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Ophthalmology Blog

Up-to-date weekly advice for ophthalmology practices, other specialty practices, ambulatory surgical centers, academic eye hospitals, and optical practices

Maintaining Financial and Legal Control in Your Billing Practice: Start by Working Unapplied Credit Balances Immediately

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By Michael Carroll on March 15, 2018

If your staff aren’t working assigned unapplied credit balance reports weekly, you might run afoul of the law. In the current healthcare field, replete with stringent financial restraints and finite resources, credit balances and unclaimed property balances may be draining the lifeblood out of your solvency. Failure of billing staff to work these elements on a […]

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Does Your Ophthalmology Practice Have an Action Plan for Collecting Deductibles?

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By Michael Carroll on March 8, 2018

While the Affordable Care Act has lowered the number of uninsured Americans, the number of people using high deductible health plans (HDHPs) has significantly increased. They have insurance, but many Americans are struggling with increased out-of-pocket costs. A report from the Kaiser Family Foundation found that the average annual out-of-pocket costs per patient increased almost 230% between […]

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The Case for Generating Weekly Patient Statements

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By Michael Carroll on March 1, 2018

Collecting patient-owed balances can be one of the most time consuming and expensive ventures for your practice. Maintaining an in-house billing department accounts for a large chunk of your operating expenses. This is why it is critical for you to maximize your efforts to reduce your receivables, collect outstanding balances and retain the services of […]

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What is the Average Denial Rate in Your Ophthalmology Practice?

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By Michael Carroll on February 22, 2018

According to the American Medical Association (AMA), insurer denial rates are down. The AMA’s most recent National Health Insurer Report Card has billers jumping for joy. Denial rates dropped by 47% in 2013 and are now as low as 1.82%. Compare that to 7.1% in 2010 and 3.48% in 2012. Medicare had the highest denial rate in […]

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5 Reasons ICD-10 is Getting a Lot Tougher in The Future

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By Michael Carroll on October 18, 2016

If you recall CMS’ statement from this past August, ICD-10 is getting a lot tougher since October 1st. For the first 12 months after CMS opened ICD-10 coding, Medicare promised not to deny physician or practitioner claims for reimbursement submitted under the fee-for-service Part B physician fee schedule and based solely on the ICD-10 diagnostic codes so […]

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Why Ophthalmology Practices Are Planning To Outsource Their Medical Billing

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By Michael Carroll on September 14, 2016

For most small physician practices, medical billing expenses comprise a significant percentage of the overall expenses for the practice. Some small physician practices simply cannot afford to hire a dedicated billing clerk and assign billing responsibilities to office managers or another staff member. In these cases, physicians run an increased risk of losing hard earned […]

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Are Your Ophthalmology Billers Correcting Rejected Claims Within 24 Hours?

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By Michael Carroll on August 26, 2016

“Time is money.” That cliche is certainly true when it comes to submitting medical claims. While billers are diligent about submitting original claims within the payer’s time frame, rejected claims often slip through the cracks.Healthcare IT News reported that one data scientist estimates providers could recoup millions by simply resubmitting claims that were rejected for ICD-10 […]

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Clean Claim Acceptance Rate in Ophthalmology: Is Your Practice’s Too Low?

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By Michael Carroll on August 22, 2016

There are a lot of reasons (and excuses) for a low clean claim acceptance rate. Health care reform, ICD-10 conversion, the transition to electronic health records, as well as patients changing insurance carriers all play a role in creating a challenging environment. It’s been a rough five years for health care, and billing bears most […]

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Increasing Your Paid Insurance Claims Through Well-Trained Front-Office Staff

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By Michael Carroll on February 22, 2016

Why do you get rejected EOBs? The reasons can run from an improper claim code to a mistake in patient information. Regardless of why the insurance company refuses to pay your claim, you’re stuck figuring out the reason and resubmitting in order to get paid. But busy practitioners lack the time to get that done. […]

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