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Do you know the cost of reworking on an Ophthalmology Denied/Rejected Claim? According to the Medical Group Management Association (MGMA), the average cost of reworking a rejected or denied claim is $25. If you take the 46 claims, the optometry practice received last month. Then, multiply it by $25 each, and it equals $1150 that the practice spent fixing errors and resubmitting the claims.

6 Eyecare Billing Rejections you can overcome Medical billing rejections and denials are often used interchangeably - however, there is a distinct difference. A rejected medical claim fails to meet specific formatting, billing criteria, and data requirements. Because a rejected claim has never been processed by a clearinghouse, insurance payer, or the Centers for Medicare & Medicaid Services (CMS), the claim is not considered "received," and it did not make it through the adjudication system. The reasons behind the Eyecare Billing rejections have been listed down below: 1. Mission or invalid information 2. Same-Day or Duplicate 3. Code or Modifier Missing or Invalid 4. Patient not Eligible 5. Missing or Invalid Billing Provider ID 6. Provider not Credentialed by Payer Are you also facing these issues in your Ophthalmology Practice? Contact us : info@medmaxtechnologies.com / 888-402-2631.

Correctly choose between Eye Codes and E/M Codes Unlike other specialties, #ophthalmologists have two sets of codes to choose from for #ophthalmology billing. Check your diagnosis code(s), eye codes are more restrictive as to what diagnosis meets medical necessity, and the specific codes can vary by payer. E/M codes do not share those same restrictions. Use E/M codes for visits that have a medical element. If the exam is strictly visual and contains no medical elements, an eye code is the right choice. To know more about Eye Codes and E/M Codes, Get in touch with us: info@medmaxtechnologies.com or Call us: +1-586-436-3761.