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What Are the Different Methods of Optometric Billing?

Osmand Vitez
Osmand Vitez

Optometric billing is the process of seeking remuneration for services performed through a bill sent to a payment clearing house. The two most common methods for this process include in-house billing and third-party billing, with slight variations mixed in as well. A common process for optometric billing is the bundling of services on one payment ticket. Under these conditions, an optometrist places several items or services on one ticket and submits it for payment. This shortens the process for putting bills together and getting them submitted and paid in a timely manner.

In-house optometric billing involves the use of a business office or manager inside an optometry office. A business manager or other administrative clerk often works with nurses or other optometry staff to prepare bills. The firm’s liaison then sends bills to an insurance clearing house for payment on any reimbursable charges. This process allows an optometry office to shorten payment time as all work is done within the local office. The biggest consideration here is finding an internal office setup that does not take away too much profit from the overall optometry office.

An optometry clinic will note the services it has performed for a patient to that patient's insurance company as part of the billing process.
An optometry clinic will note the services it has performed for a patient to that patient's insurance company as part of the billing process.

Third-party optometric billing involves the outsourcing of the billing process to a company suited for this work. In most cases, this third party may not be associated with a single insurance firm, though it may be true in some cases. Here, nurses or other office staff must put together bills and reimbursable charges and submit the paperwork to the third-party company. This business then handles the submission of paperwork to the payment clearing house and ensures fast and proper payments for services rendered. The third-party company typically offers no-hassle benefits to optometrists as the entire billing process and its associated problems are taken care of outside of the doctor’s office.

Optometrists specialize in eye care.
Optometrists specialize in eye care.

In either scenario, the bundling of services may be helpful for optometric billing. Bundling services may conduct services that pay at the same time by the payment clearing house. This allows the optometrist to bill services properly without receiving too many kickbacks on submitted bills for payment. Rejected bills submitted to the clearing house take longer to process and may result in lost fees as poor billing can prevent payment of services. In some cases, optometric billing may fall subject to providing services not paid for by the insurance payment clearing house, which results in nonpayment for services and billing customers the difference, which then results in customer backlash because they thought the service was covered by insurance.

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    • An optometry clinic will note the services it has performed for a patient to that patient's insurance company as part of the billing process.
      By: Lisa F. Young
      An optometry clinic will note the services it has performed for a patient to that patient's insurance company as part of the billing process.
    • Optometrists specialize in eye care.
      By: blueringmedia
      Optometrists specialize in eye care.