American Academy of Ophthalmology
Centers for Medicare & Medicaid Services
American Academy of Professional Coders
Certified Ophthalmology Coders
ICD-10-CM, CPT, and HCPCS Level II coding
Robotic Process Automation
Powerful AI-Scrubbing
EHR/EMR Integration
Predictive AI-Denial Dashboards
We don’t just promise results, we deliver them. For decades, we have been helping ophthalmology practices to grow their revenue. Your success measures our success:
Want to turn every denied claim into a revenue opportunity? That’s precisely what our ophthalmology billing and coding company does while working on your claims. We make sure to work on each submission like a hawk, detect and fix errors for maximum reimbursements.
Our comprehensive Ophthalmology Medical Billing Services in the USA are specifically designed to address the nuanced requirements of eye care practices across the United States, ensuring that your revenue cycle operates at peak efficiency.
Outsource Ophthalmology Billing for 20% More Revenue.
Our team verifies every patient’s insurance eligibility and benefits before the appointment to avoid front-end denials. We confirm coverage for ophthalmology procedures, diagnostic tests (OCT, visual field, etc.), and surgical authorizations.
We have AAPC-certified ophthalmology coders. We ensure compliance with payer guidelines for complex procedures. With proper ICD-10 coding, each claim undergoes code validation for modifier accuracy (e.g., 25, 59, 79) and documentation sufficiency. We handle both eye codes vs E/M codes.
We handle electronic claim submission to all major payers, including Medicare, Medicaid, and private insurers. Each claim is scrubbed for NCCI edits, missing modifiers, and payer-specific coding requirements. Our team tracks every claim with aggressive follow-ups.
We identify the root cause of denials, such as coding errors, eligibility lapses, or insufficient documentation, for faster resolution. Each denial is corrected, appealed, and resubmitted with detailed justification aligned to payer policy.
We deliver clear, easy-to-understand patient statements for consultations, surgeries, and diagnostic procedures. Our system automates reminders and enables multiple payment options to improve collection efficiency.
Our end-to-end RCM solution covers scheduling, coding, claims, denials, and collections under one roof. We monitor KPIs such as clean claim rate, AR aging, and net collection ratio in real time. Data-driven insights help optimize financial performance and eliminate revenue leakages.
Is your eye care clinic’s revenue healthy? Or are you constantly losing tens, hundreds, or even thousands of dollars a year without even realizing it? Dastify solutions for ophthalmology revenue cycle management (RCM) ensure your revenue doesn’t vanish into thin air!
Working with an in-house billing team often means being stuck with outdated, one-size-fits-all processes that might work for general practices but not for the complexity of ophthalmology medical billing. For ophthalmology practices, each insurance payer follows different billing rules for every procedure, including frequency limits, documentation requirements, and payment variations. Some CPT codes are reimbursed bilaterally, while others are unilateral and require separate submissions.
| Aspect | In-House Billing Team | Outsourced Billing with Dastify Solutions |
|---|---|---|
| Expertise Level | General billers who handle multiple specialties often miss ophthalmology-specific coding nuances. | Certified AAO & AAPC certified ophthalmology billing experts who are masters in Ophthalmology CPT codes and ICD-10 coding. |
| Technology & Tools | Relies on manual methods and old software. | Uses advanced ophthalmology billing software, AI-driven claim scrubbing, and real-time analytics dashboards. |
| Claim Accuracy | High chance of coding errors, missing modifiers, and unaddressed denials. | For claim accuracy, apply correct E/M code levels for new and established patients, ensure accurate use of modifiers (24, 25, 57, 59, etc. |
| Follow-Up Process | Follow-ups are irregular due to workload and staff shortages. | Dedicated AR team tracks, appeals, and recovers every unpaid claim within payer deadlines. |
| Scalability | Growth is restricted by staff size, training time, and turnover. | Fully scalable support, from solo ophthalmologists to multi-location practices without extra hiring costs. |
| Follow-Up Process | Often misses policy updates or payer rule changes. | Constantly updated with the latest ICD-10, CPT, and CMS ophthalmology regulations. |
