Ophthalmology Medical Billing Service by StaffCloud.net

Outsourcing your ophthalmology medical billing can save you time, money, and headaches. Many ophthalmologists struggle to keep up with the ever-changing regulations and codes, leading to errors, denied claims, and lost revenue. By outsourcing this task, you can focus on providing quality patient care while ensuring your billing is handled by experts. 

Our optometry medical billing service encompasses a comprehensive solution for managing the revenue cycle of optometry practices. It involves a specialized approach to the billing and coding process, with a focus on accuracy and timely submissions. Our team of experienced billing specialists is well-versed in the complex nuances of optometry billing and uses advanced technology and industry best practices to ensure optimal reimbursement for our clients.

Thorough Understanding of the US Healthcare System and Terminology

a) Familiar with US HealthCare System run by Federal Government Programs like Medicare, Medicaid, CHIP, Veterans, Tricare, and Private Health Insurance Programs such as Aetna, UHC, BCBS, Cigna, Humana, Kaiser Permanente, Unicare, Harvard Pilgrim, Tufts, and more.

b) Proficiency in Ophthalmology Outpatient Medical Billing Terms, such as HCPCS codes (CMS), CPT Codes (AMA), ICD-10CM (CMS), Progress Notes, CMS 1500 claim form, Modifiers, CoPay, Coinsurance, Deductible, Referral, Prior Authorization, EOB, ERA, and more.

EHR Software Management Services

Expertise in processing records, posting payments, submitting claims, rectifying errors, and verifying patient eligibility using EHR software, such as eClinicalWorks, Epic, Cerner, Allscripts, NextGen, athenahealth, and more.

Comprehensive Insurance Eligibility Verification

Bulk eligibility verification through EHR software, with proactive communication to the point of contact before patient appointments. Individual verification is conducted through insurance company websites or direct calls when needed.

Claim Scrubbing and Submission

A decade of experience in reviewing, suggesting improvements, and submitting claims prepared by providers or coders through EHR software.

Collaboration with Clearing Houses

Efficient partnership with Clearing Houses such as Change HealthCare, Availity, Navicure, Office Ally, Waystar, and more to correct and submit claims to payers.

EOB (Explanation of Benefits) / ERA (Electronic Remittance Advice) Processing

Expertise in processing hard copy (Paper EOB) and electronic remittance advice (ERA), verifying and posting them to patient accounts using EHR software.

Patient Statement Billing and Due Diligence

Ensuring all patient’s dues are included in billing statements and promptly sent to the front desk for processing.

Comprehensive Denial Management Services

a) Systematic identification of denial reasons, taking steps to resolve issues, and resubmitting claims for payment. A knowledgeable and dedicated team ensures complete and accurate claim submissions and communicates effectively with payers to resolve disputes.

b) Proactive follow-up with insurance companies on claim status, denial, and other issues for a swift resolution.

c) Detailed preparation of appeals, reconsideration, and claim review forms.

Familiarity with Various Insurance Health Plans

Knowledge of diverse health plans, such as HMO, PPO, POS, and EPO.

Proactive Communication and Collaboration

Regular communication with providers, office staff, EHR software vendors, and Clearing Houses for claim rejections, issue resolution, and information exchange.

Collection Agency Coordination

Collaboration with collection agencies, such as Transworld Collection Agency, IC System, Central Portfolio Control, and more to recover overdue patient payments by providing necessary information through their online platform.

HIPAA Privacy

We ensure that all necessary measures are taken to comply with the HIPAA Privacy Rule. These measures include the implementation of physical, technical, and administrative safeguards to ensure the confidentiality, integrity, and availability of patients’ health information.

Flexible Working Hours to Meet Client Needs.

Our team customer support is always willing to assist with any inquiries or worries you may have. If you require aid, feel free to contact us through any of the following means: calling us at +919326811779, sending an email to support@staffcloud.net, or creating a ticket. We will gladly assist you with your concerns.

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