Practice insurance strategy, RCM and credentialing
Before anything is billed, payer mix has already set what an optometry practice earns, and afterwards claims stall in places nobody owns. ORC reviews payer mix, collection performance, denial trends and credentialing status using practice-provided information. It advises on payer participation, billing workflows, denial reduction and credentialing priorities. Billing operations, claim submission and credentialing execution are separately scoped specialist services.
By Dr. David Hettler, OD & Mani Vaghedi · Updated
Billed is not collected
Payer mix sets what the practice earns before anything is billed, and claims stall in places nobody owns. We map the mix, the gap between what is billed and what arrives, and which providers are credentialed with which payers.
What ORC does
Reviews payer mix, collection performance, denial trends, and credentialing status using practice-provided information.
What ORC advises on or coordinates
Payer participation, billing workflows, denial reduction, and credentialing priorities. Billing operations, claim submission, and credentialing execution are separately scoped specialist services.
Billed and collected
Is what you bill the same number as what you collect — and can anyone say where the difference goes?
Not sure where to start?
A thirty-minute practice review, no charge. We'll look at your numbers and your floor and tell you where we would start.