Vision insurance billing audits can be very frustrating. The
scrutiny by insurance carriers can expose various inaccuracies, and errors, and can
lead to substantial fines and penalties. Having sound policies and operational
frameworks in place can be the best way to make sure your optometry practice
does not have to undergo a vision insurance billing audit.
Here are 6 useful tips that can help you protect your optometry
practice from vision insurance billing audits.
Error-free Claims Processing
Mistakes in billing processes or claim errors often lead to vision
insurance billing audits. The common claims processing mistakes are entering
incorrect patient information, not verifying patients’ insurance and benefits,
etc. Reducing these errors can play a crucial role in decreasing the threat of
audits. A dedicated optometry revenue cycle management system can ensure that
all your claims are clean and free of errors.
Proper Documentation
An important prerequisite to preventing vision insurance billing audits is proper documentation. Along with ensuring you get paid for your optometry services, adequate documentation is also required to prove that the services you provided were medically necessary. The documentation should include information such as credentialing and licensing details of the provider, assessment of the patient’s condition, justification of diagnosis and treatment plan, and other relevant details.
Self-auditing
Prevention is better than cure. And the best way to prevent vision
insurance billing audits is to do one yourself. It is always better to catch
potential problems before they lead to significant errors, disrupt your system,
and cause major payer audits. Although a huge burden on the billing team,
conducting annual or biannual self-audits can save your company from critical
hassles. This, in turn, can be beneficial in boosting optometry
billing reimbursements.
Medical
Coding Precision
Coding issues are one of the most common reasons that trigger
vision insurance billing audits. Although up coding or under-coding can be
considered accidental, such mistakes in a particular pattern and over a period
of time can have critical legal ramifications. Using certain ICD-10
(International Classification of Diseases - 10) codes or CPT (Current
Procedural Terminology) codes in excess can also result in vision insurance
billing audits. It is thus recommended to have an optometry coding specialist
to ensure accuracy and compliance in your billing tasks at all times.
Outsource Billing to Industry Experts
Vision insurance billing audits
can take a significant toll on the financial health of your optometry practice.
To prevent this, it is imperative for optometry providers to take a proactive
approach to medical billing and claims processing. Having industry experts bear
the burden of your billing procedures can be an excellent way to stay away from
payer audits. Outsourcing optometry billing can not only enhance your
practice’s profitability but will also enable you to focus more on providing
optimal patient care.
Patient Satisfaction
Patients have the provision of getting in touch with the insurance carriers if they have any issues pertaining to the bills. These issues generally involve instances where patients are billed for services they did not receive. A great strategy to prevent this from happening is to offer patients an outlet to gain information or make complaints. This can help you resolve the issue before it reaches the insurance carrier, thereby eliminating the possibility of a vision insurance billing audit.
Staying away from payer audits is
quite simple and stress-free. All you need to do is incorporate the above-mentioned strategies and take the necessary steps to not commit any grave
billing mistakes. Get in touch with CS Eye to gain outstanding optometry
billing services. Let us help you stay compliant with all necessary regulations
and prevent the threat of critical insurance audits.
