In an era of declining reimbursements and high-deductible health plans, profit margins are tighter than ever for most optometry and ophthalmology practices. That’s why having an effective optometric billing process is so important.

Our highly skilled optometric billing and coding experts work with ANY ophthalmology and optometry EHR or practice management software. For instance, our clients use MaximEyes, Acuity Logic, Compulink, Crystal PM, Eye Cloud Pro, Officemate/ExamWRITER, Eyefinity EHR, My Vision Express, iTrust, NextTech, Practice Director, Revolution EHR, Uprise by VisionWeb, and many more.

Fast Pay Health delivers expertise in managing claims, billings, and accounts receivable (AR) so you experience positive daily cash flow. There’s no need to worry about delayed payments and handling the unexpected with your staff anymore.

Fast Pay Health optometry billing services take care of the administrative details to save you time. We comply with the highest levels of HIPAA privacy and security at every point in the managed vision care plans and insurance billing process.

THE RESULT? More time to care for patients and generate revenue.

Optometric Billing Solutions for Greater Efficiency

Provider Credentialing
One of the first steps in eye care insurance billing is making sure the provider has been approved by the insurance carrier. Our credentialing specialists:

• Simplify the process by submitting and tracking provider credentialing applications based on insurance plan requirements.

• Follow-up with insurance payers regularly to make sure the providers are enrolled in-network when enrollment is open.

Eligibility and Benefits Verification
Verifying a patient’s insurance eligibility and benefits is another way we implement insurance billing services for optometry and ophthalmology offices. Our team takes care of:

• Verifying that insurance data is correct by confirming the insurance plan policy effective and term dates.

• Obtaining prior authorization for specific services, if needed.

• Verifying the patient’s out-of-pocket costs, such as co-pays, co-insurance and deductibles, as well as verifying co-pays for exam and materials for vision insurance plans.

• Authorizing benefits and confirming vision plan coverage for exams and materials, if the patient has vision insurance coverage.

Charge Entry
Charge entry is one of the most important features of the optometry billing cycle—it’s where the claims are created. We understand the importance of accurate charge entry, so your practice can:

• Collect maximum reimbursements

• Decrease payment denials

• Increase profitability

• Improve productivity

Ophthalmology and Optometry Billing and Coding
Our certified coders have extensive experience in eye care billing and coding. Coders are well versed in diagnosis and procedure coding, evaluation and management (E/M) codes, billing with code modifiers, electronic data interchange (EDI) processes, industry standards, and maintaining 100% HIPAA compliance at all times. We focus on:

• Billing the best way possible, adhering to strict state-specific coding and audit guidelines.

• Evaluating medical documents and physician notes to ensure claims are not under or over-coded.

• Reviewing previous denials that may occur due to incorrect coding, to help lower your AR even more.

Managed Vision Care Plans and Medical Insurance Claims Submission
We know the ins and outs of your payers best. We’ll make sure your claims are clean and free from errors before we submit them—delivering a consistent and positive cash flow for your practice.  

• Once we file claims electronically, our clients typically receive insurance payments in less than two weeks instead of the 3 to 4 weeks that top commercial payers take.

• We submit vision insurance claims through portals, such as VSP and EyeMed for exams and contact lenses.

• For those payers who require paper submissions, we’ll take care of submitting paper claims.

Clearinghouse and Payer Rejections
We track all claims we submit electronically through clearinghouses and ensure that insurance payers accept the claims. If we notice a rejection, our optometry billing consultants promptly fix the errors to ensure timely insurance receivables.

Payment Posting
When you delay posting payments, you keep your AR artificially high. By moving the balance to secondary insurance, you bill much quicker and improve cash flow.

• We post insurance payments that come in through Electronic Remittance Advice (ERA) and standard paper Explanation of Benefits (EOB) within 24-48 hours directly into your practice management system, so you have accurate and up-to-date accounts.

• Our team specializes in vision insurance payment postings, such as VSP, Davis, EyeMed, Spectera, and more.

Secondary Claims Filing
If a patient has secondary insurance, you can run into timely filing denials. Many payers require you to bill a secondary carrier within a specific period, after you receive the primary payment. We’ll keep those remits posted and process claims daily.
 
Denial Management
Researching unpaid or denied claims is a time-consuming process. We analyze all unpaid claims and EOBs and take the necessary steps to correct and reprocess rejected claims to recover the maximum payment possible. 
 
Accounts Receivable (AR) Cleanup & Insurance Follow-up
We have a team of experts focusing on your AR cleanup daily. Our Fast Pay Health eye care billing consultants take care of:

• Reviewing AR and aging claims to see why open balances are still outstanding.

• Analyzing unpaid claims then take the necessary steps to recover the amount due.

• Helping you reduce the number of hours you spend on the phone with insurance companies, so you can see more patients and increase revenue.

• Verifying receipt of claims with insurance companies then entering them into your practice management system, making your AR cleaner.

The graph shown below highlights how the Fast Pay Health billing team reduced accounts receivable (AR) and aging buckets by more than 90% during a one-year period for a three-doctor, one location California-based optometry practice—resulting in a higher return on investment (ROI) for the client.

Claims Audits
Avoid delays in reimbursements with claim audits. We make sure your insurance claims are clean and free from errors. We review accounts receivable aging claims daily to see why open balances are still outstanding. We believe that preventing those rejections in the first place is the best way to expedite revenue recognition.
 
Patient Statements
Having a difficult time keeping up with printing and mailing statements? We can help reduce expenses, boost your revenue, and eliminate the time-consuming task of in-house printing and mailing.

• We print and mail patient statements for your practice through our HIPAA-compliant print and mail service partner. Statements are typically mailed within 24 hours (during normal business hours) upon receipt of insurance payments.

• Or, we can print your patient statements to an assigned printer in your office, so you can mail the statement to the patient.

Quality and HIPAA-Compliancy Reviews
We take patient health information (PHI) security and privacy seriously by: 

• Continuously training and monitoring our eye care billing consultants to make sure we are complying with current protected health information (PHI) and HIPAA compliancy rules.

• Cross-checking every process, so our quality review team monitors every step of the ophthalmology and optometry billing process.

• Complying with document and workstation security, cloud security email security, fax security, data security, document disposal and destruction.

Business Analytics
Our comprehensive reports analyze the activity and the work completed for your practice. You gain insights into business strategies that help you move your optometry practice forward—growing top-line revenue for a healthier bottom line.