Specialty

Ophthalmology Medical Billing & RCM

Cataract surgery, retina procedures and optical services — with surgical bundling expertise.

What we bill

Procedures & services we specialize in

Cataract surgery & IOL billing
Retina injections (anti-VEGF)
YAG & laser procedures
Glaucoma management
Optical/material billing

Common revenue challenges

  • Complex modifier rules and frequent payer policy changes
  • High-touch pre-authorization burden
  • Underpayments hidden in fee schedules
  • Documentation gaps driving denials

Billing complexity

  • Specialty-specific CPT and HCPCS coding
  • Bundled procedures and global periods
  • Multiple-procedure reductions and modifier sequencing
  • Payer-specific billing rules

Coding expertise

  • Certified specialty coders
  • ICD-10-CM specificity tuned to your workflow
  • Audit-ready documentation review
  • Quarterly coding updates

Insurance handling

  • Eligibility and benefits verification
  • Prior-auth tracking and follow-up
  • Denial workflow with root-cause analytics
  • Patient responsibility communication

Revenue optimization

  • Underpayment recovery program
  • Fee-schedule benchmarking
  • Payer contract review
  • KPI dashboard with monthly cadence
Case Study

Ophthalmology billing transformation eliminates 95% of denials

95% denial reduction

FAQ

Ready to optimize your ophthalmology revenue cycle?

30-minute consultation. No obligation.

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