Tips to Improve Your Ophthalmology Billing and Collection Efficiency

Tips to Improve Your Ophthalmology Billing and Collection Efficiency

The word efficient is defined as “achieving maximum productivity with minimum wasted effort or expense.”

Having an efficient patient flow within your ophthalmology office is important for the best overall patient experience. Your patients will appreciate not having extended wait times for their appointments, not being left in exam rooms unattended and not having to repeat information to technicians, doctors and other staff.

But what may be even more important are efficiencies in your billing and collection process – for patients as well as your bottom line. Consider this:

  • Patients will become frustrated when their claims are returned or denied due to reporting errors
  • Irritated patients can lead to negative online reviews about your practice and the potential for a slowing in lead generation
  • The longer it takes to have claims approved, the longer your practice will wait to get paid
  • Unrecoverable claims due to missed filing deadlines results in lost revenue for your practice

Do you know what percentage of unpaid bills you have in your billing department at any given moment? Do you know the financial impact of these unpaid bills on your revenue stream? This is important information to receive on a monthly basis.

Tips to Improve Ophthalmology Billing and Collection Efficiency

The very first tip is to understand that the role of billing and collection is not limited to your billing department. Your entire team plays an important part in this process. For example, in addition to greeting patients warmly as they enter your practice, your front desk staff should be gathering and verifying the following information as accurately as possible:

  • Insurance verification
  • Demographic data
  • Address or insurance changes
  • Co-payment collection
  • Deductible collection
  • Account review

Technicians and doctors are responsible for ensuring that all of the services provided are properly identified and coded so the billing staff can submit the right codes for reimbursement. If the charges are not entered, they cannot be submitted.

The more your staff outside the billing department can accurately collect and record patient information, the more efficient the billing staff can be. Otherwise, they will have to enter into a cat and mouse chase to obtain the right information. Claims that are denied due to missing information or incorrect coding should be the exception rather than the rule in your practice. It may be well worth the investment in staff training to help every member of your team learn their responsibilities when it comes to generating revenue for your practice. Helping your staff learn the intricacies of ophthalmology coding – and keep those skills up-to-date with the constant changes in the field – will go a long way to helping your practice get paid faster.

Even a minor mistake in data entry – at any point in the process – can result in a denied claim and an unnecessarily long process to correct the problem. That is inefficiency at its finest.

Reporting for Success

You can monitor the success of your efforts by requiring your billing and collection department to provide monthly reports with the following information (at minimum):

  • Insurance Accounts Receivable % Current Aging Bucket
  • Insurance Accounts Receivable % Older than 90 Days
  • Patient Accounts Receivable % Older than 90 Days
  • Days in Accounts Receivable

By reviewing these reports on a regular basis, you can identify areas where your processes are struggling so you can implement changes. It may be that your billing and collection staff is overwhelmed. It may be that they need more training in order to submit cleaner claims. It may be that they aren’t getting clean information up-front and are constantly having to chase information.

When the Process Becomes Too Overwhelming…

You may find that keeping your billing and collection process in-house doesn’t make sense. In that case, outsourcing may be a better option. However, if you choose to outsource, make sure you select a billing partner that has extensive experience specifically in ophthalmology billing. The complexities of ophthalmology billing may prove to be just as overwhelming for an external billing company if they do not fully understand the process that applies to your specific patient care. This could result in even more denied or rejected claims and even more lost revenue for your practice.

Advantage Healthcare Consulting, a division of Advantage Administration, is a Management Services Organization (MSO) which understands that ophthalmology practices need efficient billing processes in order to grow. That’s why we have partnered with specific ophthalmology billing and collection companies to offer our MSO members access to their amazing services at a reduced rate. We have done the research work for you to find the very best of the best in not only billing expertise but also an entire range of providers for medical equipment and support services. We’ve placed all of these companies under our MSO umbrella to help ophthalmology practices of all sizes take advantage of group pricing discounts. It’s the very best way to grow your practice. To learn more about our MSO, contact Advantage Healthcare Consulting today.