How a Tailored Optometry Medical Billing Service Increases Cash Flow
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Improving collections and increasing cash flow is an essential optometry medical billing strategy for growing your practice and maintaining a healthy revenue.
Some of the most significant revenue cycle management (RCM) and medical billing challenges optometry practices face each day include how much time staff spend verifying patient benefits and eligibility, managing rejected and denied claims, submitting secondary claims, and posting payments.
For Art of Optiks, a three-doctor, two-location practice in Minnesota, outsourcing their medical billing to Fast Pay Health resulted in recouping $57,162 in lost revenue that their previous optometry billing service overlooked and mismanaged.
Spend a few minutes with Director of Operations Victoria Whitman, OD, as she explains why Art of Optiks is thrilled with returning to Fast Pay Health, how we tailored medical billing services to what doctors and staff need, and how they saw a return on investment in a few months.
Victoria Whitman, OD, Director of Operations, Art of Optiks
Why did you decide to return to using Fast Pay Health medical billing and RCM services?
Art of Optiks decided to return to Fast Pay Health for our medical billing for many reasons.
Patient Eligibility and Benefits Verification: The previous billing service relied heavily on our staff to verify patient eligibility and benefits were met before they would file a claim to vision plan or insurance payers. Because eligibility verification ensures insurance data is correct before submitting claims, we knew that this type of RCM process was essential to preventing claim denials.
Full-Service Billing and Coding: The previous medical billing service didn’t keep up with diagnosis and procedure codes, evaluation and management (E/M) codes, billing with code modifiers, adhering to coding and audit guidelines, and electronic data interchange (EDI) processes.
Claim Denial Management: Researching and resubmitting denied claims is a tedious process that involves calling insurance companies and inquiring what errors needed to be fixed if a claim was denied before you can resubmit. The previous billing service relied heavily on our staff to fix all errors before resubmitting the claims.
Secondary Claims Filing: Many of our patients have secondary vision plans and insurance so moving a paid claim for coordination of benefits was critical to keeping cash flowing. Because payers often require practices to bill a secondary carrier within a specific period after we receive the primary payment, to keep cash flowing you need to post remits and process claims daily.
Payment Posting: When you delay posting payments, accounts receivable (AR) will be high and the balance is often not moved to secondary insurance or the patient. When the balance is moved to secondary insurance or the patient, our cash flow is healthier.
Because the previous billing service struggled with posting payments into our optometry practice management software, we missed out on reporting details, such as payments by line and detailed recording.
Why is verifying a patient’s benefits and eligibility a necessary RCM process?
The fact that the patient’s eligibility and benefits verification process is a passive process is immensely helpful. Once the data entry portion is done, Fast Pay Health seamlessly steps in to verify information, update the record, and only reaches out to us with an update or concern.
Having accurate information about a patient's eligibility through both vision plans and medical insurance is invaluable. It allows us to provide a higher level of service to our patients by improving communication and setting proper expectations.
We also love that we have a direct email to contact our Fast Pay Health team for additional eligibility inquiries and other questions and concerns.
What proactive steps does Fast Pay Health take to clean up your aging claims?
Scrubbing and reviewing all claims prevents countless errors from making their way to the insurers and/or clearinghouse; therefore, saving weeks to months of valuable staff time.
When Fast Pay Health took over our medical billing in November 2020, they immediately researched our aging bucket to determine why aging claims were so high and found multiple issues.
Missed claims were not filed with vision plans and insurance companies.
Claims were not scrubbed prior to filing, which led to submission errors.
Billing and coding guidelines were not consistently followed.
Rejected claims were never fixed and reprocessed.
Denied claims were not reviewed, corrected, and resubmitted promptly, or worse, they were never reworked and instead tossed aside.
Payments were not consistently or correctly posted in our MaximEyes optometry practice management system.
Within six months, Fast Pay Health successfully cleaned up our aging bucket, filed missing and secondary claims, and processed denied and rejected claims for the period of May through November 2020. They continuously perform claim search sets to help us stay on top of aging claims, ensuring no claims are missed.
We are so grateful for Fast Pay Health’s diligence and medical billing expertise, and because of that, we were able to recover $57,162 that we thought was lost revenue with vision plans and insurance payers. What’s most impressive is that several claims were within an “untimely filing range,” and Fast Pay Health successfully appealed the claims.
How does Fast Pay Health improve claim denial management?
Fast Pay Health will often contact the insurance company searching for the reason for denial without requiring any assistance from our office. They independently determine primary vs. secondary insurers, correct payer IDs, and correct other data entry errors. This helps keep aging down and reduces staff time spent on claim clean up. We have seen a significant reduction in claims marked for our attention over the past year.
How would you rate Fast Pay Health customer service?
I would highly rate Fast Pay Health's customer service. Their optometric billing consultants take our feedback very seriously and is constantly improving its processes and communications. They are willing to work with us every step of the way.
What stands out the most with Fast Pay Health is its excellent customer service, positive attitude, and responsiveness. We receive prompt responses to all of our emails, letting our staff know that the team is working on getting us an answer. Having one consolidated email address to direct all questions, concerns, and requests has been incredibly useful for our staff.
Any tips you want to share with other optometry practices who are challenged with their billing process?
If you are considering outsourcing medical billing, first look at the actual costs of your current RCM processes and how those factor into a return on your investment. Look for a team that can improve office efficiency, save your staff time, and increase your cash flow.
Our practice highly recommends Fast Pay Health optometry billing services. The best part is that you can tailor your billing services to what you need. Our staff no longer have to manage everyday billing tasks continually; we can focus more on serving our patients.
Why consistent and reliable optometry medical billing is critical to a healthy cash flow
Don’t let inadequate insurance eligibility and benefits verification and avoiding denied claims create aging bucket chaos in your practice. The financial health of your eye care practice depends on higher efficiency and support to make your AR cleaner.
Complete, proactive optometry billing and revenue cycle management solutions are what we prescribe. Fast Pay Health is ready to help you get paid faster and grow your practice. Request a free practice analysis today.
About Victoria Whitman, OD: Dr. Whitman earned her Doctorate in Optometry at the Illinois College of Optometry, in Chicago. She received her undergraduate degree in Biological Sciences and Communications from Oakland University in Michigan, where she was born and raised. Dr. Whitman is a practicing optometrist and Director of Operations at Art of Optiks. She believes in the importance of patient education and patient involvement in overall health management. Dr. Whitman is involved in local Minnesota charities, organizations, and events. Photos provided by Art of Optiks.