Best Vision Medical Billing Software Of 2024

By Riya Jamble, Technical Content Writer at SelectHub

Is your practice or company facing claim processing and billing issues? Vision medical billing software can help you tackle these problems. You can determine correct codes, generate error-free invoices, document precise information, stay HIPAA-compliant and manage denials in just a few minutes. Billing apps provide you with an analytics dashboard to help you monitor work progress.

We understand searching for a new solution can take a lot of time off your hands. And every second matters. We designed this guide to provide valuable information about things to keep in mind while selecting a vision invoicing solution.

Executive Summary

• Vision medical invoicing apps help eye care professionals and billing companies submit precise claims, produce error-free bills and reduce A/R delays.
• Factors such as user-friendliness, specialty needs, company size, reporting modules, necessary certifications, integrative capabilities and deployment type are all things you should consider while conducting software comparison.
• According to HIPAA minimum necessary requirements, practices should follow safeguards to protect confidential information.
• Prepare a list of internal and external questions to make informed decisions.

What This Guide Covers:

• What Is Vision Medical Billing Software?
• Primary Benefits
• Features & Functionality
• Software Comparison Strategy
• Cost & Pricing Considerations
• The Most Popular Vision Medical Billing Software
• Questions to Ask
• In Conclusion

How To Overcome Billing Rejections

Don’t feel disappointed when payers reject your claims. You need to analyze the reasons for denials. And come up with the best solution to deal with the same.

According to a survey conducted by Harmony Healthcare, the top concerns surrounding denials are as follows:

• Coding errors — 32%
• Medical necessity acute IP — 30%
• Front end — 20%
• Invalid clinical information — 18%

Below we have mentioned solutions to some rejection scenarios to help you optimize your claim processing operations and receive faster reimbursements.

Rejection #1 — Invalid or Missing Information

Missing data can trigger denials or rejections. You should collect accurate patient demographic information. Keep in mind to run an insurance eligibility test to verify the client’s health plan coverage. Clearinghouses scrub claims for errors to help you submit clean claims and prevent denials. You can look for a vision billing solution that provides claim scrubbing functionality to spot documentation or coding mistakes before sending claims to insurance companies.

Rejection #2 — Duplicate Claim

There might be situations when your system crashes while submitting claims. After you restart your PC, your common instinct tells you to resubmit the claim. In such scenarios, there’s a possibility that you submitted the same claim twice. When you file multiple claims of the same service encounter, insurance companies tend to deny them. They state the reason for denial as same-day or duplicate claim. You should check with the health plan company before you refile the claim.

Rejection #3 — Invalid or Missing Modifier

Payers are likely to reject claims with incorrect procedure codes or modifiers. You should be careful while assigning codes. You should also be aware of the Local Coverage Determination (LCD) for your area to ensure precise coding. Stay informed about existing claim resubmission procedures. You can opt for software that offers medical coding modules to avoid coding mistakes.

Rejection #4 — Patient Ineligible

Health plan companies instantly reject claims of ineligible patients. Before sending claims to payers, you should verify the patient’s insurance eligibility. You should also verify the client’s out-of-pocket costs such as copays, deductions and coinsurance.

Primary Benefits

You need to establish positive cash flow to keep your practice or company running smoothly. Submitting incorrect claims leads to delayed payments, disturbing your revenue cycles.

Below we have mentioned some benefits you can reap by implementing vision medical billing solutions.

Make Informed Decisions

You need to monitor key performance indicators to achieve your business goals. Vision care billing solutions provide you with reporting modules to help you gain data visibility. They also assist you in identifying trends and resolving issues even before they arise. You can generate aging, account receivable, account payable, insurance analysis and rejection reports. BI tools help you develop personalized dashboards to track work progress.

Stay Compliant

It’s challenging to avoid health care compliance risks. Practices and organizations face business complexities and challenges with laws like:

• The False Claims Act
• The No Surprises Act
• Social Security Act
• HIPAA Act
• Patient Protection and Affordable Care Act

The attorney general of Arkansas sued Conway Eye Care and Todd Eye Clinic for submitting fraudulent Medicare and Medicaid claims and deceptive billing practices.

Humans are bound to make mistakes. And just one error can jeopardize your clinic or company. Vision care billing platforms help you adhere to health care regulations and guidelines. You can integrate with medical compliance software to meet security standards.

