Optometry Staff to check patients’ benefit plans before documentation

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Optometry Staff to check patients benefit plans
before documentation

• It is quite usual for a patient to visit an
  optometrists office with a thorough
  understanding of the insurance coverage he or she
  possesses. The optometrists staff should also
  understand and be good at reading the patients
  illnesses while comparing them with the various
  diagnosis codes. This helps them decide on
  whether to bill under vision insurance or medical
  insurance. However, in reality, most of the staff
  employed at an optometrists do not realize the
  importance of checking the patients benefits
  plans before documentation.
• This is primarily because most of them do not
  fully understand which plan is meant for what.
  Hence, more often than not they are at a loss as
  to advising the patient on what benefit plan he
  or she should be using. In such situations not
  only are the staff frustrated, they leave the
  poor patients frustrated as well.
• The staff needs to understand
• To ensure errorless billing and coding, there
  needs to be at least one staff member in an
  optometrists office who thoroughly understands
  the various insurance plans that are acceptable,
  and how the documentation needs to be done.
• In order to check this, the primary step will be
  to check for the eligibility verification of the
  patient.

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Optometry Staff to check patients benefit plans
before documentation

• It is better to call up the insurance company or
  access their website on the Internet to get to
  understand the particular plan better before
  documenting it.
• Better still if the optometrist were to instruct
  the staff to have a binder handy, containing all
  the various insurance plans.
• Before documenting a plan in the medical
  insurance verification of chief complaint and the
  diagnosis plan are essential.
• It is also a good idea for the staff to inform
  the patient about his or her copay for the
  particular exam.
•  
• Similarly, when a problem is listed without the
  relevant plan, the healthcare staff may be able
  to understand the case and decide upon its
  severity. However, the auditors may give it a
  cursory glance and may not be able to understand
  it fully. Unless there is proper and complete
  documentation, the complexity of the case cannot
  be inferred at the time of review.

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Optometry Staff to check patients benefit plans
before documentation

• Hence it is important to document an accurate and
  detailed description of the condition the patient
  suffers from and an appropriate plan for it. Any
  plan has to be clearly documented as it indicates
  the problems that were managed by the
  optometrist.
• Some more points to remember
• Staff should realize that patients walking in
  with eye injuries, infections in the eye,
  cataract or any other eye ailment related to
  diabetes, these are covered by medical insurance.
• Vision Service Plan (VSP) offers full coverage
  for eye care or eye exam. If there is a copay,
  the payment has to be done at the time of
  service.
• Medicare also covers eye examination, though
  refraction is not covered.
• Medicare also offers coverage for eyeglasses only
  for the first time after cataract surgery.
• However, the purchase of other eye care aids like
  contact lenses, eyeglass frames, coatings, etc
  are not covered under Medicare.  

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Optometry Staff to check patients benefit plans
before documentation
Hence, it is important to have an understanding
of the benefit plans of every patient that walks
in, which will play an important role in ensuring
a smooth revenue cycle management for Optometry
billing. Get in touch with us!