Optometry Revenue Cycle Management

Your claims have a second life.

Claims chases down every denied VSP and EyeMed remit, reconciles 835 files against your appointment ledger, and turns aging A/R into collected revenue — before write-off deadlines hit.

$0.0M

recovered this quarter

0.0%

first-pass acceptance rate

0-day

average time-to-payment

CLAIM LEDGER
CLM-8821
VSP
$312.00
DENIED
CLM-8822
EyeMed
$189.50
PAID
CLM-8823
Davis
$445.00
PENDING
DEPOSIT QUEUE
RECOVERED TODAY
$14,820
VSP Vision Care+$4,312
EyeMed Access+$6,108
Davis Vision+$4,400
ERA AUTO-POST
835 ✓
47 remits reconciled
089%
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Certified with

VSP
EyeMed
Davis
Spectera
Superior
Live connections
Capability Matrix

Every broken claim has a recovery path.

Browse by capability. Each card flips to reveal the exact metrics and payer coverage relevant to your workflow.

VSP CERTIFIEDEyeMed CERTIFIEDDavis CERTIFIEDSpectera CERTIFIEDSuperior CERTIFIEDVSP CERTIFIEDEyeMed CERTIFIEDDavis CERTIFIEDSpectera CERTIFIEDSuperior CERTIFIEDVSP CERTIFIEDEyeMed CERTIFIEDDavis CERTIFIEDSpectera CERTIFIEDSuperior CERTIFIEDVSP CERTIFIEDEyeMed CERTIFIEDDavis CERTIFIEDSpectera CERTIFIEDSuperior CERTIFIED

Denial Management

Automatic rework engine

Every CO-4, CO-97, and PR-1 code gets a resubmission workflow triggered in under 4 hours.

94%denial overturn rate
VSPEyeMedDavisSpecteraSuperior

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Denial Management

Performance Metrics

Avg resubmit time3.8 hrs
Overturn rate94%
Codes covered180+
Payer portals5 major
VSPEyeMedDavisSpecteraSuperior

ERA Auto-Posting

835 file reconciliation

Ingest 835 files, match every payment line to your appointment ledger, flag discrepancies before they age.

99.1%posting accuracy
VSPEyeMedDavisSpectera

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ERA Auto-Posting

Performance Metrics

Posting accuracy99.1%
Daily 835 filesUnlimited
Ledger match rate99.4%
Discrepancy alert< 1 hr
VSPEyeMedDavisSpectera

Eligibility Verification

Real-time benefit checks

Batch-verify patient benefits 48 hours before appointments. Zero surprise denials at the chair.

48 hrspre-appointment window
VSPEyeMedDavisSpecteraSuperior

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Eligibility Verification

Performance Metrics

Verification window48 hrs prior
Batch sizeUnlimited
Response time< 3 sec
Payer connections2,400+
VSPEyeMedDavisSpecteraSuperior

Payer Enrollment

Credentialing & contracts

New location? New provider? We handle CAQH, VSP panel applications, and EFT setup end-to-end.

21 daysavg enrollment time
VSPEyeMedDavisSpectera

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Payer Enrollment

Performance Metrics

Avg enrollment21 days
CAQH managementIncluded
EFT setupAutomated
Panel appsAll majors
VSPEyeMedDavisSpectera

Aging Bucket Triage

A/R prioritization engine

Claims approaching timely-filing limits surface to the top automatically. 90-day buckets get daily attention.

$0write-offs missed
VSPEyeMedDavisSpecteraSuperior

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Aging Bucket Triage

Performance Metrics

Alert threshold30 / 60 / 90 day
Write-off preventionActive
Priority scoringAI-ranked
Dashboard refreshReal-time
VSPEyeMedDavisSpecteraSuperior

Provider Credentialing

License & DEA tracking

Track NPI, DEA, state licenses, and malpractice across every provider in your organization.

100%expiration coverage
VSPEyeMedDavis

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Provider Credentialing

Performance Metrics

License types12 tracked
Expiry alerts90/60/30 day
Multi-locationUnlimited
CAQH syncAutomated
VSPEyeMedDavis
Practice Diagnostic

Find the configuration for your scale.

This isn't a feature list — it's a diagnostic. Match your practice size to the right recovery engine.

Solo OD
Independent practice, 1–2 providers
$299/mo
Most Common
Multi-Location
Optical chains, 3–15 locations
$899/mo
PE Roll-Up
Private equity, 15+ acquired practices
Custom
Monthly claim volume
< 500
500–5,000
5,000+
Payer portals managed
1–3
4–8
All majors
ERA auto-posting
Denial management
A/R aging dashboard
Basic
Advanced
Enterprise
Payer enrollment
Multi-location rollup
PE metrics normalization
Dedicated billing manager
Optional
Custom reporting API
Outcomes

The numbers speak for themselves.

$2.1M
in denied VSP claims recovered
Single-location practice, Phoenix AZ
Female optometrist in white coat reviewing patient charts in modern clinic

We were writing off $18,000 a month in VSP denials because we didn't have bandwidth to chase them. Claims recovered $214,000 in the first quarter.

Dr. Rachel Nguyen
OD, Precision Eye Care — Houston, TX
11 days
from submission to deposit
Down from 34-day average
50+
PE practices normalized
$4.2M
recovered Q1 2026
97.3%
first-pass rate
6 hrs
avg denial resubmit
Professional man in business attire at desk with computer screens showing data dashboards

Before Claims, our billing manager was logging into six payer portals before noon. Now she reviews one dashboard and the engine handles the rest.

Marcus Okafor
VP Revenue Cycle, LensCraft Group — 12 locations
Denial Code Cheat Sheet
CO-4
Service inconsistent with payer policy
Verify coverage dates & benefit period
CO-97
Payment adjusted for service covered by capitation
Confirm capitation contract terms
PR-1
Deductible amount
Collect patient balance at point of service
CO-11
Diagnosis inconsistent with procedure
Review ICD-10 & CPT code pairing
CO-22
This care may be covered by another payer
Verify COB order & resubmit to primary
+175 more codes unlocked with email

Googling rejection codes at 11pm?

Get the complete optometry denial code reference — 180 codes, fix actions, and payer-specific notes. Free download, email only.

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Free · No commitment · 48-hour turnaround

Stop writing off revenue you've already earned.

Tell us your practice size and primary payer. We'll show you exactly how much recoverable revenue is sitting in your denied and aging buckets.

Free A/R Audit — See your recoverable revenue in 48 hours
4 fields · No commitment · Results delivered by email