Secure Patient Data

Protecting patient information is of paramount importance. Recently, Central Vermont Eye Care (VT-based ophthalmology practice) reported a hacking incident that exposed the data of 30,000 patients. The case is still under investigation. You can access the data breach report published by the U.S. Department of Health and Human Services to view the list of breaches reported in the last 24 months.

With eye care billing solutions, you can store private information on secure cloud servers. They provide an extra layer of security with end-to-end encryption (E2EE) capabilities. Furthermore, they enable you to grant role-based access permissions to authorized employees, fulfilling HIPAA minimum necessary standards.

Reduce Coding Errors

Staying updated with optometry and ophthalmology codes can be challenging. Due to the COVID-19 pandemic, the American Medical Association (AMA) made significant coding revisions. Billing applications help you assign accurate CPT and ICD codes.

Maximize Revenue

While delivering quality care should be your primary goal, you need consistent revenue flow to support your practice and organization. Vision care billing apps provide you with claim management, denial resolution and payment posting modules to help you receive faster reimbursements.

Improve Productivity

Billing apps provide automated functionalities to lower administrative burdens. You can also generate work progress and revenue reports to gauge your practice and the company’s productivity and financial performance. Run patient eligibility checks to avoid risks of insurance fraud. Identify and resolve workflow gaps to streamline operations.

Key Features & Functionality

Software Comparison Strategy

The success and failure of your clinic or organization depend on your chosen software. One wrong decision can invite revenue losses and wastage of resources and disturb the company’s business operations. You have to consider several important factors while selecting a medical billing application. We have highlighted the same below.

Implementing a new solution can be challenging. And if the system isn’t intuitive enough, it will cause more problems. That’s why you should make sure the platform of your choice is user-friendly. Your employees should be able to navigate through several tabs simultaneously without any hassles.

There are several invoicing apps developed to help medical practices and billing companies streamline workflows. Remember, not all platforms can suffice your specialty needs. For instance, general practitioners' requirements vary from optometrists or ophthalmologists. You need to make sure the software you choose fulfills your specialty needs. You can consider e-prescribing, workflow managing and coding functionalities. Furthermore, you can create a medical billing requirements checklist to make data-driven decisions.

What’s your company size? If you own a small organization, you don’t want to invest in a solution designed for large practices. It will only lead to cost overruns. For instance, eClinicalWorks is developed for companies of all sizes, whereas EZClaim caters to small- and medium-sized organizations.

You might be using multiple systems such as EHR, EMR, patient engagement, patient scheduling and medical practice management. And we all know the struggles of dealing with several apps. To locate files from a central hub, you should look for integrative capabilities. It will enable you to store documents in a secure cloud environment.

Would you like to gain detailed insights into your practice or organization’s financial performance? If yes, you should look for reporting and data analysis modules. They help you prevent negative cash flow and identify and resolve issues even before they arise. You can share reports with your staff to keep everyone on the same page.

You don’t want to get into legal troubles. They hardly end well. That’s why you need to make sure the solution is HIPPA-compliant. You should also ensure that the app is ONC-ATCB certified. Don’t forget to check if the system conforms to ICD standards.

The type of deployment you choose matters. If you want to view data in real time from remote locations, cloud-based solutions are your best bet. But if you aren’t comfortable storing information outside your practice or organization servers, on-premise platforms are your best friends.

Talking to industry experts currently using these systems will provide you with valuable insights. Their feedback can help you make informed decisions.

Cost & Pricing Considerations

Let’s be real. Vendors want to sell their products. So, they might try to hype it up in the best possible way. An application might seem like a perfect match for your practice or company, covered in gold-plated benefits. Remember, there’s always a hidden catch. For instance, the solution might offer several training materials to guide your team through the implementation process. But these resources might cost you extra, leading to budget overshoots.

Below we have highlighted a few things you should consider before investing in an application.

Pricing models differ from vendor to vendor. Some offer a one-time payment facility, whereas others charge you on a monthly basis. You should always discuss openly with providers about the cost of their software.

What type of deployment do you prefer? Cloud-based billing solutions usually cost you around $26 to $112 per month, whereas on-premise platforms cost anywhere between $35 to $8,100 per month. You should evaluate your deployment needs before you make a purchasing decision.

