The process of coding and billing can be quite complex for orthopaedic practices. Codes and specific modifiers required for obtaining maximum revenue are always changing and this has resulted in a unique set of billing challenges for this specialty. To make matters worse, orthopaedic fee schedules are getting reduced every year.
It is becoming difficult to conduct operational functions without implementing the latest technology required for medical billing and coding procedure. Preparation for ICD-10, compliance to HIPAA and other reforms have put so much pressure on providers that they outsourcing their billing needs to an external company-
- CPT Manual introduced various coding changes and revisions in 2013, affecting orthopaedic reimbursement
- With 500 code changes in Category I codes, orthopaedic coding has become more complex
- There has been a complete overhaul of nerve conduction study codes. Two set of new codes for shoulder and elbow revision have been added along with a new spine fusion code
- Varied mix of payers, workers compensation and personal injury liens can lead to inaccurate coding, increase in denials and delay in claim submission
- Due to an increase in number of patients, documentation requirements have also increased, asking for more time and effort to handle reimbursement collection
- Practice costs have also increased, causing disruptions in cash flow of orthopaedic practices
Even though coding changes such as ICD-10 will benefit orthopaedic billing and coding in the long run, practices with limited resources will be the worst hit. They will face challenges in meeting the rising requirements in order to maintain profitability at their practice.
Practices will lose out on a major part of their revenue due to failure in meeting the above-mentioned challenges. They will also have to deal with staffing issues as it can be difficult and expensive to hire well-trained coders and billers.
Outsource billing requirements and ease the financial pressure:
The unique set of challenges in orthopaedic billing can be solved with extensive knowledge of complex rules that are utilized by insurance carriers to adjudicate claims. Accuracy in claim submission and timely payments can be achieved only with constant training and use of latest technology.
Outsourcing will help practices eliminate the headache of hiring or training new staff for handling the complexities of orthopaedic coding.
By outsourcing you can:
- Reduce account receivables
- Get claims paid quickly
- Enhance your ability to focus on patient care
- Error-free coding
- Early re-processing of denied claims
- Track and pursue underpayments accurately
Medicalbillersandcoders.com has a strong team of well-trained coders and billers who are experienced in handling orthopaedic medical billing. We have been offering consistent services to physicians across 50 states in the US. Our aim is to help you deal with medical billing challenges that are caused due to changes and revisions.
We will handle your revenue cycle management while you concentrate on quality healthcare provision. You can either take our entire suite of services or get it customized as per your requirements.