Ophthalmology Billing Services by Medcare MSO

Medcare MSO is dedicated to providing outstanding revenue cycle management services, including certified & experienced coders and billers.

Wide Range Of Services

Medical billing for ophthalmology, like that for any field of medicine, is complex. Not only are the codes complicated, requiring detailed knowledge of the practice in addition to understanding coding and billing, but they are changed every year. Additionally, insurers and government payers change their policies and plan frequently, and coverage rules may even vary according to the state you are in.

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Busy Medical Staff To Keep Up

All this change makes it impossible for busy medical staff to keep up with the latest billing guidelines. Outsourcing to a professional medical billing company like Medcare MSO has proven to be very successful for practices of all sizes. Because our ophthalmology medical billing services are not medical, but only focused on the revenue cycle management (RCM) aspect, we are able to stay up to date on billing and coding changes.

3 Reasons to Outsource Billing for Ophthalmology

Medical codes are complicated, and it is difficult for individual billers to stay abreast of all the changes. Medcare MSO provides an innovative approach to billing and coding, with a staff that is not only certified but also experienced in ophthalmology insurance billing. Billing done in-house can be thrown completely off if one person becomes ill or is called away on an emergency, but our large staff has someone ready to step in if the regular person doing the billing is not available.

Our ophthalmology billing specialists are also trained on HIPAA best practices, so you can rest assured that your patient information is managed appropriately. Every field of medicine has its own challenges, and these are some of the top challenges of billing for ophthalmology services.

Detailed Modifiers

Ophthalmology billing modifiers must be used with basic medical billing codes to notate whether both eyes were affected, or if it was left or right. If a minor procedure is done on the same day as an office visit, there is a modifier needed. Billers and coders must also know how to code for multiple procedures in the same setting, etc.

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Bundled codes

Charges for services are often bundled together, which simplifies coding, but it also requires medical billers and coders to be aware of what is in each bundle because sometimes the physician may determine that something additional is needed or substitution is required. Billers must know how to document additions and exceptions properly, or those services will be considered unnecessary and rejected by payers.

Multiple Insurers And Payers

Ophthalmology may be covered by insurance companies and it is covered by Medicare/Medicaid, but billers also have to be aware of which to bill. Before billing Medicare, the biller must make sure that no other insurance can be billed, including a spouse’s employer plan, Railroad Retirement, if the patient is a member of certain unions or has VA benefits, and even whether there is an injury covered by no-fault insurance.

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Medcare MSO Delivers Comprehensive Ophthalmology Billing Collection & Practice Management

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We Offer A Full Suite Of RCM Services

We offer a full suite of ophthalmology revenue cycle management services, with medical billing being one of our most popular. By relieving in-house staff of coding and billing responsibilities, we not only provide increased revenue for your ophthalmology practice but also a much less stressful work environment. Having our billing service in charge of filing the results of your claim in much higher reimbursement, improved cash flow, and less lost revenue.

We also are available to perform compliance reviews, annual payback, payer credentialing, denial management, and much more. Get a free demo today to get started on the road to more revenue with fewer headaches.