NEW YORK—As an OD, you’re also the CEO of your practice. In order to run your practice effectively, you need insight into all aspects of your business. Unfortunately, when it comes to managing your claims and reimbursements, there can be a real lack of transparency that’s effecting how you collect revenue from insurance payers.
To manage your claims effectively, you need a deep understanding of how your practice is progressing claims through the claims lifecycle, and how you compare to other eyecare practices in your state and nation by tracking and analyzing these important billing reports.
- Claim Acceptance Duration
Knowing how quickly your payers accept claims from your practice compared to state and national averages will provide you with a lot of information about the efficiency of your claim management process. For example, if the process is longer than other ECPs, then it could indicate that you’re recording inaccurate information or leaving data out altogether that’s causing a slowdown in your claim acceptance. With this insight, you can dig into your claims and identify common errors for a particular time.
- Comparison of Exams Performed
In the eyecare industry, seasonality is very real. Knowing how many exams your performed compared to months, years and seasons past will help you identify any changes you need to make to increase practice revenue. Knowing ahead of time the months you are typically slow can help you better plan promotions and marketing activities around these times to boost your business.
- Monthly Denial Rate
You can’t fix what you don’t know is broken. And, when it comes to claims management, reviewing monthly denial rates will provide a view of what you and your biller need to adjust in your processes by allowing you to dig into your claims and identify common errors and how to avoid those errors in the future.
Some common reasons payers deny claims are:
• Duplicate claims
• Payer doesn’t cover the service
• Late filing
• Bundled payment
• Uninsured patient
Claim denials can have a big effect on your productivity and revenue. That’s why we published a free eBook all about avoiding common claims denials. Download your copy today.
- Monthly Income Comparison
Similar to monitoring how many exams you performed in the past, knowing the income that your practice generated compared to the past will help you identify when you need to make changes to increase your revenue.
Keeping an eye on how your claims are generating revenue for your practice and how you can improve your claims management process to maximize your reimbursements will help you grow your practice and make the necessary adjustments to keep your revenue stream growing.