Optometry billing is different than billing for most medical practices. Eye care can either be covered by normal insurance plans or specialized vision plans. As all optometrists know, in the United States it is illegal to bill both the patient’s medical payor and vision payor for the same service. The provider usually selects the insurance plan based on the patient’s chief complaint. However, it is not always that easy.
Patient Concerns about CoverageOne of the main contributing factors in this optometry billing equation is the opinions that patients bring forward. The optometry practice is concerned about the revenue, but the patient is also concerned about how much they have to pay. A good practice will consider the point of view of the patient. Otherwise, you risk losing a patient’s long-term loyalty. You want to service the patient in the best way possible.
Optometry Billing Options: Patient’s Point of ViewIn combining the practice’s concerns and the patient’s concerns, there are several things to note. These range from the exact service being provided, the severity of diagnosis, the eye care provider’s own policies, and the patient’s understanding of how the decision is made. The following is a list of items to consider when educating the patient:
- Look into the co-pay difference for the patient. Do not disregard this aspect, as it can heavily dictate how a patient responds.
- Provide an explanation of the provider’s policy, which will most likely define the difference between a routine vision exam and medical exam. Do not confuse the patient. Put this information in simple terms. Patients are not medical experts.
- Ask patients to bring information on both forms of insurance. This request is likely to bring up questions. The reason why this information is necessary is because, as many patients do not know, optometrists have the authority to provide eye-related medical care (treating conditions and comorbidities) and eye care.