Optometry billing is based on vision plans with payers and patient routine check-up or medical plan. This results in a consortium of problems for the optometry practitioners, here comes LHS optometry billing team. We began our billing process with appointment booking, where our team get prior authorization for the complete procedure.

“We have seen an increase in Optometry denials, when providers approach us, they are confused about what went wrong. We need to have a complete prior authorization before patient visits, to determine the reimbursement will be from medical insurance, in this case, it could be from patient’s employer or separate insurance cover or even out of pocket payment.”

– Optometry Billing Expert at LHS

Verify if the payer has approved the provider's procedure. Many of the routine check-ups may not cover specific procedures, hence LHS prior authorization team will need to verify the insurance coverage.

Coding for specific patient visitation needs to be recorded accurately. Evaluation and Management (E/M) specific coding clearly verifying the reference, review, and verify. Legion healthcare solutions keeps patient records streamlined in case of patient revisits.

Medical vs. Vision insurance plan, which one to chose. We have seen that most providers tilt towards whichever covers the procedure leading to denials. Vision insurance cover routine check-ups while medical check-ups include a yearly vision check-up along with other optical procedures.

Coding experts eliminate the claims denials, whether it’s E1-E4 modifiers, -24,-25, -55, and many more modifiers help to describe the complete procedure. For coding, whether it’s 92xxx for general ophthalmology or 99xxx for evaluation and management, LHS medical billing gets it all.

Medically necessary lenses are usually required by the patient at the end of visits. Before scheduling a patient appointment, LHS can help you inform the patient about the out-of-pocket payment for a lens in such cases.

Prior authorization for each patient before each visit. Reduces claim denials by more than 90 percent.

AAPC Certified coders to provide accurate coding solutions for the providers.

To reduce AR days by less than 90 days, billing audits are carried for each claim.

To improve patient experience, API-and RPM-led technology will schedule patient appointments and even send reminders.

LHS optometry billing cycle will help your practice realize the gaping holes in RCM process and promote profitability.