Top 3 Common Mistakes in Optometry Billing and How to Avoid Them

Optometry billing can be complex, with common mistakes often resulting in claim denials, payment delays, and financial losses. Here are the top three frequent errors and how to avoid them:‍

1. Incorrect information in Patient Demographics:

Seemingly minor issues can cause significant delays in the billing process. Incorrect or missing information can cause insurance companies to deny claims. Incorrect demographic details can cause billing errors that can cause patient dissatisfaction and potential legal issues. Correcting these errors increases operational costs due to the extra administrative effort needed, and resulting payment delays can impact the practice’s cash flow and financial stability. 

How to Avoid this: Regular verification and updating of patient information can help minimize these issues.

Key Takeaways:

• Errors in patient demographics cause claim rejections, payment delays, billing errors, patient dissatisfaction, and legal issues
• Correcting demographic errors increases operational costs
• Regularly verify and update patient information for efficient billing

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2. Not Verifying Patient Insurance:

Steps can be taken to avoid denials before they occur - practices can avoid potential issues by asking about changes in patient insurance coverage and verifying insurance benefits prior to providing services. The process of verifying insurance can help a patient understand what to expect, and also can help a practice catch incorrect or missing information. Patients expect their information to be handled accurately, and repeated errors and the associated administrative hassle can erode patient trust and satisfaction with the healthcare provider.

How To Avoid this: Practices should make it a habit to verify patients’ eligibility prior to the patient being seen. This can be done during the initial call to schedule the appointment, or some offices verify all charts up to a week before the appointment.

Key Takeaways:

• Incorrect patient information complicates insurance verification
• Lack of verification leads to claim denials and payment delays
• Verify patient eligibility before appointments

3. Under billing for services rendered:

Services provided but not invoiced results in lost revenue. Under billing for services rendered can have several negative consequences on a practice, including operational efficiency, legal consequences, and the financial health of a practice. Over time, under billing can lead to significant financial instability, affecting the ability to invest in new technology, hire additional staff, or expand services, thereby limiting the office's growth potential.

How to Avoid This: top-tier office communication from the front to the back of the office helps ensure accurate coding prior to patient check out. 

Key Takeaways:

• There are legal and financial consequences to under billing 
• Ensure all procedure codes are entered before checkout
• Maintain clear communication within the office to prevent errors

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Conclusion

In summary, ensuring accurate patient demographics, verifying insurance information, and preventing under billing are crucial steps for maintaining a smooth and efficient revenue cycle in an optometry office. These practices not only enhance operational efficiency but also improve financial stability and patient satisfaction. By addressing these common issues, healthcare providers can avoid delays in payments, reduce administrative burdens, and ensure a more reliable cash flow.

For more information on how Barti's Revenue Cycle Management (RCM) services can help streamline your practice's billing process and enhance financial performance, please reach out to us at info@barti.com.

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