Maximizing Collections: A Guide to Optimizing Ophthalmology Patient Statements and Follow-Up

By Stephanie Adams August 21, 2025 Ophthalmology Practice Tips

If you’re reading this, chances are you’ve seen the generic advice. You’ve read the blog posts from giant healthcare IT companies and financial institutions telling you to “communicate clearly” and “offer payment plans.” Yet, the gap between patient responsibility and actual collections in your ophthalmology practice continues to feel more like a chasm. You’re not just imagining it. The standard playbook for patient collections wasn’t written for the unique financial workflow of an eye care practice. You need more than high-level tips; you need a specialized strategy that addresses the specific challenges you face every day. This guide provides that strategy, moving from the common frustrations you experience to the actionable steps that will transform your revenue cycle.

The High Cost of “Good Enough” in Patient Collections

For many practices, the patient collections process is a patchwork of inherited procedures and well-intentioned but overburdened staff. This “good enough” approach, however, masks a significant financial drain. The numbers paint a stark picture of a nationwide problem: an estimated 80% of medical bills contain errors. These errors aren’t just typos. They create confusion, erode patient trust, and lead directly to payment delays that can stall a claim for up to 90 days. For patients, the experience is just as frustrating; they spend an average of 20 hours trying to resolve these billing issues. The result? Hospitals fail to collect on a staggering 76% of patient bills, and even for commercially insured patients, providers collect only 34.4% of what they’re owed. This isn’t just lost revenue; it’s a critical breakdown in the patient experience. Research from CommerceHealthcare shows that 60% of patients would switch providers over inaccurate bills. Before you can fix the process, you must first understand why your practice is different.

Why Generic Collections Advice Fails Ophthalmology Practices

General advice on patient collections falls apart when faced with the realities of an ophthalmology practice. Competitors in the health tech space like Waystar and athenahealth offer broad frameworks, but they miss the nuances that define your revenue cycle. Your practice navigates complexities that a general practitioner or dermatologist simply doesn’t encounter:

• The Vision vs. Medical Dilemma: Patients rarely understand why their “vision plan” doesn’t cover a medical diagnosis like glaucoma or diabetic retinopathy. A generic statement that doesn’t clearly explain this distinction is a recipe for a confused and unpaid bill.
• The Co-Management Conundrum: Billing for post-operative cataract care shared between the surgeon and a co-managing optometrist requires precise communication and coding. A standard invoice can’t properly delineate these charges, leading to patient disputes.
• Refractive vs. Medical Services: Explaining why a comprehensive eye exam is covered but a refraction isn’t is a recurring challenge. Your statements and follow-up conversations need to be designed to handle this specific scenario with clarity and confidence.

Relying on generic advice is like using a general-purpose tool for a highly specialized surgery. It might seem to work, but it lacks the precision needed for optimal results.

Anatomy of a Patient Statement That Actually Gets Paid

The single most powerful tool in your collections arsenal is the patient statement itself. It should be a clear, concise communication tool, not a confusing financial document. Most practices send statements that are cluttered with cryptic CPT codes and unclear balances, inviting patients to set them aside. A high-performing statement, however, is designed with the patient in mind. It transforms confusion into clarity and encourages prompt payment. Let’s break down the essential elements:

1. Plain-Language Service Descriptions: Instead of “CPT 92250,” use “Retinal Imaging for Macular Degeneration.” This immediately connects the charge to the care the patient received in your office.
2. Clear Financial Summary: Prominently display what insurance paid, what adjustments were made, and what the final patient responsibility is. A simple, bolded “Balance Due” is essential.
3. Multiple Ways to Pay: Clearly list all payment options – online portal, QR code, phone number, and mailing address. The easier you make it to pay, the more likely patients are to do it.
4. A Designated Point of Contact: Provide a direct name, phone number, and email address for a billing specialist. This tells the patient, “If you have a question, we have a person ready to help,” preventing frustration and call-forwarding nightmares.
5. A Note on Vision vs. Medical: For relevant diagnoses, include a brief, pre-written explanation: “Your medical insurance was billed for the diagnosis and treatment of a medical eye condition. Your vision plan covers routine eye exams, which is a separate service.”

Redesigning your statement is the first step. The next is ensuring your follow-up process maintains the same standard of patient-centric communication.

