Time to Revalidate Your Medicare Enrollment!

By Dave Kegel, Manager of Credentialing Two years ago, during the COVID-19 Public Health Emergency (PHE), Centers for Medicare & Medicaid Services (CMS) enacted a waiver that allowed new, non-certified Part B suppliers, physicians, and non-physician practitioners to obtain temporary Medicare billing privileges. CMS also temporarily waived the associated application fee, criminal background checks, and site visit requirements. All Medicare …

No Is Not (Always) Their Final Answer

By Amanda Kissinger, RevCycle Partners Billing Service Group Manager The best insurance billers are tenacious. They have to be. Think of the number of times an insurance payer denies payment. You did your research. You used the right CPT codes for the service provided. You reported the necessary additional information, such as the referring provider. You know it was posted …

Outsourcing: It’s Not All or Nothing. 3 reasons optometry practices outsource a piece of their RCM.

Outsourcing: It’s Not All or Nothing

By Melissa Jacobson, Operations Manager When the subject of outsourcing comes up, the office mood can tighten. Staff can feel threated as they wonder, Will my role be eliminated? Am I not doing a good enough job? In some cases, the job simply isn’t getting done, and outsourcing every aspect of the function is a necessity for practice survival. High …

Commonly Misused Coding Modifiers: Definitions and examples to help you get it straight.

Commonly Misused Coding Modifiers

By Melissa Jacobson, Operations Manager Modifiers are complicated. Using the incorrect procedure modifiers—or missing them altogether—can lead to denials. Denials, of course, mean delays in payment, or worse, non-payment. As a refresher, below are commonly misused coding modifiers for optometry insurance billing. Modifier 25 “Used for significant, separately identifiable evaluation and management service by the same physician on the same …

The Foundation of a Smooth Patient Experience

The Foundation of a Smooth Patient Experience

By Christine Schneider, VP of Operations “But patients will be annoyed! They don’t want to be bothered.” That’s what many patient care coordinators may think when faced with the decision of whether to verify eligibility and benefits by phone prior to a patient’s visit. But what if that extra step actually creates a better patient experience? What if the call …

Relief for an Optometry Practice in Transition

Relief for an Optometry Practice in Transition

By Amanda Kissinger, Billing Services Group Manager Is your optometry practice in transition? Maybe you’re growing and buying up a practice or two. Or maybe your practice is being purchased. Or maybe because of the pandemic-induced staffing shortages, you’re having trouble hiring staff. Whatever the reason for the transition, it likely will be a chaotic time for your practice—especially when …

ABN Update

Details on the 2021 ABN Update

By Melissa Jacobson, Director of Insurance Billing Advanced Beneficiary Notice of Non-coverage (ABN) Form In January 2021, the Centers for Medicare and Medicaid Services (CMS) revised the Advanced Beneficiary Notice of Non-coverage (ABN) Form. The ABN Form CMS-R-131 is issued to the patient or client by providers, physicians, practitioners, and suppliers in situations where Medicare payment is expected to be …

New Evaluation and Optometry Coding Changes for 2021

By Casey Squicquero, Billing Support Group Manager, RevCycle Partners The new year always brings new coding guidelines. Here are a few coding changes for 2021. Rather than using history, examination, medical decision-making and time to determine the level of E/M service, like providers have always used, the update to the E/M coding guidelines will be determined based on 1 of …

Embracing Outsourcing as a Strategy

Is it time to rethink your strategy now that you are reopened? When it comes to outsourcing your optometry office’s functions, it’s natural to look only at the direct costs. You analyze your in-house staff wages. And then compare them to a vendor’s fees. But there’s more to it than a basic wage to fee comparison. And it’s not an …

advances in improving your AR

Advances in Improving Your AR

How we are changing our aging claims process to fight your insurance battles. by Melissa Jacobson, Operations Manager of RevCycle Partners Transparency translates to accountability. And accountability translates to better service. That is why we are improving our aging claims procedures. Our goal, each month, is to touch every aging claim, and place them in front of you in an …