optometry collections

Facts About Optometry Collections And RCM

The demand for optometry care is increasing day by day, when the demand increases the workflow of the service providers also increases. As it is increased to such a large extent the revenue collection management is the big challenge many health care service providers face nowadays. To overcome all these challenges an effective system that comprises billing, coding, valid documentation is needed but there are several other factors that need to be considered especially in the case of optometry. Before we move on to Facts about optometry collections and RCM, let’s have a quick look at optometry billing. 

Optometry billing collections: 

The billing collection is one of the most important steps of any industry to make sure that the flow of revenue would be stable. As it is the same case in optometry, the billing collections is optimized and monitored to ensure the smooth flow of revenues.

How did Optometry billing services work? 

Optometry collections are worked the same way as the other medical billing system works.

  • The first step is to collect the data of the patient, his complete name, address, and information about his insurance provider. 
  • In the second step, the treatment and medication services have been provided as well as recorded.  
  • In the next step, all the information has been converted in the form of codes, because the insurance companies are working with the coding. 
  • Typically it is done by the workers of the health service providers who have some expertise in coding or they may outsource the team for billing and coding 
  •  In the last step, the billing information is forwarded to the insurance companies, and after analyzing they may release the amount due.

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Trends of optometric industry in the U.S: 

With the growing population in the U.S, the demand for optometric services also increases; it is estimated that 65% of U.S citizens require products related to vision correction. These individuals also required an annual eye check-up and other eyes related treatments like surgical consultation, vision therapy, and other preventive care consultations. 

New Revenue Opportunities for the optometrist: 

As said earlier, with the growing population the demand for optometrists is also expanding. It is the best time for the optometrist to take the share from the industry, especially for the independent optometrist. 

Reasons behind new revenue opportunities: 

One of the first reasons behind the revenue opportunity is the growing and aging population. It is estimated that 85% Of the population above 45 uses products related to vision correctness. So it will also enhance the revenue of the eye care products supply industry. The changes in lifestyle are the emergence of the complications like cataracts, glaucoma, macular degeneration which lead to vision care treatment like surgery and screening.

Facts about Optometry: 

Going into more detail, Below are some detailed facts and figures about the optometry industry:

Trends and statistics of the industry:

According to the 2021 statistics, the market size of the optometric industry is $18.4 Billion by revenue. The market size of the optometrist industry is expected to increase by 9% by the end of 2021. While in the US the market size of the optometrist’s industry is growing at the pace of 1.4%. While the industry comprises $36 billion in which the segment of services has a share of $15 billion. And the remaining shares are held by the products related to optometry. It is expected that with this trend the industry will grow at the rate of 1% to 2%. 

Optical products shares: 

The sale of the optometry products like glasses and contact lenses is the main source of the market share of the revenue. The selling of these products also enhances the growth of optometric practices. The low-cost products are expected to contribute more to the industry due to high demand and strong supply chain advantages. The revenues are expected to increase in the near future.

Participants of the industry:

The optometric industry has various participants from independent opticians to optometrists and ophthalmologists to the manufacturer and distributor of the products related to eye care. 

The Manufacturer of the industry delivered the products like contact lenses and glasses and machinery. The optometrist which is an independent service provider, provides the services of an eye exam, medical eye care and in very rare cases it indulges in the service of retail sale corrective devices. On the other hand, the ophthalmologist is involved in the eye exam, medical eye care, and surgery and retail sale of corrective devices. 

Annual revenue of Optometrist: 

The majority of optometrists offer their services through private practices or Government organizations. The increasing U.S population enhanced the demand for refractive and medical eye care services. It is estimated that with this increasing demand the number of optometrists will grow by  2% in the coming years.

While 80%-85% of the primary objective of an optometrist is to give services related to eye care. Which comprises a revenue of about 17%. If legislation allows optometrists to perform surgeries then it will enhance their revenue by many folds. Moreover, optometrists take the revenue of about $14 billion annually.

Annual revenue of Ophthalmologist: 

Ophthalmologists are more experienced and more qualified eye care service providers. They can diagnose full-spectrum and perform surgery, they also perform refractive surgery. Stats show that the need for ophthalmologists is constantly increasing from year to year. And it is estimated that they grab the revenue of $12 billion from their services annually. 

Optometry revenue cycle management program: 

An estimate indicated that the insurance plan comprised 67% of optometrist revenue. It is expected that it will increase more than it was ever before when more people will gain access to health plan coverage. Self-pay currently accounts for 20%. While private and self-directed plans account for 60% of plans.

On the other hand for the effective billing process, the task associated with the billers and coders also increases. The billers and coders need to keep themselves updated about the new policies and regulations of Medicare.

Do you lack coders and billers in-house? Don’t worry! The Mediator has a team of professionals who ensure a smooth billing process, ensuring no coding errors and false claims. If you want to make your optometry collections more effective, then call us at (888) 277-1460.

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