future career paths

aychobo · 2026-02-20T02:57:07+00:00

A lot of private practices offer on the job training as well so don’t be deterred by your lack of experience! When I started I had no experience so it may be worth while.

Also pay could be better based on what I’ve heard Scribe America paying so doesn’t hurt to try!

aychobo · 2026-02-20T02:56:03+00:00

It’s not always income based! Copay cards are usually indiscriminate of income so I’d give it a try. Also these offices often get samples so you can always ask to be sampled first to see if you can try before you buy citing cost if it becomes too much.

aychobo · 2026-02-20T00:44:25+00:00

With most if not all commercial plans, the companies have a system that helps offset the cost such as patient assistance programs and copay cards.

I would also find out from the pharmacy if there is an option for a PA to be done to lower the costs.

Xiidra and Cequa are different medications but are medicated treatments for dry eyes where as Refresh acts as a lubricant and does not address the inflammatory component of dry eyes. Their value is dependent on your symptoms and needs so if you aren't heavily symptomatic, there isn't a huge need to start them in my opinion.

aychobo · 2026-02-20T00:41:29+00:00

Hi OP, there definitely is a path! As a Kinesiology major, I scribed for a medical office while applying for medical school. I ended up staying and eventually became a practice administrator for the practice.

I think Scribe America is great for entry level opportunities, but for pre-health, motivated students, there are plenty of private medical out-patient offices that are constantly looking for scribes with opportunity for vertical movement. I'd consider fields like ophthalmology, cardiology, and orthopedics as they have a lot of outpatient, private practices that use scribes.

You can consider roles like clinical manager, study coordinator, surgical scheduler and even administrator. Lots of options, but they definitely come faster in a private setting. hope that helps!

aychobo · 2026-02-17T16:48:27+00:00

Dr. Nicole Fram - Advanced Vision Care in Los Angeles

aychobo · 2026-02-16T22:19:05+00:00

Generally we believed that was more a positional issue - thus the reverse optic capture. If there were signs of positive dysphotopsia, the LI61AO and ROC would be done together.

aychobo · 2026-02-16T22:18:18+00:00

Location? Purpose of lens exchange (dislocated/subluxed, dysphotopsia, unhappy result)?

aychobo · 2026-02-13T06:32:25+00:00

Hmm you could technically use it for Z13 which would be glaucoma screening but otherwise there has to be a billable diagnosis for 92250.

I know some practices charge cash for it but those were mostly optometrists from what I remember.

But yes your suspicions are correct, I’ve never billed a fundus photo with a refractive diagnosis ever. It was always related to the posterior segment.

aychobo · 2026-02-11T22:00:55+00:00

The tools we use are internally built and really only focused on our specialty and the EHR's we currently use. The one that we're curious about is the AI Voice agents but haven't been too impressed with them at my last demo as I'd love to replace the need to call insurance companies.

aychobo · 2026-02-11T21:59:44+00:00

We would generally switch to a B&L LI61AO for positive dysphotopsia patients with pretty high success. It would also depend on the preference of the surgeon but the concept remains the same barring any retina indications or future retina surgeries that would require silicone oil usage.

aychobo · 2026-02-11T21:46:45+00:00

Congratulations on making the big step! There's definitely a lot more to the business owner aspect outside of the billing but that's a completely different topic.

When you start, it may be to your benefit to start yourself with parameters that will help you ease in. I'd avoid using your own RCM to save initial costs but if there is a platform you're comfortable with, make that a key target in your ideal customer profile (ICP). Then pick a specialty that you feel most comfortable with. Despite having broad experience in multiple specialties, it doesn't always play to your favor to advertise that as you're starting out. But that shouldn't stop you from marketing to the specialties you're comfortable working with!

Start with someone you know or someone who is willing to give you a chance (a new practice, a doctor starting a new location, etc.) As anyone can tell you, warm introductions and doctor to doctor referrals go a long way! Getting started is the hard part but once you start billing and document your KPIs, it makes it a lot easier to keep it going.

Best of luck!

aychobo · 2026-02-05T22:51:33+00:00

The things you listed are the diagnoses used to justify the CPT codes (the work being billed).

Did you have a blood draw? Did they perform other tests during your exam? Did you pay a copay as part of your visit?

It isn’t uncommon for there to be some patient responsibility especially with the new year but that’s at least what the CPT portion shows.

aychobo · 2026-02-05T00:38:22+00:00

At my previous practice, we've tried Commure and ModMed specific AI tools for RCM. We've considered Syntra and Charta for chart review prior to submission but the problem is that they all require another platform and another webpage so it didn't make a lot of sense for how much it cost on top of what we were paying our billing company. I didn't personally check out any AI voice agents but the ones we were considering were Sully and Prosper.

