Are You Running a Modern Billing Department? If Not, Here’s How

Use the latest technology and third-party services to make insurance processing more efficient for your practice.

There are many aspects to utilizing technology, software and people to modernize billing and tracking of both vision and medical insurance. Your practice can make the most of such technology to make billing more efficient and profitable. Here is how you can do it.

Recognize 5 Keys to Optimizing Billing Technology

SOFTWARE THAT GENERATES REPORTS: Utilize practice management software that is capable of generating reports on billing status.

EDUCATE STAFF: Educate staff to be dedicated to efficient use of insurance. Education of a key staff person to coordinate vision benefits and medical benefits is imperative. It is also necessary to train front desk employees to capture insurance information prior to the patient being seen by the practice.
PREVIEW INSURANCE INFO:  Provide insurance information to the doctor prior to seeing the patient. The doctor needs to be aware of medical as well as vision benefits for both professional fees as well as ophthalmic materials.

DELEGATE: Assign a single individual the final responsibility of making sure claims are filed and accounts receivable reports are up to date.
USE A CLEARING HOUSE:  Utilize a clearing house (a third-party company that you send your paper claims to for transference into electronic claims) to achieve maximum efficiency.

The modern practice and its billing department can benefit from the innate efficiencies of a clearing house. VisionWeb could be your clearing house of choice, however there are several to choose from such as Gateway, and Eyefinity. Having implemented VisionWeb/Emdeon many years ago in our practice, you may enjoy the following benefits:

Centralized Claim Filing
It is possible to file claims online without using a clearing house, but this method is far from ideal. Filing claims electronically without a clearing house means going to multiple sites on the Internet, with varying user interfaces, to get the job done. Advanced billing departments realize there is a better way. Clearing houses are a go-to solution for practices because the clearing house software allows employees to do all of the following in one location:

  •    Check patient eligibility
  •    Submit and track claims
  •    Process secondary claims
  •    View detailed reporting information
  •    Manage Electronic Remittance Advice (ERA)

Efficient Management of Reporting and Analytics
Even the most efficient office will have denied claims. The way we keep a close eye on our claims is through detailed reporting and analytics that cover every aspect of claims, such as:
-The number of claims that have been rejected vs. accepted
-Top payers that are rejecting claims, by amount
-Timeline of claim submission for tracking
-Top rejection reasons
Optimized Practice Management Systems
Good practice management software is the brain center of a practice. Practice management software is a significant investment, and yet, practice owners are putting them to work, especially for claim filing. Technologically advanced practices utilize their practice management system claim filing functions to:

-Create batch claim files directly within the system
-Upload the batch claims and submit directly to payers
-Reduce redundancies associated with re-keying claims
-Generate reports quickly and easily on demand

Utilize Electronic Remittance Advice (ERA)
Billing departments become more efficient when they avoid paper claims. EOBs, especially, since payers have migrated to electronic payment methods, are processed more quickly via the internet.  Electronic Remittance Advice is common among progressive practices. Filing via your computer simplifies the reconciliation and secondary claim filing processes by:

-Providing remittance information in a searchable, electronic format
-Making it easy to search remits by payer,  date or provider  
-Giving users the ability to print only the information they need for secondary filing

Utilizing the most efficient electronic format increases the productivity of your personnel and your practice. Change is often disruptive initially, and yet, we adapt and change or we continue to fall behind. Make the insurance processing technology changes your practice deserves!


Where Do You Take Your Children for Eye Exams?

Independent eyecare practitioners (ECPs) seem to be the provider of choice for parents who have taken their child to receive an eye exam sometime within the past two years, according to The Vision Council‘s VisionWatch Parent-Child Vision Care Report.

In fact, 51.2% of all parents with children who have received an eye exam within the past 24 months took their child to an independent ECP for that exam. Parents with health insurance coverage, especially vision care coverage, were more likely than other parents to have taken their child to an independent ECP to receive an exam. Moreover, parents with children who wear prescription eyewear, particularly eyeglasses, and parents from households with high annual incomes were more likely to have taken their children to an independent ECP for their most recent eye exam.

13% of parents who have taken their children for an eye exam in the past two years went to an optical chain (such as Lens Crafters or Hour Eyes) for the child’s last exam. Optical chains were a particularly popular option for parents with children between the ages of 14 to 17 and parents with annual household incomes between $40,000 to $60,000. An additional 9.4% of parents took their child to a mass merchandiser location for the child’s most recent eye exam. Mass merchandisers were especially popular for parents who were not willing to spend more than $100 on their children’s eyewear.

Finally, a little over 16% of parents whose children have had an eye exam during the past two years took their children to a general MD. This was especially common for parents with more than two children living at home and for parents with younger children. Just over 8% of parents said they took their child to a department store or “other” location for their most recent exam.

What %?

Where did they go?

Why and What were the trends?


Independent ECP

1.       Health insurance coverage, especially vision care

2.       Children who wear prescription eyewear

3.       Households with high annual incomes



General MD

1.       Parents with > 2 children living at home

2.       Parents with younger children


Optical chain

1.       Children between the ages of 14 to 17

2.       Annual household income between $40K-$60K


Mass merchandiser

1.       Parents not willing to spend more than $100 on children’s eyewear


Department store or “other”


1.       Does your practice actively promote seeing infants (e.g.: InfantSee)?

2.       Are you marketing effectively to children between the ages of 14-17?

3.       Does your optical have options for parents not willing to spend more than $100?

Make Your Office Health Insurance Portability and Accountability Act (HIPAA)-Compliant

The Health Insurance Portability and Accounting Act (HIPAA) mandates that healthcare providers protect patient information. That general mandate requires that doctors zero in on the specifics of their office operations. Examine your patient-staff interactions from the time a patient calls the office for an appointment to the time they check out and you may be surprised at how often you inadvertently release protected information.

The key to HIPAA compliance is based on the concept of preserving and protecting the patient’s privacy and dignity. It simply isn’t as easy as it sounds and we need to be constantly vigilant. Here is a checklist to assess how well your office operations comply with HIPAA. Keep in mind that doctors should always consult their own attorney or state board for clarification.

1. Don’t Repeat Sensitive Info with Others Present

2. Use Discretion when Verifying Insurance Information

3. Turn Over Sensitive Documents and Turn Computer Screen Away

4. Keep Personal Information Off Sign-In Sheet

5. Ask Whether Elderly Would Like Caretaker to Accompany in Exam Room

6. Always Debrief Parents of Minors–Even When Parents Not in Exam Room

7. Conduct Parent or Caretaker Debrief in Private

8. Don’t Publicize Diagnosis and Treatment Plan at Check-Out