As an orthopedic specialist, are you sure your billing practices aren't leaving millions on the table? The fear of incorrect orthopedic coding, facing payer audits, and managing complex coding procedures can be overwhelming.
Yet, underestimating medical decision-making or missing out on code specificity can drastically impact your revenue. It is time to ensure you are collecting every dollar you deserve while maintaining compliance.
Improving your net collection ratio is essential for ensuring you collect all legitimate reimbursements. Many practices mistakenly believe they perform well in this area but often misunderstand contractual adjustments.
Aim for a net collection ratio greater than 95%, with top practices achieving up to 99%. This can significantly boost your cash flow and bottom-line results.
Minimize your days in accounts receivable (A/R) to improve cash flow. Industry benchmarks suggest keeping your A/R days under 45. Faster collections lead to a healthier financial outlook for your practice.
Lowering your denial rate is crucial for maximizing insurance payments. Denials often result from inaccurate coding or submission errors. Aim for a denial rate between 5% and 10% to ensure quicker, more accurate payments.
Improving your rejection rate, which measures the percentage of claims rejected before processing, is vital. The industry benchmark for rejection rate is 5% or less.
Reducing rejections ensures timely, accurate claim processing and payment––easing the administrative burden and enhancing cash flow.
Orthopedic specialists face unique challenges with complex coding guidelines and tight schedules. Outsourcing billing services to reputed providers like Medical Billers and Coders (MBC) can be a game-changer.
Take control of your orthopedic billing today and ensure you are not leaving millions on the table. MBC can help in analyzing key performance indicators and optimizing your revenue collection.
Contact Medical Billers and Coders today to transform your orthopedic billing and secure the financial health of your practice.
A: Common CPT codes include 29877 for knee arthroscopy, 27130 for total hip arthroplasty, and 23410 for rotator cuff repair. Understanding these codes is crucial for accurate billing.
A: Staying informed about updates from the Centers for Medicare & Medicaid Services (CMS) and the American Academy of Orthopaedic Surgeons (AAOS) is essential. Regular training sessions and utilizing advanced coding software can help maintain compliance.
A: Modifiers such as -59 (distinct procedural service) and -LT/-RT (left/right side) provide additional information to procedure codes––ensuring accurate billing and reimbursement. Proper use of these modifiers can prevent claim denials.
A: Integrating Electronic Health Record (EHR) systems and coding assistants can enhance documentation accuracy, reduce errors, and streamline billing processes, ultimately improving reimbursement rates.