Ethical Follow-Up: Scripts and Strategies for Eye Care

Soft collections aren’t about harassing patients; they’re about professional, persistent, and helpful follow-up. Your team’s confidence and tone during these conversations can make the difference between a paid invoice and a damaged patient relationship. Equip your staff with scripts designed for ophthalmology’s unique situations. This removes the guesswork and ensures every conversation is both effective and empathetic. Maintaining this trust is paramount, and it’s why understanding the legal & ethical considerations in patient soft collections is not just good practice, but a necessity. Here’s a sample script for a common scenario: Scenario: Following up on a past-due balance for cataract surgery where the patient owes co-insurance. Staff: “Hi, [Patient Name], this is [Your Name] calling from [Practice Name]. I’m following up on your recent cataract surgery with Dr. [Doctor’s Name]. How are your eyes feeling?” (Start with care, then transition to business.) Staff: “Great, I’m so glad to hear that. The reason I’m calling is to follow up on the statement we sent for your co-insurance balance of [Amount]. We wanted to make sure you received it and see if you had any questions about how your insurance processed the claim.” (This frames the call as helpful, not demanding.) If the patient has questions: “That’s a great question. Your plan covers 80% of the surgical fee after your deductible, and this balance represents the remaining 20% co-insurance. I can walk you through the Explanation of Benefits from your insurer if that would be helpful. Would you like to pay that balance today over the phone, or would you prefer we set up a payment plan?” This approach is consultative, not confrontational. It preserves the goodwill you’ve built with your patient while moving the account toward resolution.

The ECBC Difference: From Best Practices to Best-in-Class Results

Understanding these strategies is one thing. Implementing them consistently while running a busy ophthalmology practice is another. This is where the gap between knowing what to do and having it done becomes clear. This entire guide outlines the process that a dedicated, specialized billing partner executes on your behalf, every single day. At Eye Care Billing Consultants, our entire model is built on the principles of ophthalmology-specific expertise.

• We Design Clear Statements: Our statements are built from the ground up to answer patient questions before they’re even asked, incorporating plain-language descriptions for everything from visual fields to OCT scans.
• Our Experts Handle the Calls: Our team of seasoned ophthalmic billers – with over 35 years of combined experience – conducts the professional, ethical follow-up. They don’t just know billing; they know how to explain co-management and the nuances of different insurance plans.
• We Leverage Technology for You: Through our exclusive partnership with iMedicWare and our use of the latest billing technology, we ensure timely invoicing, secure patient data, and seamless integration with your practice management system. This approach is a core part of our service, not an add-on.

We turn best practices into guaranteed performance. Our mission is to provide you with the highest collection rates possible by eliminating the errors and communication breakdowns that plague generic billing systems.

Frequently Asked Questions about Optimizing Patient Collections

1. My team is already swamped. How can we implement all of this?

This is the core challenge for most practices. The time and expertise required to perfect patient statements, train staff on scripting, and consistently follow up is significant. A specialized partner like ECBC takes this entire operational burden off your team, allowing them to focus on patient care and in-office tasks.

2. Won’t more follow-up calls upset our patients?

It’s not about making more calls; it’s about making smarter, more helpful calls. Aggressive, uninformed collections tactics damage patient relationships. A professional, consultative approach, like the one we use, actually builds trust by helping patients understand their financial responsibility and providing them with clear, simple ways to pay.

3. How is ophthalmology billing really that different from other specialties?

The difference lies in the unique financial journey of an eye care patient. Navigating vision vs. medical plans, explaining non-covered refractive services, and coordinating co-management billing are daily occurrences in ophthalmology but rare in most other fields. This requires a level of niche expertise that generic billers simply don’t possess.

4. What kind of results can we realistically expect?

By focusing exclusively on eye care, we eliminate the errors and delays common with all-in-one billers. Our clients see a direct impact on their bottom line. For example, one ECBC client reported a 24% increase in revenues and achieved the lowest accounts receivable their practice had ever experienced. Your practice deserves a collections strategy as specialized as the care you provide. If you’re ready to move beyond generic advice and see what a dedicated, expert approach can do for your revenue cycle, let’s talk. Schedule a no-obligation analysis of your current billing process with Eye Care Billing Consultants today.