The Importance Of Billing Codes For Optometry

To get the right claims, optometrists must follow the right plan for making the billing codes

. Even a minor mistakes committed by them would lead to making optometry the target for investigations. Therefore, The staff should pay full attention while creating the billing codes for optometry.

Optometrists must learn the correct use of billing codes for optometry or face rejections of the claims they submit. While insurance is a great deal for patients and for doctors, it is important to learn quickly in order to be paid for the work done. Those experienced in the field know common errors that can cost the practice money.

Take time to ensure you have selected the right plan. Plans may have variations or multiple levels on coverage, allowing the practice to joint some panels without joining all. Not all plans tell you all you need to know upfront. It is important to find how much it pays, the frequency of payments and the companies covered near a practice. Remember the computer only reads the code to authorize payment.

Staff should inquire about insurance at the time a patient calls for an appointment. This allows the practice to inform the patient if it is not a provider. In addition, patients can be informed of any co-pay necessary before arriving at an appointment. When patients arrive, be sure the staff gathers necessary information.

The diagnostic code must match the code for the procedure code. Remember there may be more than one diagnostic and/or procedure code applicable in filing the form. It addition, the placing a diagnostic code in the space for a procedural one will result in denial of the claim.

It is important for staff to know if a diagnosis should be entered as a four or five digit code. Leaving a zero after the decimal point out of the coding may not mean much to anyone else, but to the computer and insurance company it is very important. If left off, the claim will likely be rejected.

Be careful that you do not bill for one procedure more frequently than similar providers in the area. In doing so, a higher utilization pattern is established. In addition, there are procedures, such as cataract surgeries that have a one fee covers all needed care within the specified time. The provider who bills repeat visits under the same diagnosis during the time will be rejected.

To operate a successful practice, it is important one understand the importance of billing codes for optometry. Love it or hate it, the practice must deal with insurance to stay afloat. If an office does not accept coverage, it will lose a large number of potential clients. If the practice accepts insurance but does not file claims correctly, it will lose money due to rejected claims.

by: Karen Van Laningham

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