Optometry Billing

Maximize Your Optometry Practice Revenue.

Eye care billing has unique complexities — vision vs. medical insurance, routine exams, and medical eye care. We understand the nuances that affect your bottom line.

In a state-of-the-art eye clinic, a patient sits before an ophthalmic scanning machine while a doctor conducts a thorough retinal examination

Optometry Billing Has Its Own Rules.

The distinction between vision and medical billing is critical. Understanding when to bill each payer type is the difference between profit and loss.

Vision vs. Medical

Knowing when to bill vision plans vs. medical insurance is critical. Medical diagnoses often lurk behind routine exams.

Complex Diagnoses

Cataracts, glaucoma, macular degeneration, and diabetic retinopathy require precise ICD-10 coding for medical billing.

Frame & Lens Billing

Managing vision benefit allowances, upgrades, and материалs requires meticulous attention to detail.

Coordination of Benefits

When patients have both vision and medical coverage, proper coordination is essential for maximum reimbursement.

Medical Necessity

Documenting medical necessity for diagnostic tests and treatments is essential for payer reimbursement.

Timely Filing

Vision and medical plans have different timely filing limits. Missing deadlines means write-offs.

Optometry-Specific RCM Solutions.

We understand the unique challenges of eye care billing. Our team specializes in vision and medical eye care coding, payer rules, and documentation requirements.

Vision/Medical Determination

We help identify when services should be billed to vision plans vs. medical insurance, maximizing legitimate reimbursement.

  • Medical eye exam coding
  • Diagnosis code selection
  • Payer-specific rules

Medical Eye Care Coding

We ensure proper coding for medical eye conditions including diagnostic tests, treatments, and procedures.

  • CPT/ICD-10 accuracy
  • Visual fields & OCT
  • Glaucoma management

Vision Plan Management

We handle the complexity of vision benefits including frame allowances, lens upgrades, and materials billing.

  • VSP, EyeMed, Davis Vision
  • Allowance tracking
  • Patient responsibility estimates

Denial Management

We work your vision and medical denials with payer-specific strategies, appealing when appropriate.

  • Root cause analysis
  • Appeal submissions
  • Prevention workflows

Real Results From Optometry Practices.

$67K

Average Annual Recovery

96%

First-Pass Rate

35%

Medical Billing Increase

28 days

A/R Reduction

"We were missing significant revenue by not properly billing medical insurance for our medical eye care visits. DoctorBilling.ai identified over $45,000 in medical billing opportunities we'd been losing. Now our team focuses on patient care while they handle the billing complexity."

— Practice Administrator, Multi-Location Optometry Practice

Frequently Asked Questions

Common questions about optometry billing and how we help practices.

Ready to Maximize Your Optometry Revenue?

Book a free optometry practice revenue audit. We'll review your current billing operations and show you exactly where you're leaving money on the table. No commitment, no obligation.

HIPAA Compliant BAA Available 14-Day Implementation