Optometry Billing Services
Boost your optometry practice’s revenue with expert billing services that eliminate administrative burdens and maximize insurance reimbursements. Our team ensures compliance with HIPAA, Medicare, and vision care billing rules while handling your entire RCM — from coding to claim resolutions.
Let us handle your billing so you can focus on patient care and profit growth.
Our Optometry Medical Billing Services
Insurance Verification & Eligibility Checks
We confirm vision and medical insurance for eye exams, therapy, surgeries, and more — ensuring fewer denials and clean billing from the start.
Patient Registration & Pre-Authorizations
Accurate CPT, ICD-10, and HCPCS coding for everything from refractions to diabetic exams — submitted on time, authorized, and ready for reimbursement.
Payment Posting & Reconciliations
Fast, accurate payment entries from payers and patients. We flag and resolve discrepancies to keep your cash flow uninterrupted.
Denial Management & AR Recovery
We recover lost revenue from claim denials involving glaucoma, cataracts, and more — cutting down AR days and improving profitability.
Compliance & Documentation Support
Stay protected and paid. We align your billing with HIPAA, CMS, and payer-specific rules to prevent rejections and audits.
Why Choose Our Optometry Billing Company?
Optometry-Specific Coding Experts
We specialize in CPT, ICD-10, and HCPCS codes for exams, lens fittings, diagnostics, and surgeries.
Full-Service RCM Outsourcing
From insurance checks to AR follow-up, we handle it all—cutting overhead while boosting revenue.
Faster Denial Resolution
We don’t wait. We track, appeal, and recover claims quickly to keep your cash flow steady.
Lower In-House Costs
No more billing staff headaches — reduce payroll, eliminate training needs, and gain efficiency.
Challenges in Optometry Billing Services
Eye Exam Coding Errors
Incorrect CPTs (92002, 92004, 92014) can cause underpayments and delays. We ensure precision.
Contact Lens Billing Issues
Misfiled CPT 92071/92072 codes = lost revenue. We handle them accurately.
Diagnostics & Imaging Scrutiny
Claims for OCT (92134), visual fields (92081), and similar diagnostics require tight compliance — we’ve got it covered.
Chronic Eye Disease Management
We ensure complete, medically necessary documentation for glaucoma (H40), cataracts (H25), and others.
Vision vs. Medical Insurance Confusion
Routine vs. medical visits? We verify and route the claim to the right payer — preventing costly rejections.
Missing Prior Authorizations
Our proactive process secures prior approvals, reducing denials and lost revenue for specialty treatments.
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 | Purpose |
|---|---|
| HIPAA | Protects patient billing data |
| CMS Guidelines | Accurate Medicare/Medicaid billing |
| ANSI 837 Format | Electronic claims formatting |
| ICD-10 Compliance | Proper diagnosis coding |
| CPT/HCPCS Modifiers | Prevent billing errors and rejections |
| Medicare & Medicaid | Vision care reimbursement guidelines |
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 | ICD Code |
|---|---|
| 99213 – Moderate E/M Visit | J01.90 – Acute Sinusitis |
| 99214 – High-Level E/M Visit | M54.5 – Low Back Pain |
| 17000 – Skin Lesion Removal | C44.119 – Basal Cell Carcinoma |
| 36415 – Blood Draw | E11.9 – Type 2 Diabetes |
| 93000 – Electrocardiogram (EKG) | I10 – Hypertension |
Get In Touch With Our Optometry Billing Experts
Stop losing money on denied claims and internal inefficiencies. Let’s talk about how we can simplify your billing and grow your profits.
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Quick answers to questions you may have. Can't find what you're looking for? Get in touch with us.
Every claim is double-checked by our Quality Control team to ensure compliance and clean submissions.
Absolutely. We tailor our billing systems and reporting to fit your EMR and processes.
We implement strict access controls, encrypted data handling, and internal audits to meet all HIPAA requirements.