Ophthalmology and Optometry Coding Alert

Question: We saw an established patient for a glaucoma check and when the remittance advice came back from Medicare, we were surprised to see that the patient had not yet met her deductible. Since it’s almost the end of the year, we assumed she had met it. Now we’re having trouble collecting from her for it. Can you advise?

Arizona Subscriber

Answer: The best way to prevent issues like this is to verify that your front office staff is collecting at the time of service rather than waiting to send patients a bill after the fact. Remember that sending a statement internally or through a payment management system is also an expense.

No matter how late in the year it is, you should be confirming whether patients met their deductibles yet ($203 in 2021). You should also collect all copay and coinsurance amounts so you don’t have to chase down payments after the fact.

In your situation, you should send the patient a bill, and if she isn’t paying it, call her to ask if she would like to be placed on a payment plan. Speaking directly with the patient might make it easier to arrange for payment. If you have tried all of these avenues and the patient still won’t pay, you may unfortunately need to send the account to collections.