You need to determine the number of user licenses you require. Some vendors offer unlimited access, while others charge you based on your license requirements. Don’t forget to ask providers about the validity period of these licenses.

You might face situations where the system lags or crashes? Only the support team can help you overcome these issues. Most vendors provide text, email and phone support options. Some providers enable you to submit tickets via the support or customer portal. But be cautious. These services might come at an additional cost.

The Most Popular Vision Medical Billing Software

Selecting a perfect solution is a challenging task. You don’t only have to think about your existing requirements but also need to consider a scenario where your enterprise grows. We understand how difficult it can be. You already have a lot of tasks on your plate. We can take the burden of software selection off it. Below we have mentioned some products offering functionalities to solve vision medical billing problems.

Note: These are our top overall medical billing platforms and may not cater specifically to vision medical billing.

DrChrono

DrChrono is a cloud-based solution designed to help multi-specialty practices and billing companies simplify business processes. The vendor offers a team of billing experts to assist you in processing claims, running insurance eligibility checks, credentialing and improving billing efficiency. Reporting modules help you monitor claim statuses, revenue flow and other vital billing measures. Patients can access medical records, book appointments, view clinical summaries and pay statements via the patient portal.

The provider offers an in-house Coding Compliance Officer to help you review clinical documentation and ensure compliance. Analyze workflow practices to optimize billing outcomes. Send statements to clients in a timely manner to recover receivables faster. Denial resolution capabilities enable you to identify denial causes to achieve a clean claims ratio.

Monitor payment statuses using DrChrono.

CureMD

CureMD provides billing, practice management, insurance verification and coding modules. It helps you submit clean claims and avoid payment delays. It also enables you to send automated notifications to patients about statement deadlines. You can gain visibility into performance indicators via the KPI dashboard. You can also set payment plans to lower clients' financial burdens. Create error-free super bills to prevent up/down coding practices.

You can monitor work progress from remote locations through iOS devices. Automatically identify and track denials to reduce future rejections. Store unlimited documents on a secure cloud server. Conduct insurance eligibility checks to submit clean claims.

Analyze key performance indicators via the dashboard with CureMD.

Kareo Billing

Kareo billing is a web-based platform developed to help medical professionals and organizations improve collections and billing workflows. Leverage customizable patient statements to reduce administrative costs and save time. Access patient records, track tasks and payments, print reports, and store documents through the billing dashboard.

Flag denials that require review and resubmit claims on time. Automatically post payments to streamline billing processes and improve productivity.

The vendor offers a team of billing experts to assist you in generating accurate statements, resolving coding mistakes and submitting clean claims. Automate repetitive tasks to increase efficiency and drive profitability. Load common diagnosis codes and modifiers into procedure line items by creating procedure macros.

Monitor insurance collections using Kareo Billing.

Questions to Ask

Where do I start? This is the first question that comes to your mind when you decide to implement a solution. The best place to start is at your practice or company. Prepare internal questions to kickstart internal discussions. Below we have mentioned a few questions to help you make informed decisions.

• Do we need the software to provide unlimited user access?
• What functionalities do we need to solve our documentation issues?
• Do we need a cloud-based system?
• Will the implementation process disturb our company’s operations?
• Do we require the software to provide coding assistance?

While some vendors deliver what they promise, some might not inform you about certain things. That’s why it’s important to ask the right questions. Use these questions as a starting point for conversations with vendors.

• Does the app provide reporting capabilities?
• Does the system adhere to HIPPA privacy standards?
• Will the solution integrate with existing EHR or EMR applications?
• What training options does the vendor offer?
• How will the provider handle system updates?

In Conclusion

Billing for optometric and ophthalmologic practices is complex in nature. From documenting correct information to collecting payments, it’s a lengthy process. Vision medical billing software makes this procedure easy for you. They help you generate precise statements and submit accurate claims. They also assist you in staying compliant with the latest billing laws and regulations. You can store unlimited documents in a secure, cloud environment.

Comparing several eye care billing solutions is not a piece of cake. You can use our comparison matrix to evaluate multiple apps simultaneously.

We prepared this guide to help make your software selection journey a cakewalk. For further assistance, please don’t hesitate to contact us via phone or email mentioned on our website. Hope to hear from you soon!