Ophthalmology RCM, built around the injection chair
Intravitreal drug billing, anatomical modifiers, and ASC facility splits for ophthalmology practices.
Why ophthalmology billing is different
High-cost intravitreal injections carry real financial risk. The wrong anatomical modifier, a missing prior authorization, or an uncounted vial of drug waste can turn a routine injection into a write-off. Ophthalmology practices also run vision and medical claims side by side, and a generic system rarely tells them apart correctly.
What generic software misses
- RT, LT, and bilateral modifiers get left off intravitreal injection claims, triggering denials on expensive drugs.
- Vision plan and medical plan eligibility are checked as one, when they should route differently.
- Same-day diagnostic imaging gets bundled into the injection claim and denied instead of paid separately.
- Cataract global-period follow-ups get billed on top of bundled post-op visits.
What the platform does about it
Anatomical modifier automation
RT, LT, and bilateral modifiers are generated directly from the physician's documentation.
Ocular drug clearance
Prior authorization status for high-cost biologics is checked before the injection is scheduled.
Same-day imaging and injection billing
OCT, angiography, and visual field claims are checked against bundling rules and separated when supported.
ASC dual billing
Professional and facility claims for surgical cases generate together instead of on separate forms.
Generic software vs. Unlimited Financials
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