Wiki Billing contacts or glasses prior to patient picking up materials...


Quitman, MS
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I am very new to coding/billing for the optometry practice I currently work for since April of this year. They have been billing insurance for contact lenses and/or glasses prior to actual pickup. To me this feels wrong. I would think that you shouldn't bill for a product the patient does not have. The argument is "that's how its always been done" and "but they've given us permission to order and bill insurance prior to pickup".

Can someone give me some guidance on this issue?

Just my personal opinion as a former private practice owner. Eyeglasses are a custom made medical device made for the patient from the doctor's prescription. Once the glasses have been ordered and made, the practice has incurred an expense from the optical laboratory. They're not going to wait to bill you for their work until after the patients pick them up.

In some cases, patients wouldn't pick their glasses up for weeks or months after they were made. Why should the practice not be reimbursed for expenses it incurred on behalf of the patient when they occur versus having to possibly wait months to do so?

You can make the same case for contact lenses ordered for a patient.

In these days of lower and lower reimbursement from insurers, cash flow is critical for the financial wellbeing of a practice.

Tom Cheezum, O.D., CPC
Thank you. That does make sense. As I said I am very new to the optical side so I very much value your input. Happy Thanksgiving!