Optometry Billing Services
Our optometry billing services improve your revenue cycle management (RCM) while ensuring compliance with HIPAA, Medicare, and vision insurance regulations. Our specialized team handles CPT coding, claim submissions, and denial management, optimizing reimbursements for eye exams, diagnostic tests, and treatments.
Outsourcing your medical billing to us means reduced administrative burdens, improved cash flow, and greater focus on patient care. Let our experts streamline your optometry practice’s financial operations while ensuring accuracy and compliance.
Our Optometry Medical Billing Services
Insurance Verification & Eligibility Checks
We verify patient insurance coverage for optometry services like routine eye exams, vision therapy, and surgical procedures. This prevents claim rejections and ensures accurate billing.
Patient Registration & Pre-Authorizations
Our team handles CPT, ICD-10, and HCPCS codes for optometry services, including refractions, contact lens fittings, and diabetic eye exams. We ensure coding accuracy for clean claims and faster reimbursements.
Payment Posting & Reconciliations
We manage payment postings from insurers and patients, ensuring accurate financial records and reconciling any discrepancies to prevent revenue loss.
Denial Management & AR Recovery
We track and resolve claim denials related to vision care services, including glaucoma screenings and cataract evaluations. Our proactive approach speeds up reimbursements and reduces outstanding AR.
Compliance & Documentation Support
We ensure all optometry billing follows HIPAA, CMS, and payer-specific guidelines. Our documentation support minimizes errors and maximizes claim approvals.
Why Choose Our Optometry Billing Company?
Expert Code Handling
We manage optometry-specific CPT, ICD-10, and HCPCS codes for exams, vision therapy, and surgical procedures, ensuring accurate claims and faster reimbursements.
Full RCM Management
From patient eligibility checks to final reimbursements, we streamline your revenue cycle to improve cash flow and reduce inefficiencies.
Denial Resolution & AR Recovery
Our proactive denial management and AR follow-ups ensure faster resolutions for rejected vision care claims, maximizing reimbursements.
Lower Administrative Costs
Outsourcing optometry billing reduces staff workload, cuts overhead expenses, and eliminates the need for in-house billing personnel.
Challenges in Optometry Billing Services
Coding for Eye Exams
Ensuring accurate coding for comprehensive (CPT 92004, 92014) and intermediate (CPT 92002) exams is critical for proper reimbursement. Incorrect coding can lead to underpayments, delayed claims, or audits that disrupt cash flow.
Contact Lens Fitting & Evaluation
Billing for contact lens fittings (CPT 92071) and evaluations (CPT 92072) requires precision to secure full payment for services. Misclassification of these procedures can result in claim rejections and lost revenue for optometry practices.
Diagnostic Tests & Imaging
Proper coding for visual field tests (CPT 92081), OCT scans (CPT 92134), and other diagnostics is essential to avoid claim denials. Insurers often scrutinize these claims, making compliance with medical necessity guidelines crucial.
Management of Eye Diseases
Accurate coding for conditions like glaucoma (ICD-10 H40) and cataracts (ICD-10 H25) ensures appropriate reimbursements. Failing to document disease progression correctly can lead to reimbursement challenges and revenue loss.
Vision vs. Medical Insurance Billing
Navigating between vision and medical insurance for services like routine exams vs. disease management can lead to claim rejections if not handled correctly. Proper verification and documentation help prevent incorrect billing and ensure timely payments.
Prior Authorizations & Claim Denials
Many optometric treatments and specialty lenses require prior authorization, and failure to obtain it can result in denied claims and revenue loss. Proactively handling authorizations and appeals helps minimize disruptions to patient care and practice revenue.
Compliance in Optometry Billing
Adhering to regulations ensures accurate claims, prevents denials, and secures timely reimbursements. Below are key compliance areas in optometry billing:
| Regulation | Description |
|---|---|
| HIPAA | Protects patient data in billing and claims. |
| CMS Guidelines | Ensures Medicare/Medicaid billing accuracy. |
| ANSI 837 Format | Standardized electronic claims submission. |
| ICD-10 Compliance | Requires correct diagnostic coding. |
| Modifier Rules | Ensures proper use of CPT/HCPCS modifiers. |
| Medicare & Medicaid | Defines reimbursement policies for vision care. |
Common CPT & ICD-10 Codes in Optometry
Precise coding ensures accurate billing, prevents denials, and supports compliance. Below are key CPT and ICD-10 codes used in optometry billing:
| CPT Code & Description | ICD Code |
|---|---|
| 99213 – Office visit, moderate E/M | J01.90 (Acute Sinusitis) |
| 99214 – Office visit, higher E/M | M54.5 (Low Back Pain) |
| 17000 – Removal of benign skin lesions | C44.119 (Basal Cell Carcinoma) |
| 36415 – Venipuncture for lab testing | E11.9 (Uncontrolled Type 2 Diabetes) |
| 93000 – Electrocardiogram (EKG) | I10 (Hypertension) |
Get In Touch With Our Optometry Billing Experts
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Specialties We Excel In
Ophthalmology Billing Services
Optometry and ophthalmology often work together to address vision-related issues. While optometrists provide routine eye exams and corrective prescriptions, ophthalmologists handle more complex medical and surgical eye conditions. These services complement each other in comprehensive eye care.
Pediatrics Billing Services
Optometry services are essential for children’s vision care, identifying early eye conditions that may affect learning and development. Pediatric optometrists work alongside pediatricians to ensure children's eye health is monitored and treated appropriately.
Geriatrics Billing Services
As patients age, optometry plays a key role in managing age-related vision issues, such as cataracts and macular degeneration. Geriatric care often includes optometry services to help maintain quality of life and independence for elderly patients.
Leadership Team
Dimitar Talevski
Dimitar is a seasoned marketing specialist and the visionary behind CLICKVISION. With over 10 years in digital marketing, he excels in crafting marketing strategies that boost rankings, which in return increase leads, conversions, sales, profits, and ROI.
Filip Dimitrijevski
With a strong background in the marketing industry and healthcare leadership roles, Filip is responsible for CLICKVISIONBPO's sales strategies and onboarding new clients. With a passion for sharing insights gained from his experience, he also shares valuable knowledge through industry related articles.
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We maintain high-quality outsourcing optometry billing services through our dedicated Quality Control team. They double-check all claims for accuracy and compliance before submission, reducing the risk of errors and ensuring optimal reimbursements.
Absolutely. When you outsource optometry billing to us we offer customized billing services tailored to the unique needs of your practice. Our flexible approach allows us to meet the specific billing requirements of solo practitioners and multi-provider clinics alike.
We prioritize compliance by adhering to strict HIPAA guidelines and other industry regulations when providing our outsourcing optometry billing services. Our team stays updated with the latest billing rules and standards to ensure that all claims are submitted accurately and securely.