Turning Problems into Profits

Billing for ODs

OBS can help your practice!

Posted by on Jun 4, 2013

–Are you struggling to maintain control over your insurance billing and account receivables? –Trouble finding or keeping trained billers who understand the confusing maze of insurance billing? –Is your staff too busy to follow up on unpaid claims? –Are you writing off thousands of dollars in uncollected money because you don’t have the expertise to get insurance companies to pay? If so, you’ve joined the ranks of untold other optometric practices that are losing thousands of dollars in lost revenues and mounting ARs. Optometric Billing Solutions can help! . We‘re experts at: • Submitting claims to ensure maximum insurance reimbursements • Posting insurance payments accurately and quickly • Managing Account Receivables, working EVERY unpaid claim • Following up on problem accounts, researching and reprocessing so they pay out • Serving as a professional resources for billing and insurance questions • Helping set up procedures for effective billing processes • Compiling monthly AR reports for the practice to track trends and monitor receivables • Increasing the practice’s insurance reimbursement   OBS is an experienced billing company serving ODs from all over the country for over 10 years. We work with...

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OBS Advantage

The OBS Advantage

Posted by on Jun 4, 2013

Our services pay for themselves.  We’re professionals who know how to collect every available dollar.  We know your insurance payers, so we know how to maximize reimbursements.  We can help you identify claims in which you’re consistently leaving money on the table. Our billing processes are accurate and efficient, so claims go out clean and right the first time, leaving fewer unpaid accounts.  If there is a problem claim, we know how to research and follow up so that it pays out, and we’re experts at tackling your AR.  Plus, you won’t have to worry about staff turnover, covering vacation time, or unpredictable cash flow because you’ll always have full-time professionals working on your accounts. We’re experts in the field of optometric billing.  We only serve optometrists, so we understand the unique demands of a profession that requires a strong knowledge of both medical and routine billing and how to meld the two for the greatest financial benefit.  We have practices in over thirty-five states.  Therefore, we already know your insurance payers and their rules, so we know how to get claims to pay on the first submission.  We’re not an optometric department within some large medical billing company who mainly serves MDs; we...

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Learn More About OBS

About Optometric Billing Solutions

Posted by on Jun 4, 2013

. Optometric Billing Solutions currently serves clinics in 39 states and is owned by Brooke Armstrong and Branda Barton, two sisters who have both managed large clinics.  They understand the financial challenges facing optometric practices because as managers they’ve faced the very same problems themselves. Brooke has a degree in Healthcare Administration and managed a six million dollar practice for over five years. Branda, whose educational background is also in Healthcare Administration, served as the financial manager of a 1.8 million dollar practice before leaving to travel throughout the United States as a practice management software consultant. Over and over again, she found the same problems facing optometrists all over the country–the need for better control over practice’s finances. Optometric Billing Solutions was founded on a mission to help doctors regain financial control.  Branda and Brooke–along with our team of trained, experienced billers–currently serve optometric practices in 39 states.  Our clinics range from small, one-doctor start-ups to seven-doctor clinics with multiple locations.   Many of our staff have received their medical coding and billing certification, and all billers work in-house.  Unlike other companies, we do not out-source our accounts to off-site or overseas staff because it is...

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Outsourcing Your Billing

Outsourcing: What You Need to Know

Posted by on Jul 7, 2013

Do you need help with your billing but have concerns about turning it over to an outside company? You are wise to be cautious! We get frequent calls from optometrists who have had bad experiences with outsourcing–for a variety of reasons. Medical billing companies don’t understand the hybrid world we live in that combines medical and routine vision. Some companies hire employees with little experience and don’t give them the training and support they need to do the job well. Some companies spread themselves too thin, taking on too many clients without the resources to adequately devote to each account. Some companies outsource their accounts to off-site employees–some of whom are home-based and some who are located overseas, making it difficult for billing companies to control the quality and consistency of their work. There are some things you can do to help protect yourself and reduce frustrations! Recently we came across a great article published in AAPC’s The Coding Edge, a healthcare magazine for medical coders and billers. The article was called “Ask the Right Questions Before Outsourcing Your Billing.” * Here...

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Recent Posts

Medicare Overpayments

Medicare Overpayments6.1.16   On March 14, 2016, new Medicare legislation called the 60 Day Final Rule went into effect that directly impacts our clinics and doctors.  The law concerns refunding Medicare money when the clinic realizes that Medicare overpaid on an account.  Please note that this new legislation does not change the existing process when Medicare realizes that they’ve overpaid and issues a Demand Letter, but rather addresses those instances in which the clinic discovers the overpayment before Medicare.  The new law requires offices to return any overpayment, regardless of the amount, within 60 days.  There are now serious fines for failure to comply, as well as the possibility of prosecution for fraud under the False Claims Act.  It should be noted that the law only applies to traditional Medicare, not Medicare Advantage plans, Medicaid, or commercial carriers.

Actually, Medicare has required providers to return overpayments within the 60 day window for the last six years.  What has changed with the new legislation, however, is RESPONSIBILITY, ACCOUNTABILITY, AND CONSEQUENCES!   The new law says that it is the provider’s responsibility to identify and return Medicare overpayments.  Medicare now holds their providers accountable to “reasonable diligence.”   In other words, lack of knowledge, training, poor business processes, or carelessness is not a protection from prosecution.  The bottom line is this:  If you didn’t know there was an overpayment but you should have known under standard business practices, you are guilty under the law.  Careless business operations such as failure to post remits and reconcile accounts or putting an insurance credits aside to investigate later is no longer acceptable.  In fact, the law actually says Medicare will not allow an “Ostrich Defense.”   Not realizing Medicare overpaid or ignoring overpayments is open to the same prosecution as deliberate fraud.

It doesn’t matter how small the amount of the overpayment–from 32 cents to $320 dollars, we are now required to return every penny in overpayments, and we have 60 days to get the money back in Medicare’s hands.  One piece of good news, however, is the effective date is not retroactive.  The 60 Day Final Rule begins with overpayments which are identified on or after March 14, 2016, so practices are not required to do internal audits to find older overpayments.

The 60 Day Final Rule even addresses third-party billing companies like OBS.   Our doctors are responsible for OBS’s compliance and can be prosecuted for our failures in handling your Medicare overpayments correctly.  OBS is taking the new legislation seriously.  We have put into place processes to handle overpayments and have trained all staff members. 

Since you as the provider are responsible for the manner in which we handle your accounts, we want to outline the process by which we will be managing your Medicare overpayments:

  1. When an OBS biller identifies an overpayment and realizes Medicare is due back money, the biller will send the credit to a manager for review to ensure it is accurate.
  2. Once the manager confirms the money is due back to Medicare, OBS will fill out a Voluntary Refund form for your Medicare jurisdiction.Voluntary Refund form
  3. We will attach the completed form to the Information Requested page on your Team Site. (You will need to open the IRS entry in Edit Mode to download the form.)
  4. Please review the form, sign, and mail it to Medicare along with a refund check for the amount shown.
  5. Post the refund on the patient’s account to off-set the credit and send the IRS entry back to OBS along with the check number so we can document the account.

Please know that OBS is doing everything we can to meet the requirements of the new law.  Together we can exercise “reasonable diligence” and ensure that your practice is not at risk!