Our ophthalmology billing software is built for the coding complexity of eye care. The software is capable of managing everything from cataract claims to intravitreal injection billing with industry-grade accuracy in every claim.
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Ophthalmology practices manage medical billing, surgical coding, and vision claims, sometimes within the same patient visit. Standard RCM tools that practices use are not capable of this overlap. The following are the billing gaps that cost practices revenue that use standard RCM tools:
Bilateral cataract surgery requires a -50 modifier which if missed, means the payer reimburses one eye which standard tools often miss.
There can be two claims for one visit and the insurance routing is mostly done wrong which results in immediate claim denial.
Intraviral injection and cataract surgery require prior authorization that requires prompt tracking which standard tools can’t do.
MedCare MSO’s ophthalmology billing software manages your entire revenue cycle in one place. Whether it’s surgical claims, diagnostic coding, medical-vision splits, or any other stage of the ophthalmology revenue cycle, our billing software is capable of doing it. It has specific workflows that make sure every claim is validated before submission, and if any problems arise, the software promptly addresses them. As a result, your team spends less time fixing errors and more time on patient care.
Our Ophthalmology billing software has built-in AI features that are built around the specific coding and billing workflows that your practice needs. The following are the features that keep your revenue steady.
The engine uses AI to check -25, -50, -59, and LT/RT modifiers before claim submission.
This feature identifies and splits dual-insurance claims to the correct plan through automation.
Matches correct NDC codes to ophthalmic injections like anti-VEGF agents at the claim level.
It monitors PA status across all active payers and provides automated alerts before anything goes wrong.
Our software flags claims submitted within surgical global periods to prevent post-op denials.
Surfaces denial trends by code, procedure, and payer so your team resolves patterns, not just claims.
MedCare MSO’s ophthalmology billing software can be easily integrated directly with practice management systems and EHRs you are currently using. No need to migrate or disrupt current operations.
Onboarding to our ophthalmology billing software is seamless as it integrates directly with your existing system without disrupting operations.
Whether your claim volume increases drastically over time or you expand to a multi-site setting, the software will scale with you and help you grow.
Our ophthalmology software is built with ease in mind and has one dashboard to manage all of your coding and billing workflows with complete visibility.
We offer a complimentary AR assessment through our billing software along with a clear plan on how the software can help you recover revenue.
MedCare MSO’s ophthalmology billing software validates whether the claim is for medical or vision insurance based on the diagnosis and the service rendered. After that, it routes the claim to the correct payer and flags any dual-insurance visits that require claim submission separately.
Yes, every claim is validated by an AI scrubber within our billing software before submission. It checks if there are any modifier errors, missing laterality, documentation gaps, and incorrect code pairings. Claims that don’t meet these requirements are flagged and put on hold until they are corrected.
The software considers the payer, code, and denial reason of every denied claim. This way your team can act on the patterns to prevent further denials while resolving the existing ones.
Yes, the software includes NDC-level drug billing accuracy that helps you bill accurately. It also tracks prior authorization requirements and the frequency limit by payer to prevent denials on high-volume drug claims.
The platform provides real-time dashboards that have every revenue cycle insight you need to make informed decisions. It includes AR aging, denial rates, collection performance, and payer-specific reimbursement details in one reporting dashboard. There is also the feature to filter reports by provider, payer, and procedure to further help you in decision making.
Ready to maximize your revenue while reducing administrative work? Let’s team up! Our medical billing expert will reach out within 12 hours.
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