Ophthalmology and Optometry

Ophthalmology and Optometry Billing Cash Flow

Your medical eye care and routine vision claims run on different timelines, while cataract surgery and anti-VEGF injection balances sit 30 to 90 days with commercial payers.

The problem

Medical eye care claims sit while balances grow.

UnitedHealthcare and Anthem can take 30 to 90 days to pay a comprehensive eye exam or a surgical claim, and Cigna and Aetna are rarely faster. Split billing routes medical eye care to commercial health plans on one timeline while routine vision services run on another.

While you wait, high-cost cataract surgery and recurring anti-VEGF injection balances stay tied up.

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Eye care payers, days to pay

UnitedHealthcare75 days
Anthem64 days
Cigna54 days
Aetna45 days

Commercial medical eye care claims routinely sit 30 to 90 days while high-cost surgical and injection balances stay tied up.

Service-line purchasing

Purchased at the code level, not blended.

Copay prices each claim individually at the service line, using how that specific code performs with your payor, so a 66984 cataract procedure is valued on its own merits rather than a portfolio average. A 92083 extended visual field examination is priced the same way.

Every eligible ophthalmology and optometry code is funded the next business day.

Codes Copay purchases

92014Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visitsEligible for purchase
66984Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical techniqueEligible for purchase
67028Intravitreal injection of a pharmacologic agent (separate procedure)Eligible for purchase
92134Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; retinaEligible for purchase
How it works

How Copay works for your practice.

Your billing team submits claims exactly as they do today. Nothing changes except when you get paid. Copay reads claim data at the clearinghouse layer, so there is no new software and no retraining.

Connect once, keep your EHR and payor relationships, and let eligible claims fund automatically.

See how it works
01

Connect

Connect your billing software once. Takes minutes, no IT ticket.

02

Submit

Submit claims through your existing EHR exactly as you do today.

03

Get paid

Capital lands in your account the next business day, by ACH.

Non-recourse

A tied-up cataract balance is our risk, not yours.

Non-recourse means a denied eligible claim is Copay's loss, not yours. When a high-cost 66984 cataract claim is purchased non-recourse and funded the next business day, that large balance no longer sits on your books, and if the commercial plan later denies it, your capital is not clawed back.

See how non-recourse works

Large balance, absorbed

Claim 66984

UnitedHealthcare · $1,650.00

Tied up

A high-cost cataract balance is exactly the gap Copay closes.

Funded the next business day, before the commercial plan ever resolves the claim.

Common questions

Eye care billing, answered.

No. Copay is not a loan, not factoring, and not a merchant cash advance. Copay purchases your eligible ophthalmology and optometry claims outright and deposits funds the next business day, with no debt and no repayment schedule.

Copay purchases eligible commercial ophthalmology and optometry claims, including those billed to UnitedHealthcare, Anthem, Aetna, Cigna, Humana, and Blue Cross Blue Shield plans.

Medical eye care claims that go to commercial health plans are eligible for purchase and fund the next business day, regardless of the slower timeline those payors run. Routine vision services billed to vision plans follow a separate track, so the medical side of your book never waits on the vision side to settle.

Yes. High-cost cataract surgery claims and recurring intravitreal anti-VEGF injection claims are exactly the large balances that tie up your cash. Copay prices each claim at the service line and funds eligible claims the next business day, before the commercial payor resolves them 30 to 90 days later.

No. Your billing team submits claims exactly as it does today through your existing EHR, billing software, or clearinghouse. Eligible claims are funded the next business day.

How Copay works for ophthalmology and optometry practices

From submitted claim to funded account.

While insurance takes 30 to 90 days, Copay moves in one.

Step 01 · Submit

You submit your claims as normal

Nothing changes about how your billing team works.

Claim #18473

DOS 02/04/24

CPT code66984

Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure)

PayerAetna
Billed$1,650.00

Step 02 · Verify & Price

We verify and price in real time

Copay checks payor history and prices the claim at the CPT level.

Underwriting in progress

Step 03 · Approved

Advance approved

Capital is approved and scheduled for next business day deposit.

Advance Approved

$9,000

Net advance

Funds wired to your account, next business day

Step 04 · Funded

Capital in your account

While the payor takes 30 to 90 days, you already have your capital.

Your account

$0

Available balance

Copay reconciles automatically when the payor pays. You do nothing.

Get paid on your ophthalmology claims the next business day.

Copay purchases your eligible ophthalmology and optometry claims. No loans, no personal guarantee, no workflow change.