Understanding Comprehensive Care for Joint Replacement (CJR) Model

In line with the Obama Administration’s efforts to provide high-quality care while reducing costs, in April 2016 CMS announced an initiative to implement bundled payments for hip and knee replacement surgeries, called Comprehensive Care for Joint Replacement (CCJR). Recently in May 2021 CMS published an 81-page final rule to extend and change the Comprehensive Care […]

Telehealth Billing Guidelines for Orthopedics

During the COVID-19 public health emergency, reimbursements for telehealth continue to evolve. The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. More Medicare Fee-for-Service (FFS) services are billable as telehealth during the COVID-19 public health emergency. In this blog, we shared telehealth billing guidelines for medical billing […]

Improve Orthopedic Collection Process

Orthopedic practice owners are struggling to maintain the financial stability of their practice. There are many reasons for this struggle as expenses aren’t declining while reimbursement from payers isn’t increasing. As per a recent orthopedic billing survey, more than 30% of orthopedic surgery claims are incorrectly submitted. Such a high portion of rejected and denied […]

Understanding Global Period for Orthopedic Surgery

Basics of Global Period In Orthopedic surgery, the global period can be an important consideration for the billing of services. A global period is a period of time starting with a surgical procedure and ending some period of time after the procedure. Many surgeries have a follow-up period during which charges for normal postoperative care […]

Medicare Reimbursement for Orthopedic Surgery

The Centers for Medicare & Medicaid Services (CMS) sets reimbursement rates for Medicare providers and generally pays them according to approved guidelines such as the CMS Physician Fee Schedule. Medicare reimbursement for orthopedic surgery follows the same set of rules; however, recently the amount of Medicare reimbursement for orthopedic trauma surgery has fallen by nearly […]

How to manage Orthopedic Bundled Payments?

In a bundled payments model, providers and/or healthcare organizations receive a single payment for all the services delivered during an episode of care. When it comes to Orthopedic Bundled Payments, these models are becoming more sophisticated and standardized with the help of analytic insights based on collected data from surgeons. CMS has made numerous changes […]

Is orthotics the same as orthopedics?

Is orthotics the same as orthopedics? If you are looking for an answer then you are at the right place. An orthotic is a device that supports and stabilizes a joint or weakened/injured body part, creating proper alignment, pressure relief, and management of pain while orthopedics is a branch of medicine that focuses on the […]

Impact of COVID-19 pandemic on Orthopedics

COVID-19 has impacted the day-to-day life of people, businesses, manufacturers, and even the healthcare industry. COVID-19 pandemic has also affected the orthopedics field by which doctors are not effectively concentrating on their regular patients. The shortage of physicians and support staff and even the ventilators, medicine, and other equipment and devices are the major concerns […]

Common Practice Challenges Faced by Orthopedic surgeons

There are many distinctive as well as common practice challenges faced by orthopedic surgeons over and again. These encounters mainly hinder their business cycle, and sometimes you may also find orthopedic healthcare units closing down. Challenges like rising or unavailability of implants and their costs, healthcare reform implementation, and a clean revenue cycle in the […]

CMS 2018 Final Rule To Impact Orthopedics ASCs

The Center for Medicare and Medicaid Services (CMS) has issued the final rules on Ambulatory Surgical Center (ASC) reimbursement and changes that could have important implication on the orthopedics billing in ASC. The rule includes update to payment policies, payment rates and also the quality provisions for the services provided under the Physician Fee Schedule […]

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