Optometry Billing Services

Optimize Your Practice Revenue & Billing Efficiency

Getting Started

Our Optometry Billing Services help vision care practices efficiently manage complex coding and billing requirements. From routine eye exams to specialized treatments, we ensure accurate coding and adherence to payer guidelines. Our solutions minimize denials, enhance cash flow, and allow optometrists to concentrate on providing outstanding patient care in a dynamic healthcare landscape.

Optometry Billing Services

Maximizing claim efficiency and compliance for superior revenue management

The growing complexity of optometry billing, with its detailed coding and regulatory demands, requires specialized expertise. Outsourcing these services minimizes administrative workload, improves revenue flow, and ensures adherence to industry standards—allowing practitioners to concentrate fully on patient care.


  • Lower risk of billing errors and insurance audits
  • Greater focus on clinical care without administrative interruptions


our billing experts bring unmatched accuracy and professionalism to every aspect of optometry revenue cycle management. Their strong credentials and deep understanding of the field ensure that your billing remains precise, efficient, and fully aligned with current payer standards.


Qualifications & Capabilities:

  • Certified by the American Association of Professional Coders (AAPC)
  • Highly experienced in electronic health record systems used across optometry practices
  • Proficient in CPT, HCPCS, and ICD-CM coding per CMS regulations
  • Well-versed in working with Medicare, Medicaid, and private insurers to support timely and complete reimbursements


We’ve successfully supported optometry practices by managing billing with a wide range of insurance carriers, helping ensure accurate reimbursements and timely payments.


We work with:

  • Major commercial payers including Blue Cross, Aetna, Humana, and UnitedHealthcare
  • Medicare and state Medicaid programs
  • Experienced in payer communication to resolve issues and secure faster reimbursements


At Gedeihen, we bring unmatched proficiency, end-to-end service capabilities, and innovative technology to support optometry practices in managing their billing operations with ease and accuracy. Our experienced team works closely with providers to simplify workflows, reduce operational burden, and secure financial strength in a fast-changing healthcare environment.


Compliance-Focused Operations: Adherence to CMS and payer-specific guidelines to mitigate audit risks and billing discrepancies.

Practice Growth Support: Seamless coordination that supports patient referrals, expands research potential, and fosters sustainable business growth.

Experienced Billing Team: Skilled professionals with deep understanding of optometry coding standards, payer policies, and regulatory updates.


Mastering Every Code for Ambulance Transportation Specialty

Explore key figures that highlight our commitment to seamless coding and optimized reimbursement.

Ophthalmic Visit Codes (920XX)

92002

Ophthalmological Services - New Patient, Intermediate

92004

Ophthalmological Services - New Patient, Comprehensive (one or more visits)

Evaluation and Management (E/M) Codes (992XX)

99201-99205

New Patient Office Visits (vary by complexity)

99211-99215

Arthroscopy of the knee, diagnostic

HCPCS "S" Codes (S062X) : Specialized codes

S0620

Routine ophthalmological examination including refraction - New Patient

S0621

Routine ophthalmological examination including refraction - Established Patient

Up to

27%

More cash collected

Up to

23%

Outstanding A/R collection

Up to

29%

Patient collections

Up to

$80 M

Charges billed last year

Medical Billing At A Glance

Explore key figures that highlight our commitment to seamless coding and optimized reimbursement.

Claims Processing Metrics

96%

First Pass Resolution Rate

Percentage of claims paid on the first submission.

23-40 Days

Average Days to Payment

Average number of days it takes for claims to be paid.

First-Pass Claim Acceptance Rate (FAR):

We consistently maintain a >96% first-pass acceptance rate, reducing delays and ensuring faster reimbursements.

Days in Accounts Receivable (AR):

Our optimized workflows help keep AR days well below the industry benchmark, improving cash flow predictability.

Clean Claim Rate:

With robust coding accuracy and claim scrubbing tools, we achieve a clean claim rate of over 95%, minimizing rework and denials.

Financial Metrics

90%

Net Collection Rate

Percentage of total charges that are collected.

30 Days

Average Denial Resolution Time

Average number of days taken to fix and resolve a denied claim.

Operational Metrics

94%

Average Claims Submitted Per Month

Volume of claims submitted.

97%

Volume of claims submitted.

Claims processed per biller per day.

Aged A/R Clearance Rate:

Measures the percentage of aged receivables (especially over 90days or above)

Reflects the effectiveness of backlog reduction efforts.

A faster resolution time means improved collections and cleaner aging reports

Unbilled Claims Backlog:

Goal: Minimal backlog—claims should be submitted within 24–48 hours of service. Impact: Directly affects cash flow and delays reimbursement.

Denial Resolution Rate:

Tracks the number of denied claims that were appealed, corrected, and successfully reimbursed. Benchmark: 63–79% resolution rate. Denial management efficiency and recoverable revenue.

Reach Us

Address

3/1159, water tank road, choolaima nagar, Thoraipakkam, Chennai - 600097.

© 2023 Gedeihen Healthcare.