Author Topic: optometrist  (Read 4393 times)

margemib

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optometrist
« on: May 19, 2009, 11:57:39 AM »
hi Michele,
I spoke to a optometrist office manager today that is thinking of changing billers, I remember you saying this type of billing is the same as any medical billing. But I was thinking how does this work with eyeglasses and so forth?
Please tell me what I need to know that would help before before she calls.
margemib
Margie Finlay CMRS

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Re: optometrist
« Reply #1 on: May 19, 2009, 03:12:57 PM »
it varies per visit. I can come in for a routine eye exam, and they determine I have glaucoma, the visit now turns to medical. I can come in for a routine eye exam and have UHC, but my vision benefits are with VSP. *you can still have an exam with uhc too*. When you bill for contact lenses/glasses you have to determine the benefit. ex: a client can have 200.00 limit on contact lenses/frames but also a limit on the #. You can have a sale on frames $50.00 the client has a 200 max benefit, but can still only get 1 pair of frames per calendar year. Also Medicare doesn't cover unless its a medical exam. They don't cover the refraction...there is a lot to optometry.

Michele

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Re: optometrist
« Reply #2 on: May 19, 2009, 07:18:14 PM »
The codes for lenses and frames are just HCPC's and the provider will give them to you.  V2020 for frames, V2100 for single vision, etc.  There is a little to learn, but don't let it scare you.  It is different is many ways, but it is also cpt & icd9 codes. 

Michele
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Pay_My_Claims

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Re: optometrist
« Reply #3 on: May 19, 2009, 11:10:13 PM »
Sorry but thats not accurate. I worked in optometry and the billing is very different. The frames and contact lenses may be cut and dry, but the rest is different. They also have pqri reporting etc that is done in the billing. One big difference is knowing if you are billing for a medical as opposed to a vision benefit. There is global billing with optomety. OUr optometrist also did lasik and she performed visual fields, and also did surgery in a DAC. Optometry is not cut and dry with very little to learn.

PMRNC

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Re: optometrist
« Reply #4 on: May 20, 2009, 06:11:44 AM »
I'm with Charlene on this one. Also Ophthalmology vs Optometry are different...both are tedious to bill out and a lot rides on the proper coding, benefit verifications, pre-determinations, etc.
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Re: optometrist
« Reply #5 on: May 20, 2009, 07:58:33 AM »
Yes, and I must correct something, I worked for an Ophthalmologist, not Optometrist.

Michele

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Re: optometrist
« Reply #6 on: May 20, 2009, 04:35:59 PM »
She had indicated that it was an optometrist and we do a lot of optometry billing.  I agree that it has it's rules that need to be followed, but what I was trying to say is don't let it scare you.  Most optometry billing is fairly straight forward, they do a lot of routine eye exams, and lenses and frames.  They will also do some medical eye exams and some basic testing, but for the most part, it is pretty straight forward.  There are some quirks, like our local BC requires all routine eye exams to be billed with a V72.0 diagnosis, instead of the myopathy codes, or other routine visual diagnoses. 

As with any specialty there are things you need to learn and it is important that you do what you can to learn all about the specialty.  In my opinion, optometry is not too difficult to pick up and I didn't want her to run away scared.  I was just trying to encourage her that optometry is not a difficult specialty to pick up.   :)

Michele
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margemib

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Re: optometrist
« Reply #7 on: May 20, 2009, 05:05:47 PM »
Thank you Michele I appreciate your thoughts!
margemib ::)
Margie Finlay CMRS

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Re: optometrist
« Reply #8 on: May 20, 2009, 05:46:30 PM »
I understand your desire to not scare anyone, but the "a little to learn" kinda threw me. Every specialty has its differences. I went from , clinic, to inpatient, to outreach, to peds, to geriatrics,  to optometry to dme. Every field had a lot to learn. I just don't want her to think its a quick and easy billing opportunity.

Michele

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Re: optometrist
« Reply #9 on: May 20, 2009, 09:15:56 PM »
Nothing in this business is quick and easy, is it?  I hope I didn't give that impression, I'm just a very optimistic person.  My glass is usually 2/3 full.  I didn't mean to downplay it too much.  There certainly is stuff to learn.

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Pay_My_Claims

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Re: optometrist
« Reply #10 on: May 21, 2009, 06:55:07 AM »
Agreed, if you have the desire to learn, and the passion for the field, you can learn how to bill in any specialty!

margemib

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Re: optometrist
« Reply #11 on: May 21, 2009, 09:39:50 AM »
Thank You Guys for all the help!
margemib
Margie Finlay CMRS

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Re: optometrist
« Reply #12 on: May 21, 2009, 12:58:26 PM »
We all have that one specialty we either hate or admit we just plain "stink" at. Mine is chiro.. I hate chiro.. I hate everything about billing for chiropractors.. LOL
Linda Walker
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