Orthopedic billing is a crucial process of any orthopedic practice. To keep your practice running smoothly by minimizing claim denials and cash flow problems, It is important to keep in mind a few aspects while billing:
- Double-check patient information,
- Verify insurance coverage,
- Use the right code and
- File your claims quickly.
How Does Orthopedic Billing Work?
Orthopedic billing begins with proper documentation before, during, and after a patient’s visit. It’s important to pay proper attention to coding during the full extent of services. Why?
- One, for maximizing reimbursement and minimizing claim denials and
- Second, for year-end service cost analysis
Simple errors like missing or incorrect patient information such as name spellings, date of birth can result in a rejected claim. Apart from errors, it’s important to know insurer preferences and deadlines. With ICD-10, coding has become more precise than ever. So, it’s important to train your staff completely on the changing rules, regulations, and practices to avoid severe fees and penalties. If orthopedic billing and coding are mishandled or small details are overlooked, it may result in disastrous consequences for practices. Even small errors or inefficiencies may lead to reimbursement delays and denials or audits. No doubt, failure to comply with payers is less detrimental than compliance with HIPAA and state regulation.
Orthopedic provides an extensive range of services for patients that includes injury prevention, correction in the joints, muscles, and ligaments, etc. When it comes to handling medical billing and coding services, it surely translates into a complex process. But if you have no time to train your in-house staff or feel that your billing management is too complex, it’s advisable to outsource your orthopedic billing services to reduce your stress and increase reimbursements.
Advantages of using Orthopedic Billing Outsourcing Services:
- Outsourcing your billing to Orthopedic Billing professionals with the experience and knowledge of perplexities of orthopedics eases all your efforts required for updating your staff and systems. These professionals have the required knowledge of the complex rules utilized by carriers to adjudicate claims and the ever-changing CPT codes and associated modifiers applied to ensure proper reimbursements.
- With certified medical coders and Orthopedic specialized billers, these billing services can help you identify past billing problems and denied claims. The professionals evaluate the underpayments and submit claims appeals with correct documentation. The bill appropriately using correct ICD, CPT, and modifier codes, ensuring maximum reimbursement.
- Outsourcing billing services help in reducing the overall cost of regular training and education of the staff, ensuring the staff focuses on the tasks they are more experienced and comfortable at, and providing valuable care to the community.
- Since all the information and coding of all the charges are correctly processed at the very first time, reimbursements are quick and your practice gains the added benefit of lower than industry average accounts receivable balances.
- Apart from that, these trained and experienced professionals track each claim meticulously until the payments are received. They do the required A/R follow-up with payers and patients.
Outsourcing your orthopedic billing services can actually increase your net revenue and ensure that you receive the maximum amount covered by the insurance companies while minimizing any out-of-pocket expenses for your patients.
It’s important to be sure that the company you hire understands the orthopedic specialty while getting you every dollar you deserve!