Most practices do not need to hand their revenue to a billing company at a percentage of collections. They need one trained person working the claims queue every day. That is what an optometry billing virtual assistant is.
Optometry bills two kinds of payers, and both are getting harder. The Optum 2024 Revenue Cycle Denials Index put the average claim denial rate at 12 percent in 2023 and found that 84 percent of denials were potentially avoidable (Optum, 2024). Experian Health's 2025 State of Claims survey found 41 percent of providers now see more than 10 percent of claims denied, up from 30 percent in 2022, and 68 percent say submitting clean claims is harder than a year ago (Experian Health, 2025). MGMA's own benchmarking puts first submission denials at 7 to 8 percent across the past four years (MGMA Stat, July 2026).
Each denial costs money to fix, and many are never fixed. MGMA cites an average cost of $25.20 to rework a claim, and reports that 48 percent of avoidable denials are not recoverable (MGMA). The pattern holds even where appeals work: the AMA found that 83.2 percent of prior authorization denial appeals succeeded in 2022, yet only one in ten of those denials were appealed at all, with 48 percent of physicians citing insufficient staff time as a reason (AMA, 2024).
For optometry specifically, the AOA's income survey reports that owner doctors collected 84 percent of billings in 2021, with revenue split 31 percent direct patient payment, 30 percent vision plans, 23 percent private medical insurance and 16 percent government programs (AOA, 2022 Survey of Optometric Practice Income). Nearly seven dollars in ten come through a payer. The claims queue is the practice's cash flow.
There are three ways to keep that queue worked. They are priced very differently, and they leave the practice with different amounts of control.
| Factor | Outsourced billing company | In-office biller | Billing virtual assistant (EyeCareWorks) |
|---|---|---|---|
| Pricing model | A percentage of collections, typically 4 to 7 percent of monthly collections per one vendor's published guide; another vendor's worked example is 5 percent, or $25,000 on $500,000 collected (Medisys, CureMD) | Median $24.59 an hour for a medical records specialist, May 2025, plus payroll taxes and benefits (BLS) | Flat $10 an hour for tracked hours, billed weekly, no contracts. Full time is about $20,800 a year |
| Where the work happens | In the vendor's system; your data and your claims history live with them | In your practice management system | In your practice management system, clearinghouse and payer portals, under your logins |
| Who does it | A team you rarely speak to, working many practices | One person; coverage stops when they are out | One trained person assigned to your practice, with a free replacement if the fit is wrong |
| Scope | Claims, denials, posting, statements, reporting | Whatever the role is defined as | Claims follow up, denials and appeals, payment posting, prior authorizations, eligibility, and front desk backup if you want it |
| Best for | Practices that want billing fully off their plate and accept the percentage | Large practices with volume for a full department | Practices that want the queue worked daily, inside their own system, at a known cost |
The honest line: a billing company is a fair choice for a practice that wants to hand the whole function over. A billing virtual assistant is for the practice that wants to keep it, and simply needs the hours.
Two boundaries, stated plainly. First, coding decisions stay with your doctors and your certified coder. The assistant works the claims your practice produces; they do not choose the code. Second, this is not a billing company with a percentage of collections. You are paying for a person's tracked hours, and you can see every hour in the weekly report. If you want a firm that takes contractual responsibility for your entire revenue cycle, that is a different product, and the comparison above is meant to help you choose it with open eyes.
Every assistant holds a HIPAA Certificate of Completion, passes a background check, and signs a Business Associate Agreement directly with your practice before any system access, which is what HHS requires of anyone who handles protected health information on a practice's behalf (HHS). Work happens over an encrypted remote session into your own systems, with individual credentials, multi-factor authentication, and no patient or payment data stored on the assistant's workstation. Time and activity are tracked to the minute. The full arrangement is on our HIPAA compliant virtual assistant page.
No contracts. No setup fees. Cancel anytime.
Works your claims queue every day inside your own practice management system: pre-submission checks, clearinghouse rejections, denials and appeals, payment posting and reconciliation, A/R follow up by payer, and prior authorizations. Vision plan claims and medical claims both.
A billing company takes the function into its own system and charges a percentage of collections, typically in the 4 to 7 percent range per published vendor guides. A billing virtual assistant works inside your system under your logins for a flat $10 an hour, and you keep control of the data, the process and the reporting. Coding decisions stay with your doctors either way.
A flat $10 an hour for tracked hours, billed weekly, with no setup fees and no contracts. A full time assistant is about $20,800 a year. For comparison, the BLS May 2025 median wage for a medical records specialist is $24.59 an hour before payroll taxes and benefits, and 5 percent of $500,000 in collections is $25,000.
Yes. Assistants work through a secure remote session into the systems you already use, including RevolutionEHR, Eyefinity, Crystal PM, Compulink and your clearinghouse and payer portals. Nothing is installed and no data leaves your environment.
Yes. Eye care assistants are trained on the vision plan portals and on medical claims to Medicare and commercial payers, including the routine versus medical determination that causes so many eye care denials in the first place.
No. Coding stays with your doctors and your certified coder. The assistant works the claims your practice produces, flags mismatches for review, and keeps the queue moving.
Every assistant holds a HIPAA Certificate of Completion and signs a Business Associate Agreement directly with your practice. They work over an encrypted session with individual credentials and multi-factor authentication, and no patient or payment data is stored on their workstation.
A short call to walk through your payer mix, your current denial and A/R picture, and what the first two weeks would cover.
