How to Choose an Optometry Billing Service: 10 Questions to Ask

Choosing an optometry billing service is one of the biggest financial decisions a practice makes. The right partner gets claims paid faster and keeps your A/R clean. The wrong one can quietly cost you money for months before anyone notices.

Eye care billing is different from general medical billing. Your practice bills both vision plans and medical insurance, often for the same patient, and the rules change from payer to payer.

Here are the questions we think every practice owner should ask before signing with any billing company, including us.

1. Do you specialize in optometry?

Ask how much of their work is eye care. A company that mostly bills for family medicine or physical therapy may not know when an exam belongs on a vision plan versus medical insurance, how to bill refractions, or how payers treat diagnostic testing like OCT and visual fields.

2. Do you handle both medical and vision claims?

Some services only work medical claims and leave vision plans to your front desk. Others do the opposite. Find out exactly which payers they will work, and who is responsible for each part of the claim.

3. Who will actually work my claims?

Ask whether you will have a dedicated person or team, where they are located, and whether any work is passed to subcontractors. You should know who to call when something goes wrong, and they should already know your practice.

4. How do you handle denials and old A/R?

Every billing company submits claims. The difference shows up in what happens after a denial. Ask how quickly denials are worked, whether they write appeals, and how they handle claims that are already aging when they take over.

5. What will you report to me, and how often?

You should never have to guess how your billing is doing. Ask to see a sample report. Useful reports show collections, A/R by age and payer, denial reasons, and what is being done about the open items.

6. Which practice management and EHR systems do you work in?

A good partner works inside your existing system instead of asking you to switch. Confirm they already know your software and how they will access it securely.

7. Do you verify eligibility and benefits?

Many denials start before the patient is ever seen. Ask whether insurance verification is included or offered, and how results are passed back to your front desk before the appointment.

8. Can you help with credentialing?

New doctors, new locations and payer changes all require credentialing and enrollment. If a billing partner can handle this too, you avoid gaps where claims cannot be billed at all.

9. How is pricing structured, and what does the contract say?

Billing services are commonly priced as a percentage of collections or a flat fee. Ask what is included, what costs extra, how long the agreement runs and what happens to your data if you leave.

10. Will you sign a business associate agreement?

Any billing company that handles patient information must protect it under HIPAA. A signed business associate agreement is a basic requirement, not an extra.

The bottom line

The best optometry billing service is one that understands eye care, works both sides of your insurance, tells you plainly how your money is moving, and treats your practice like its own.

Collective Revenue was built by Hannah Boyd, who has worked in optometry since 2006, and Dr. Douglas Boyd, a practicing optometrist. We would be glad to answer any of these questions for your practice.

Not sure where your practice stands? Take our free optometry billing assessment or see how our optometry billing services work.