Did you know on average, a medical practice loses out on about $80,000 a year in insurance claims and medical billing? Ophthalmology practice is no different. So knowing the right ophthalmology medical billing code for billing is the key to keeping your clinic going and staying afloat in practice.
With ophthalmology billing and coding practice being more complex, the chances of getting your money back for the service rendered can be quite challenging. The knowledge of choosing the correct code requires the person to know:
- • In-depth knowledge of the medical necessity qualification
- • Reimbursement rates of each code
- • The rules put forth by the insurance company
Without this understanding in place, your staff can easily fill in the wrong codes leading to claim rejection.
Two Types of Codes – Complicating It Further!
Staying in compliance with the ever-changing billing regulation is already a challenging situation. Adding to that the understanding of two types of pathology billing, i.e.,In ophthalmology medical billing services, one has to choose between two categories of codes:
- • Evaluation & Management (E&M) Codes
- • Eye Codes
Under these two sets of codes, there are other details that the claim filing staff needs to be aware of. While only two codes can seem to be a flexible option, it also often leads to a lot of confusion.
When you have to select between the two codes for filing the claim form, one needs to be aware of the following:
- • Checking the diagnosis code(s)
- • Whether you use E/M codes when there is a medical element to the visit or stick with eye code?
- • Checking the history of the patient since eye codes are edited frequently. For example, a billing code XXX is limited to only once per year per patient.
- • Verifying the eye code documentation rigorously since it is different for all payers
- • Which code to choose when all things are equal, i.e., your patient meets both the elements of E/M and eye code?
These additional factors must complicate the simple two types of codes further. Making the right decision in choosing the codes decides the future of your practice with our ophthalmology billing services.
An Improved Collection with Comprehensive Solution!
Outsource ophthalmology billing to Info Hub Consultancy Services to warrant the payment for the service rendered. As your partner, we will help you in identifying the areas which can increase your collection. It will not only improve your ROI but give you the best chance to provide a better service to your patients.
With we outsource ophthalmology medical billing services, you get:
- An efficient audit system to warrant proper and timely documentation of the claims and bills
- Our certified and experienced coders are well versed with the latest CPT, HCPCS, and ICD codes and regulations
- Advanced software is used to suit your practice
- We take care of the patient scheduling and enrolment
- Analysis of the account
- Denial management
- Claim rejection follow-ups
Help You in Staying Out-Of-Networking Billing
Why outsource ophthalmology medical billing?
At Info Hub Consultancy Services, we know the dangers of making an out-of-network (OON) billing. It is the process where the billing is done without a payer contract. When your practice engages in such an incident, you will not lose the claim but also risk the chance of violating the fraud and abuse laws.
ICS, however, has the expertise and in managing the OON status when required by practice. Our knowledge in the field is extensive to warrant your practice does not engage in any fraudulent exercise.
So, we can do the required OON to ensure you do not lose money while keeping a squeaky clean image of your practice.
