There are many distinctive as well as common 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 its costs, healthcare reform implementation and a clean revenue cycle in the form of error-free medical billing and coding that amplifies the reimbursement rates.
When we talk about the orthopedics field its main role is in patient care. But, professionals working today are undergoing changes in their working environment and autonomy. Orthopedic surgeons and facilities can look very well look forward to this ongoing phenomenon as the ability to serve and help increasing numbers of our patients.
Here are few critical but common challenges facing orthopedics and how you can overcome these obstacles.
Are Implants Costly?
A big area of concern related to the revenue cycle management of the orthopedics in surgery centers is the implant costs and reimbursement rates.
Numerous procedures that we could perform and probably save the patient and insurance company money; like the open reduction internal fixation of a distal radius fracture, as of now are not possible at many centers in the United States. Also, some of the insurers will not pay for implants and pay only the facility fee. Very often, the total amount is less than the cost of the implants, making these procedures impossible to perform from a financial perspective.
Expensive implants that surgeons want to use are also a burden to profitable orthopedics. And experts in the field see this as a significant challenge for not only for a solitary orthopedic facility but to many centers.
As a solution to overcome this challenge it’s vital to look at the benefits and prove that it is worth the expense. If it improves your facilities RCM then it’s worth it. If it’s just like the ones that are already in the market, then you’d be making changes.
Getting the perfect equipment at the best price is still a challenge for orthopedic practices. The surgery center setting may end up needing updated medical equipment as a situation arises where every surgeon may want to use a different product. However, doing so can quickly drive up costs and reduce the orthopedic center’s ability to make bulk and discounted purchases.
Orthopedic practitioners should attempt and standardize equipment when possible, allowing better price negotiation.
According to industry experts, all the new equipment at the center should be agreed on pricing before they can be used and purchasing orders are issued.
If your orthopedic center is successful and has the potential to undertake many cases in a day, the facility should have enough and updated equipment to facilitate the patients.
Inaccuracy leads to Claims Being Denied
Orthopedic medical billing is directly tied to your profitability. The income cycle needs to consistently flow into the practice, which clearly says that you’re coding needs to be clean.
When there are errors in the billing and coding processes it could hold up claims for a long period of time. Also keep in mind that even if you have the best in-house medical coding and billing team, they can make mistakes if they are overwhelmed, and much can go overlooked.
The solution to this problem is to perform audits on a regular basis. Medical auditing by professionals can provide areas of improvement for your coding team.
Medical billing auditors can diagnose under coding, bad unbundling habits, and overuse of codes. The coding staff will then be able to charge appropriately for documented procedures.
The up-to-date running of an orthopedic practice comes with various challenges. Some of which are scheduling appointments, creating a dependable team and the overall expenses of running your practice.
Let our experts handle your orthopedic medical billing and coding needs…
At Medical Billers and Coders we assure you of taking at least one thing off from the long-running list of your daily work, which is to make sure the practice remains profitable.
Our team of certified and professional medical coders and billers has needed experience you need and specialize in orthopedics and surgery.