Optometry Coding: Focus On Timely Filing to Keep Your Payments Coming In

With the Medicare deadline coming down from three years to one, using a chart can certainly help.


As the impact of healthcare reform continues to define how medical practices function, one result is a decrease in the amount of time you'll have to file your optometry coding claims.


Section 6404 of the Patient Protection and Affordable Care Act brings down the maximum time for submission of all Medicare FFS claims from three years to one calendar year post the date of service.


So if you are not prepared to process claims quickly, you will be doing a lot of write-offs. This is of course unless you follow these sure-success tips.


Keep a chart handy and stick to it


Timely filing means that your practice submits a Medicare fee-for-service (FFS) claim within the time determined by the carrier.


As per the new law, claims for services furnished on or after January 1, 2010 must be filed within one calendar year after the date of service. Earlier it was three years.


The consequence: Medicare will not accept your claim if it arrives post the deadline date, so your practice has to stay on top of claims.


The key to staying on top of filing deadlines is tracking claims with short filing times.


2. Keep proof on hand


One good thumb rule is to always keep proof of the electronic filing.


Option 1: You can use a claims clearinghouse that stores your confirmation of receipt by your payers so that you can access them on demand when you need to appeal timely filing denials. If your clearinghouse doesn't provide this service, think about changing to one that does.


Option 2: If your practice doesn't want to or cannot change its process, the alternative is to print these confirmations on paper. You might also save them as PDF files when you receive them from your clearinghouse and store them locally on your computer so that you can use them to prove timely filing.


3. You have choices if the patient held up the claim

If your practice had the claim ready to send, but the patient didn't provide his insurance information in time, you may go for any of the following:

Appeal

Write off the claim

Follow-up with the patient for cash

The only time you can place a bill to the patient post the timely filing deadline and successfully seek payments is if the patient didn't provide you with the proper information prior to the filing deadline. The payment then becomes the patient's responsibility and you should bill the patient rather than writing off the claim amount.


For more timely filing tips for your optometry coding, sign up for an audio conference.