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Ophthalmology

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    Monday - Tuesday:9am - 6pm

    Friday - Sunday:8am - 5pm

    Sunday: Closed

    Ophthalmology

    Ophthalmology practices require precise billing to handle complex procedures like cataract surgeries, corneal transplants, and treatments for conditions such as diabetic retinopathy or strabismus. QuantumX RCM provides specialized billing solutions that address the unique coding requirements of ophthalmology, including CPT and ICD-10 codes specific to eye care. Our services include

    QuantumX provides:

    • Accurate Coding for Procedures: Expertise in coding for diagnostic tests (e.g., visual field tests, OCT scans) and surgical procedures (e.g., LASIK, vitrectomies).
    • Denial Management: Reducing claim denials by ensuring compliance with payer policies for vision-related services.
    • Insurance Verification: Confirming coverage for specialized treatments and procedures to minimize patient billing issues.
    • Revenue Optimization: Maximizing reimbursements for high-cost procedures and ensuring timely payment for Medicare and private insurance claims.
    With QuantumX, ophthalmology practices can focus on patient care while we streamline their billing processes for improved cash flow and compliance.

    Ophthalmology billing is complex due to the need to use both evaluation and management (E&M) codes and eye-specific codes. E&M codes (99201-99215) cover office visits, while eye codes (92002-92287) address specialized services like visual field testing and fundus photography. The American Academy of Ophthalmology highlights the importance of staying updated with coding changes to reduce denials, as ophthalmology practices often deal with both medical and surgical services.

    Billing services typically include patient registration, insurance verification, claim submission, denial management, and collections. Companies like Eye Med Management Solutions emphasize increasing reimbursements through streamlined processes, which quantumX can replicate by offering dedicated account management and follow-up teams.

     

    Billing Challenge QuantumX RCM Solution
    Complex Procedure Coding Accurate coding for diagnostic tests (e.g., OCT, VF) and surgeries (e.g., LASIK, vitrectomy).
    Denial Management Resolves denials for bundled procedures and ensures compliance with CPT/ICD-10.
    Insurance Verification Confirms payer-specific coverage for treatments like diabetic retinopathy or corneal transplant.
    Revenue Optimization Ensures correct use of E&M (99201–99215) and Eye Codes (92002–92287) for maximum reimbursement.
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