Monday, October 26, 2015

From the AOA: CMS Will Issue Comparative Billing Reports to 6,500 Doctors of Optometry this Week

Doctors of optometry should be aware that the Centers for Medicare & Medicaid Services (CMS) has contracted with eGlobalTech to provide comparative billing reports (CBRs) to doctors of optometry. CBRs will be sent to 6,500 doctors of optometry this week. The CBR will come directly from eGlobalTech. The majority of doctors who have been selected to receive a CBR will receive the report via fax. In some cases the report will be sent via mail if a physician does not have a fax number listed in the CMS National Plan and Provider Enumeration System (NPPES) or if more than 5 doctors in a practice were selected to receive a CBR. If you are one of the 6,500 doctors of optometry that have received a CBR, here are the top 5 things you need to know:

1. CBRs are educational reports that provide comparative data which demonstrates how you compare to your peers. These reports are not intended to be punitive in nature and are not intended to be used to make assumptions regarding how you practice. CBRs have been issued to many specialties and were issued to ophthalmologists in April focusing on many of the same services that are included in the optometry CBR.

2. CBRs are not an indication of fraudulent or inappropriate billing. Even if a report indicates that you are an outlier compared to your peers, this is not an indication of fraudulent or inappropriate billing. There are many reasons a doctor could be considered an outlier compared to peers. If you received a CBR and are surprised regarding how your practice compares to peers, this is a great opportunity to conduct a self-audit. Additionally, if the data reported from CMS differs greatly from your billing records, the report provides an opportunity to correct any billing information transmission problems between your practice and CMS.

3. A number of factors were considered when selecting which doctors of optometry would receive a CBR. First, the universe of doctors of optometry enrolled in the Medicare program was identified. Then the codes that were reported most frequently by doctors of optometry were identified. eGlobalTech then selected measures to evaluate doctors of optometry based on most frequently billed services. Any doctor who was an outlier based on one of the measures selected was placed into a pool of physicians that could potentially receive a CBR. Out of that pool of physicians, any doctor who treated fewer than 115 Medicare beneficiaries and billed less than $15,000 from July 1, 2014, to June 30, 2015 was eliminated from the pool of potential CBR recipients. Out of that remaining group, 6,500 doctors of optometry were selected to receive a CBR.

4.Attend the CBR Webinar. On Wednesday, November 18, 2015 from 3:00 p.m. – 4:30 p.m. Eastern Time a webinar will be held to review the CBRs. There will be a question and answer session following the presentation. Register for the webinar at: If you are unable to attend the webinar, a recording will be available 5 days following the presentation.

5. AOA is here to help. If you have questions regarding your CBR, please contact Rodney Peele or Kara Webb

eGlobalTech can also be contacted through their CBR Support Help Desk: 1-800-771-4430 or via email at:

Thursday, October 15, 2015

POA members meet with Rep. Ryan Costello

Dr. Kevin Rehak, Rep. Ryan Costello, Dr. Yujia Jones, Dr. Lori Gray, Dr. Richard Christoph, Dr. Karen Rule, and Dr. Charles Stuckey met at Dr. Gray's practice to have an informal meeting to discuss optometry and some current national legislative issues.