Ophthalmology practices deal with specific procedures and treatments. Billing service providers have experienced coders who understand the nuances of ophthalmic coding, ensuring accurate claims submission and maximizing reimbursements. Ophthalmology billing services can manage the entire billing cycle, from patient registration and insurance verification to claim submission, follow-up, and collections. This frees up valuable time for ophthalmologists and their staff to focus on patient care. Medical billing is subject to strict regulations. Ophthalmology billing services ensure that practices stay compliant with HIPAA and other relevant regulations.
Billing Care Solutions Services
Medical Billing & Coding:
Billing Care Solutions experienced team specializes in ophthalmic coding, ensuring accurate and timely claim submissions for all your eye care procedures and treatments.
Revenue Cycle Management (RCM):
Billing Care Solutions manage your entire billing cycle, from patient registration and insurance verification to claim submission, follow-up, and collections. This frees your staff to focus on what matters most – patient care.
Account Receivable Management:
Billing Care Solutions stay on top of outstanding balances and work towards timely collections, improving your cash flow.
Provider Enrollment & Credentialing:
Billing Care Solutions handle the complex process of enrolling you and your staff with insurance companies, saving you valuable time and frustration.
Eligibility & Benefit Verification:
Billing Care Solutions ensure patients covere for your services before their appointment, minimizing claim denials due to coverage issues.
Authorization and Referral Services:
Billing Care Solutions obtain necessary authorizations and referrals from insurance companies on your behalf, streamlining the pre-authorization process.
Business Intelligence Reporting Services:
Billing Care Solutions provide comprehensive reports that give you valuable insights into your practice’s financial performance, allowing you to make data-driven decisions.
Patient Support:
Billing Care Solutions dedicated team assists your patients with insurance questions and billing inquiries, ensuring a smooth and positive experience.
Benefits of Partnering with Billing Care Solutions:
- Increased Revenue & Collections
- Reduced Administrative Costs
- Improved Cash Flow
- Enhanced Efficiency
- Accurate Coding & Claim Submissions
- Streamlined Revenue Cycle Management
- Improved Patient Satisfaction
- Focus on Patient Care
Coding System
Current Procedural Terminology (CPT codes):
These codes describe specific services and procedures performed by the ophthalmologist. The range of CPT codes for ophthalmology services is 92002-92499. Here’s a breakdown of some subcategories within this range:
- 92002-92014: General Ophthalmological Services and Procedures (e.g., eye exams, refraction testing)
- 92015-92287: Special Ophthalmological Services and Procedures (e.g., tonometry, ophthalmoscopy)
- 92310-92326: Contact Lens Services (e.g., fitting and evaluation)
- 92340-92499: Spectacle Services (Including Prosthesis for Aphakia) (e.g., fitting eyeglasses after cataract surgery)
- 92499: Other Ophthalmological Services or Procedures (used for uncommon procedures not covered by other codes)
Evaluation and Management (E/M) codes:
These codes represent the level of service provided by the ophthalmologist during a patient visit. E/M codes, used across all medical specialties, not just ophthalmology. They typically range from 99201-99499.
Modifiers
RT (Right Eye) and LT (Left Eye): These modifiers are used to indicate that a procedure or service was performed on a specific eye.
E/E Modifiers (E1-E4): These modifiers are used for eyelid procedures. E1 signifies upper left eyelid, E2 signifies lower left eyelid, E3 signifies upper right eyelid, and E4 signifies lower right eyelid.
M -24 (Unrelated E/M service during the postoperative period): This modifier is used for an E/M service (eye exam) performed during the global period of a surgery that addresses a completely unrelated issue.
Modifier -25 (Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other services): This modifier is used for a separate and significant E/M service provided on the same day as a minor procedure (e.g., treating an unrelated eye condition during a routine eye exam).
Modifier -50 (Bilateral procedure): This modifier indicates that a procedure was performed on both eyes.
M-51 (Multiple procedures): This modifier signifies that multiple unrelated procedures performed on the same day during the same encounter.
Modifiers -54 (Surgical care only) and -55 (Postoperative care only): Used to separately bill for the surgical and post-operative care components of a major surgery.
In conclusion, Billing Care Solutions team experienced medical billing and coding specialists, takes the burden of billing off your shoulders. Billing Care Solutions handle the entire revenue cycle, from accurate coding and claim submission to managing denials and ensuring timely payments. This allows you and your staff to dedicate more time to what matters most – providing exceptional care to your patients.
We specialize in Medical Billing and Coding and provide comprehensive support for your practice. For more information visit
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