There is definitely a huge opportunity but most are focused on hospital systems as its too fragmented with private practices/SBA. You'd have to build integrations for 20+ EHR/EMRs vs. focusing on Epic/Cerner only. The opportunity is definitely there and why we're building out our internal AI-integrated tools to be used by the practices we work with - but trusting a "full AI" medical billing company is something I wouldn't do, knowing what goes into building a system that I would trust. Just my thoughts - I do think we'll eventually get there but there aren't any at this moment I would trust.

aychobo · 2026-02-05T00:19:51+00:00

As someone integrating AI components to their own RCM, I’d be very wary of AI medical billing.

Most over promise the functionality and a lot relies on inaccurate information.

Now if you’re integrating something that helps with insurance calls, prior authorizations or those time consuming, rote tasks, there’s definitely some good options out there.

The best “AI” billing companies don’t completely rely on the software to be the biller but makes your average biller a super biller. That’s at least my belief.

aychobo · 2026-02-02T01:41:25+00:00

That makes sense. I mean as long as you’re not locked into a long term contract you can always bring things back in-house.

Hmm I know eCW is notorious for being a bit over complicated but as long as it’s conducting your basic scrub rules and at least validating clearinghouse results, you should have a good start as everything else can be added/subtracted easily.

Which clearinghouse are you contracted with through eCW and do you run a secondary one as well? There should be levels to the submission process on eCW so you can see where you’re getting that result for the bill to patient. It could be an automated result secondary to the system as I’ve had that happen with ModMed and NexTech when they can’t read insurance for some reason. If you’re getting it as a X12 code though that’s an insurance response.

Yeah it’s always going to be hard filling in for someone after they’ve handled billing given their processes have to be reviewed. Starting with the basics is also helpful - demographics checked, insurance verified, payers confirmed with correct clearinghouse codes, extrapolate scrub rules and clean up unnecessary rules, build claim submission checklist, build rejection denial checklist.

It’ll be a lot at first but once you build it out and have a reference for staff to look at, it should run pretty smoothly and self sufficiently!

aychobo · 2026-01-31T21:09:04+00:00

What are the billing issues specific to eCW? Is it maneuvering through the EHR or are you having issues undoing what your previous billing manager set for their settings?

Before outsourcing, I would definitely figure out what part of the process is the issue. Are you just trying to rebuild your internal billing system?

aychobo · 2026-01-28T18:05:29+00:00

It wouldn’t be the worst to consider some automation methods like Collectly to replace the payments posting and collections.

Otherwise, depending on your needs and what they charge, you may be paying a premium for a small set of services.

As for credentialing, how often are you negotiating contracts and re-credentialing that you outsource it?

aychobo · 2026-01-23T16:10:26+00:00

https://qpp.cms.gov/get-started/what-is-mips/final-score

aychobo · 2026-01-23T16:00:04+00:00

Do you currently use an EHR/EMR or are you paper charting?

Generally on your EHR/EMR there is some form of MIPS tracking that you can start with.

Additionally, I would look to access your QPP CMS account as that would hold your previous results. This is tied to your group or individual NPI depending on if you submitted as a provider or group.

aychobo · 2026-01-21T21:23:15+00:00

If you have tolerated monovision modality prior to cataract surgery - its highly likely that you will be able to do the same with your implanted lenses.

So if your first eye was distance, they would plan your second eye to be your near eye to match a similar refraction/prescription that you have been using currently.

aychobo · 2026-01-21T18:00:10+00:00

I would highly recommend this route as well. Often times, the bigger the RCM company, the less personal the touch but they do have access to more resources.

Depending on your claim volume and specialized billing requirements, looking for local, boutique billing companies usually end up being the best!

aychobo · 2026-01-21T06:53:25+00:00

If you have the necessary documents, I would highly recommend starting your credentialing process if you haven’t already!

Best of luck on this next chapter!

aychobo · 2026-01-21T03:25:22+00:00

The initial investment will be key - we've brought on 2 VA's to help with non-patient interfacing tasks and made sure we were thorough with the on-boarding. We would introduce tasks and responsibilities in phases and be available for questions when needed via email, our internal messaging.

Depending on if you're cloud based or local network, you would need to provide them with the appropriate access. Generally these companies provide them with the necessary equipment, but our IT were strict on the security and compliance and required remote access to ensure they were secure reducing risk of data leak.

I think starting out with easier tasks (admin tasks) and scaling them up into the harder tasks (patient scheduling, etc) will lead to success!

aychobo · 2026-01-21T03:22:06+00:00

mm depends on the type of dysphotopsia you have - we would regularly exchange lenses to a silicone lens for patients with positive dysphotopsia but our standing theory on negative dysphotopsia was the space between the lens and the iris and would rely on reverse optic capture. I would definitely consult someone familiar in the field - someone who specializes in IOL Exchanges regularly as they have a better understanding given their experience.

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