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5 Tips to Optimize Your Orthopedic Practice Billing Process

Effective administration of medical billing and coding is crucial to the success of any orthopedic practice. Many orthopedic doctors find it difficult to follow through on their claims and bill payments because the healthcare system is a complicated maze. Fortunately, the practice managers can use orthopedic medical billing services to ease the orthopedic practice billing process and increase their bottom line and hasten cash flow.

Medical billing facilities can concentrate on patient care while utilizing advanced systems, streamlined procedures, and technological know-how to expand their practices by outsourcing to orthopedic practice billing businesses. 

Here are five suggestions for improving an orthopedic practice’s revenue cycle procedure.

1. Get your claims out there as soon as possible

As soon as you can, send clean claims out. Have the procedures in place to guarantee that clean claims are submitted up front, he advises, and you will profit later. A crucial step in processing clean claims quickly is having a procedure in place to verify a patient’s insurance status or coverage.

The office staff will be able to handle the patient more effectively if the practice uses automation technology to put a mechanism in place to verify insurance coverage before the visit, especially if insurance coverage has just been cancelled. Through fewer rejections, this approach will enable faster payouts.

2. Motivate staff to pay strict attention to accounts receivable

A practice management support company needs to monitor the accounts receivable and invoicing process. The physician frequently trusts workers to manage the A/R and billing process as effectively as possible, but occasionally it’s not being handled appropriately.

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Because they are managing the practice’s cash flow, the qualified staff who perform revenue cycle duties should receive fair compensation. Employees in oversight need to be held responsible, given incentives and recognized for their efforts. Orthopedic practices should give revenue cycle managers clear objectives, such as keeping the number of accounts receivable (A/R) older than 120 days at 15% or less of total A/R and a net collection ratio of more than 95%, and rewarding staff when objectives are fulfilled.

3. Use software for tracking payments

When a doctor signs a contract with a payer, they frequently anticipate that the terms of the agreement would be followed. Payors occasionally underpay on contracts, and losing this money might significantly affect the practice. According to Dave Wold, CEO of Healthcare Information Services, one of his clients recently found over 500,000 underpayments, and another found 100,000 cases where the payor ceased paying for a second operation despite the contract’s instructions to do so. 

The doctor can enter various negotiation schedules into payment monitoring software and then run the payments through to make sure the payor is adhering to the terms of the contract with each claim.

4. To ensure accurate coding, don’t rely just on technology. 

For many healthcare practitioners, electronic medical records (EMR) are the way of the future. One of their features is automating the surgeon’s dictation and generating a report. Surgery professionals can greatly benefit from using electronic medical records (EMRs), but they shouldn’t expect that the software will always be able to code claims appropriately.

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For instance, five treatments may be carried out in two compartments during arthroscopic knee surgery. The EMR software may only allow surgeons to select from pre-populated “drop-down menu” options, preventing them from specifying that a number of procedures were carried out in one compartment before moving on to another. In this instance, the EMR menu’s oversimplification would materially alter how this procedure is classified and consequently reimbursed. Surgeons need to understand how their dictated CPT codes are created and how it may impact the bottom line.

5. Audit charts to ensure proper coding. 

Examine the medical records to make sure the surgeons are accurately reporting or classifying the services provided and recording all applicable codes. The surgeon must be aware.

Lastly, you can hire orthopedic medical billing services for the optimization of your orthopedic practice billing, which will take all the work from your plate, will take care of all the medical billing work on your behalf and you will get plenty of time to focus on your patient’s health.