Unpaid Claim Management
Insurance Billing Rules
We bill using your software system and simply establish a remote connection into your computer using HIPAA compliant methods. Your staff scan any mailed insurance payments and vouchers to us on a daily or weekly basis. We post and reconcile all medical and vision insurance payments and work every claim and rejection within 48 hours of receipt. You keep full control over your money, while we make sure that you get paid for every claim. Our clients are our biggest advocates:
"They have significantly decreased claim errors and the necessity of patient refunds while increasing revenues collected to all-time highs. They remain accessible for consultation and have been a distinct pleasure to work with." Roger R. Seelye, OD
Fee Schedule Review
Key Practice Metrics and Bench Marking
OPS stays up to date with the continuous insurance
changes. We will proactively keep your office up to date
with the evolving insurance world. Our teams conduct weekly
continuous education classes. We are experts in billing
all vision carriers including VSP, EyeMed, Spectera, NVA,
and Davis, as well as the traditional medical insurances
including Medicare, DMERC, BCBS, and Medicaid plans.
We know software. Our team at OPS are experts with
software systems including MAC and PC platforms. We currently bill on many software systems including OfficeMate, Revolution EHR, Practice Director, CompuLink, CrystalPM, AllScripts, eClinical Works, My Vision Express, and GOAL.
Insurance Billing Experts
Medical Billing companies normally charge 6-9% of total receipts for specialists and primary care clinics. However, optometry has over 50% of its receipts paid for in-house work (ex. optical sales & contacts). To account for that, we reduced our fee by over 50% and that allows us to offer our premium services for 2.0-3.5% of your total receipts, depending on your software, location(s) & practice size. We base our fees on your total receipts because we work all aspects of your unpaid claims, medical and vision. What many practices don't know is all of the money they lose because vision claims are not billed properly by staff and thousands of dollars go uncollected every month. We fix these problems and you earn more money than ever before as a result. Our clients are amazed at the money they are able to earn after just working with us for 3-6 months. And we don't trap you with multi-year contracts and then don't deliver on our service. We rely on our reputation and we are only interested in building long-term relationships with our clients.
We scrub all of your medical claims & minor vision claims to ensure that your claims get paid on the first pass. This includes matching the CPT & diagnosis codes, especially with special testing. We utilize your clearinghouse to send all charges and work all of your rejects daily. We post & work all of your insurance payments within 48 hours of payment. We coordinate claims to secondary and tertiary payers, including medical claims to vision carriers. We work your insurance accounts receivable every day so that no claim expires due to timely filing. We also create monthly reports showing production and collections activity, and your key practice metrics (Days in AR, % of claims over 60 days old...). When necessary, we re-credential your providers, and enroll new providers. Note that your staff continue to bill vision plans that own their own labs such as VSP & EyeMed.
"John and his team have provided our office with a holistic approach to billing that has proven results. Many billing companies claims to do more than just submit your claims, but OPS works each and every claim, making sure to collect on any and all insurance dollars..." Matt Maki, OD