Optometric Billing & Coding Support for PECAA Members
Revenue cycle management is one of the key components to a financially successful practice. Knowledge and understanding of the overall revenue cycle processes benefit the practice in establishing efficient and effective systems. Revenue cycle management consists of all administrative and clinical functions that contribute to the capture, management and collection of patient revenue. Therefore, the revenue cycle begins when the patient schedules an appointment and ends with capturing all earned revenue, either from the patient or a third-party insurance.
At PECAA, we offer Billing & Coding services in the areas of patient revenue, coding support, claims management and accounts receivable analysis.
Let us support your practice with your revenue cycle needs!
In today’s healthcare environment the patient has become your most substantial payer. Statistically, patient revenue makes up 60% of the practice’s revenue.
Mastering the insurance verification and patient collection process is crucial to the financial health of your practice.
- Capturing patient data
- Insurance verification
- Patient statements and collection
Coding elements, such as CPT, ICD-10-CM and modifiers drive claim reimbursement. Knowledge of what these coding elements mean and the story they tell the payer is important not only for reimbursement but also compliance. Understanding the policies of your individual insurance payers aid in compliance, prompt reimbursement and a reduction in denials.
- CPT references
- ICD-10-CM references
- Payer policies
Claims management focuses on denial prevention and denial management.
Denials are very costly to the practice. Resolving denials timely as well as understanding how to prevent future denials is key to a healthy bottom line.
- Denial prevention
- Denial resolution
Accounts Receivable Analysis
The revenue cycle is central to a health care practice’s financial system, and one of the pillars in keeping the practice successful. Understanding revenue cycle management is only part of the equation. The next step is interpreting if your revenue cycle processes are working within the practice. Focusing on key billing metrics will allow you to build cash flow transparency. Identify potential issues and implement process improvements to increase and support cash flow.
- Accounts receivable assessment
- Focusing on key billing metrics
- Review of revenue cycle processes based on assessment
- Recommendation for process improvements
Meet Your Advisor: Teri Thurston
Teri is a revenue cycle professional with over 25 years of experience in the eye care industry. She has managed complex billing teams for ophthalmology and optometry practices. She has worked with various physicians to increase profitability, implement RCM efficiencies, and ensure billing compliance. She is passionate about supporting eye care professionals through billing and coding education.