The Eye Care Provider (ECP) is challenged daily with the management of a patient’s Vision Plan and Medical Insurance benefits. In the typical practice, Vision Plans account for over 50% of the practices revenue and force profits down limiting the ECP and patients choice. Medical Insurance plans are ever changing and the ECP must be prepared and educated on how to deal with these challenges.
With the challenges facing Optometry, business operations remain at the core of a practice’s ability to be successful and profitable. Recent changes in the medical insurance industry do not exclude Optometry and only create greater challenges. Navigating compliance (CMS, ICD-10, HIPAA etc.), coding changes, regulations and changing technology creates substantial obstacles to succeeding in and creating sustainable profitability in the practice. The challenge remains; How do you grow your bottom line within the myriad of changes that are impacting the practice?
Who is OMS?
OMS, partners with your practice to enhance clinical and administrative workflow processes creating efficiencies while increasing profits. We perform a comprehensive diagnostic review of the practice: a GAP analysis. Through this analysis, we assess your practice documenting the findings in a report with specific case examples. An action plan is developed with recommended processes for correction to be implemented.
Based on the action plan, it is then determined how our services best fit the practice. Solutions are developed based on the needs identified and services are matched to provide the necessary changes leading to increased efficiency and profitability. OMS becomes an extension of your practice. We continually work with and educate the practice on medical eye care both clinically and administratively to ensure compliant utilization of the patients medical insurance benefits in conjunction with their vision plan benefits.
We provide expert, turnkey, Revenue Cycle Services that assist the practice in providing higher standards of care through training, consulting and claims management.
Case for Change
Historically, Optometry is a retail-oriented profession. Patient care is provided to drive the retail aspect of the profession. OMS is your expert to facilitate your move into the Medical Model.
To effectively manage this move on your own, an expert in medical billing and coding commands a high salary and should process over 500 claims per month to be cost effective. Experienced personnel of this type are beyond most optometrist’s budgets; especially when they are just starting out in medical billing. Pooling resources allows. We provide expert medical billing staff at a fraction of their actual cost. We provide the following distinct advantages:
- Implementing a medical protocol driven system through developing clinical pathways maximizing revenue per diagnosis.
- Education for Doctor and Staff for clinical and coding support.
- Uninterrupted services. When a key employee leaves unexpectedly it can create havoc in a small office. Optometric Medical Solutions maintains a full staff experienced in medical billing.
- Remaining current. It takes more time and energy to keep abreast of the submission requirements from carrier to carrier. Our staff is constantly discovering new and better ways to ensure your submitted claims are paid.
- Turnkey Services. We don’t just process claims. We provide everything from Credentialing to Telephone support.
- Consulting. Our experienced Medical Experts, Revenue Cycle Managers and claim processing staff will provide consulting support for your practice.
- Risk mitigation through utilizing clinical protocols establishing consistent standards of care and practice.
Focusing on eye care best practices to promote growth.
OMS, partners with your practice to enhance clinical and administrative workflow processes creating efficiencies while increasing profits.
- Increased cash flow from efficient processing of medical claims
- Increased speed of payments from medical payers
- Reduced staff expense in administrating the process
- Medical growth through proper patient benefits utilization
- We are the doctor’s advocate to the medical insurance company
- Increased disease management (education and compliance support)
- No software upgrades cost, down time: it is covered in our services