Denial Management For Optometry Providers

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Denial Management For Optometry Providers
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INTRODUCTION

• A rise in cash flow and enhanced processes will
  improve the efficiency of the billing process,
  which comes merely with timely and effective
  denial management. In no small measure, in the
  world of medical billing, the rejection of claims
  is a significant cause of annoyance and declining
  profits for doctors and a myriad range of
  healthcare providers. Thus, it is crucial for
  practices to pinpoint the causes, stop them from
  circling, and choose strategies that will help
  them become more financially and strategically
  functional.
• Squaring closer to optometry billing, the
  processes are integrally tied to claim
  administration and reimbursement, and these are
  frequently seen by optometry professionals as
  being very difficult and time-consuming jobs.
  Its really not their fault, is it? After all,
  these complex tasks are supposed to be taken care
  of by the medical billing companies.

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Denial Management For Optometry Providers

• Optometry billing procedures present a unique set
  of difficulties, most of which are connected to
  claim administration and payment.
• These difficulties act as hurdles for the
  optometrists and ophthalmologists from maximizing
  their income cycles.
• This is the sad truth, however the best part is
  that this can be avoided. Firstly, lets glance
  through the common denial reasons, shall we?

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Common Denial Reasons And Their Solutions

• 1. A claim for the same service or procedure is
  submitted twice
• 2. The patients health plan coverage expires,
  they are not eligible for services
• 3. The doctor is not a part of the provider
  network
• 4. Incomplete or incorrect patient demographic
  and insurance data
• 5. The benefit involves more visits or services
  than are permitted
• 6. There is a need for a prior authorization
  number for the claim

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Common Denial Reasons And Their Solutions

• 7. Either a code or modifier is missing from the
  claim, or the modification is invalid
• 8. Instead of bundling services, the bills should
  have been issued separately
• 9. The POS does not correspond to the action
  taken
• 10. The service is not medically necessary or is
  not covered by the plans coverage

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Common Denial Reasons And Their Solution

• It might be time to outsource medical billing if
  workflow efficiency is declining across your
  entire firm.
• By doing this, your staff is free to concentrate
  on patient-important responsibilities while a
  knowledgeable billing team keeps track of and
  scrutinizes claims to ensure smooth billing
  procedures.

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Denial Management For Optometry Providers

• Post the pandemic, optometrists have seen
  significant changes in the way they conduct
  business.
• Outsourcing optometry billing services tops the
  list of their efforts regarding claim management
  and reimbursement due to the impact of COVID-19
  on insurance coverage!
• This is a smart move given the stemmed fact that
  they do not have the right skills and advanced
  technology to toss away the lingering challenges
  and bring solutions to the table.

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Conclusions

• At Medisys Data Solutions, we understand that it
  can be challenging for optometrists to enhance
  denial management due to a lack of knowledge on
  various amendments to rules, regulations, and
  laws pertaining to optometry medical billing
  services. Without the assistance of medical
  billing professionals, the process of medical
  billing is a challenging subject to comprehend
  and it may be challenging to stay current with
  changes in this field. Fret not, we have got your
  back!

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About Us

• Medisys Data Solutions is a leading medical
  billing company providing complete assistance in
  medical billing and coding. We can assist you in
  receiving accurate insurance reimbursement from
  private and government payers. With our services
  like benefits verification and credentialing
  enrollment, you can add more providers in your
  practice. To know more about our specialty
  specific medical billing and coding services,
  contact us at info_at_medisysdata.com/ 302-261-9187.
• GET IN TOUCH
• 302-261-9187
• Address
• Medisys Data Solutions Inc.
• 8 The Green STE A, Dover, Delaware 19901,USA
• Email info_at_medisysdata.com

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Thanks

• Do you have any questions?
• info_at_medisysdata.com
• 302-261-9187
• medisysdata.com