The solution that simplified one OD’s billing and increased revenue
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Dec. 4, 2024
For Allen Chung, OD, and his team at Focal Optometry in San Diego, Calif., lagging reimbursements due to incorrectly submitted claims, or claims that were not submitted on time, were a problem.
Navigating the complexities of billing for procedures often left money on the table caused by confusion about insurance requirements. Fortunately, they found a solution with HELIX’s Revenue Cycle Management (RCM). Soon after implementing RCM services, accounts receivables were substantially reduced.
Taking Work Off Your Hands
“RCM takes a lot of the work out of my hands, and our office has been growing ever since we’ve been with them,” says Dr. Chung of RCM, “so, naturally, our reimbursement has been going up as well.”
Dr. Chung notes that having experts in claim submission, like RCM, changes how fast, and at what level, your practice is reimbursed.
“I think in optometry, a lot of us are frustrated by our reimbursements,” he said. “You need to understand the rules of the game and use the rules to your benefit. My billing team [at RCM] understands the rules and is up-to-date with these rules.”
Clearing Up Confusion Behind Billing
Dr. Chung points out that the rules for reimbursement are set by third-party payers, and frequently change, or have nuances that are easy to miss.
A practice that is trying to learn all these rules themselves, and keep on top of them on their own, is facing a significant challenge.
The better alternative for his practice, says Dr. Chung, was to use a service like RCM with a team that knows these rules better than he or his staff ever could.
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“RCM has definitely cleared up a lot of the confusion behind billing, and we’re now billing more accurately and getting reimbursed more,” he says.
Catching the Potential Problems You & Your Team Miss
“Before, when we billed insurance, if we were missing [clicking] a box or missing a code, and we got the rejections, we didn’t have time to go back and figure out what’s going on and refile,” Dr. Chung shares. “The RCM team helps us figure out which boxes need to get clicked or which billing code we need to hit, and then they, themselves, will help us refile. So, it creates a system versus, beforehand, when we got a rejection, half the time we would just write it off.”
With RCM, there is no need for Dr. Chung and his team to write reimbursements off. They have a partner now ensuring they get all the reimbursements due to them. This creates a practice with a much stronger potential for growth in profitability.
The best part? Not worrying about insurance claims means more time to devote to patient care and ensuring patients have a great experience in their office, Dr. Chung emphasizes: “RCM allows my office to focus on other things, on patient care.”
