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  • Viewpoint: 5 Tips to Maximize Your Practice Revenue

    Viewpoint is a column created by AAOE® specifically for ophthalmologists and leaders in practice management.

    Small steps can add up over time to make a big impact. Check out these five relatively easy steps you can take to boost your bottom line.

    1. Verify patient’s insurance eligibility prior to the visit.
    Rejected claims are the biggest potential drain on reimbursement. Lack of insurance coverage is one of the leading causes of rejected claims whether it be from employment changes or changes to the policy itself. But most patients aren’t 100% knowledgeable and don’t know if their coverage has changed since they last time they were seen.

    Checking insurance eligibility and coverage prior to the visit can help you avoid missed reimbursement. In fact, most practice management systems have an electronic eligibility feature which will allow you to instantly verify current information.

    Pro tip: Create a process to check patient eligibility two days prior to an appointment and speak with the patient if it appears that there’s a coverage issue.

    2. Don’t forget appointment reminders.
    Patients today want online scheduling with easy, seamless technology. In a busy world, text and phone reminders are helpful not just for your patients but also your practice — no-shows and late arrivals can become a significant financial drain.

    Whether it’s lost revenue from missed appointments or the added work associated with reshuffling schedules due to a late patient, reminders can be the stitch in time needed to save you nine.

    Pro tip: An automated reminder system can reduce your staff’s workload and provide a valuable service to your patients. Does your practice serve a diverse community? Consider a system that can deliver reminders in your patients’ primary language (e.g., Spanish).

    3. Collect patient payment at the time of service.
    Collecting patient co-pays and balances at the time of service can greatly reduce amounts that end up uncollectable. Fees collected at the visit can benefit your accounts receivables (A/R), as well as reduce the amount of time your staff works collections.

    Have you made payments easy? Many patients would prefer to pay by credit card. If you don’t already accept them, consider finding a processing system that charges a low processing fee and also integrates with your current practice management software.

    Pro tip: Create patient check-out protocols and train your staff so that everybody is comfortable collecting payments before the patient leaves your office. 

    4. Submit “clean” claims the first time.
    Billing is a team effort. Make sure your team is able to submit “clean” claims by putting a streamlined billing process in place. The front office should be collecting accurate demographic and insurance information. Billing staff needs to be entering accurate coding. [See related article: Billing: It's Everyone's Responsibility]

    Pro tip: Your first-pass clean claim submission should be at least in the mid-ninety percent range of your total claims. If you’re not operating at this level, you could be losing revenue due to unnecessary rejections and/or the high cost of resubmissions or denials.

    5. Address claim errors and rejections as they are received
    Mistakes happen but they’ll have a much smaller impact if dealt with quickly. Follow these best practices for timely corrections:

    • Address any claim rejections as they’re received and resubmit claims immediately.
    • Have a system in place for addressing denied claims right away — timely filings may still apply.
    • Know how you’ll handle sending medical records or other information when requested. The quicker the information is received, the quicker the claim can be processed.

    About the Author

    Lindsay Stratton, MHA, OCS is director of operations at Eye Med Management Solutions, an ophthalmology-focused outsource billing and practice management company. She has her BA in political science and history from the University of Colorado and a master’s in health care administration from Chapman University. She can be reached at or 760.451.6412.