can't be trusted. 

CRAP CLAIMS LIKE THE ONE ABOVE LEAD TO A LOSS OF PRECIOUS REVENUE IN MANY PRACTICES IN THE UNITED STATES.

Optometric Billing at Saratoga Springs!

This weekend, March 22-24, opticXpress will be hosting an exhibit at the Saratoga Springs Coding Conference in Saratoga Springs, NY. We encourage you to come visit us and see what we have to offer and what we are all about.

We will also be joined at our table by the president of Liquid EHR which is our choice for clients that need high quality EHR software. Also, we will be highlighting our free billing software and EyeCor, coding software for OD's.

We hope to see you there!

For more info, please call us at 866-688-3335 x1.

Click Here to Let opticXpress Become Your Optometric Billing Service Today.

Optometric Billing-opticXpress Updates Web Page

opticXpress has updated their webpage. It now includes easier access to information about services, the ability for patients to logon and pay invoices they have revamped it throughout with cleaner, more concise text.

Click Here to Have a Look Today.

Optometric Billing-New 1500 Claim Form

In case you are not aware, though I am sure you are, there is a new 1500 claim format going into effect April 1. After looking over the attached manual there are many changes going into effect that you as a billing person or doctor's office should be aware of. Below you will find a copy of the most recent new 1500 claim form and a link to the intsruction manual for filling this out. It would be in your best interest to print out the form and fill it in with "dummy" information according to the attached instructions as many times as needed in order to familiarize yourself with the information and new form.

Instruction Manual Contained Here

As always, opticXpress can handle all your billing needs and help you ease the transition to this new format. 

Click Here and Call Us Today!

Optometric Billing-Vermont Medicaid Timely Filing Limits

As Per Section 8.1 of the Vermont Medicaid Timely Filing Manual:

1) When Vermont Medicaid is Primary the timely filing limit is 6 months (one of the shortest in the nation):

When the system indicates that Vermont Medicaid is the primary payer, the timely filing

limit for such claims is six months from

the date of service.  In no case will a claim be

considered if the date of service is greater than two years prior to the DVHA’s receipt of

the claim. If a claim has a date or dates of service past the timely filing limit, it may be

submitted for payment directly to HPES if one or more of the following conditions are

met:

•HPES denied the claim within the timely filing limit for a reason other than

exceeding the

time limit. A copy of the remittance advice showing the denial must be

attached to each

claim.

•Abeneficiary’s eligibility was made retroactive and the date of service is within the

retroactive period. The claim must be submitted within the first twelve months of

thedate on the Notice of Decision. Include a note with the claim stating the

retroactivedate

of eligibility.

•Inpatient claim, the timely filing limit is 180 days from the date of

discharge. 

2) Crossover Claims-you have 2 years (weird but true):

When a claim is billed to Medicare with Vermont Medicaid noted as the secondary payer

(using the crossover function), the crossover claim will be

considered timely if it is

received within two years of the date of service.

opticXpress specializes in Medicare and Medicaid billing for optometrists. We also handle the billing of ALL other insurance companies as well, espescially our home state of Vermont. 

Click Here now to let opticXpress be your optometric billing company or clearinghouse today!

Optometric Billing-Submitting Refractions to Medicare-92015

For those of you who are not sure, you can not bill Medicare for a refraction...it is considered to be part of an eye exam by default and is therefore "statutorily excluded" from being billed (ref: EyeCor, 2014). However, you do have options.

1) You can bill your patients at the time of service for this service, ALWAYS MAKE SURE TO GIVE YOUR PATIENTS AN ABN (CALL opticXpress at 866-688-3335 x1 if you need a copy of one) informing them in advance of your intention to do this.
2) Don't bill Medicare for the refraction at all
3) Include the refraction on your claim but use a "GY" modifier. This will signify to Medicare that you know this service is not covered and you have informed of this via an "ABN". (Hint; if you chose option 1, you will need to perform option 3 as well).

 As always, opticXpress is here to help! Click here to contact us today and let us handle your optometric billing for you!

Optometric Billing-VSP to Begin Covering Google Glass

The following text was copied from a January 28 article in "Optometry Times". This will most likely affect optometric billing personnel over the coming months and it would be a good time to start aquainting yourself with these developments. I am sure that many other insurance companies will begin following suit, espescially if it proves to be popular. It will also be a good way for an optometric practice to provide cutting edge technology to its patients and customers and one more reason to get people through your doors.

Begin Article:
San Francisco, CA*VSP and Google have reached a deal to offer subsidized frames anq
prescriptlon lenscs for Google Glass.
"We know our 64 million members are seeing and hearing about Google Glass and how itwill affect
their lives and vision, so we are really focusihg on the eye health management perspective," says
Jim lvlcGrann, president of vsP vision caro, vsp's insurance division, which insures one-fifth of
Americans.
Google plans to sell Glass to the public lator this year, While it did not originally offer traditional
framos or prescription lenses, early Glass owners "hacked" the device to add prescription lenses
an0 sungtasses.

Now, Google has designed 4 styles-curvy, thin, split, and bold, all shown above*made of
lightweight titanium, and plans to offer 2 new styles of sunglasses. The color, frame, and shade
choices will offer 40 style variations for Glass.

Justin lJazan, OD, Optometry flmes Editorial Advisory Board member, speaking exclusively, says
ho hopes VSP's decision to cover Google Glass will bring in new customers looking for prescription
versions of the much-hyped new device.

"Being able to provide €yewear that incorporates revolutjonary technology will make us more
valuable to our patients," says Dr. Bazan.

VSP and Google croated a training program foroptometrists to learn howto mount Glass on frames
and fit thc device on patients. '[he companies have alroady begun training ODs in New york City,
San Francisco, and Los Angeles, although they have not said how many ODs have been tralned.
"VSP providers can prepare online. I got an e-mail directing to me a specifically designed Web site.
I watched a video, took a quiz, signed a non-disclosure document and then was told something like
'Congratulations. Your VSP Glass welcome package will be mailed to you. Expect it in a week or
so,"'says Dr, Bazan.

VSP's lab rn Sacramento, Cn, will cut lenses for Glass frames. Google Glass costs g1,SOO for thosc
invited to buy the current version, but it will retail for several hundred dollars less when it is
introducod to the public later this year. The titanium frames will retail for $225. VSP will reimburse
members based on their plan, with an average reimbursoment of $120, plus the costs of buying
prescription iensos. lt will not subsidize the computer portion of Glass.

"Smart glasses may or may not find their way into our practices. -fhere
are companies out thero that
aro likely to do everything online and skip using an eyecare provider. In fact, I would say it's only a
matter of time before we see smart glasses available direct from the manufacturer
or reseller online," says Dr. Bazan.ODT

CLICK HERE TO CONTACT OPTICXPRESS FOR HELP WITH YOUR OPTOMETRY BILLING TODAY!