Refining Your RCM Strategy for Orthopedic Practice

A channelized-strong RCM partner can allow Orthopedic Practice to avoid leakages in the RCM process. The healthcare rules and regulations are pushing the healthcare industry towards lowering the cost of services and equipment beyond the tipping point.

Dr. Brian an Ohio-based orthopedic center works as an independent orthopedic center the major chunk of their resources was used for scheduling prior appointments with a patient which included the verification of patient insurance history. The second reason where the clinic used to waste their money was in managing claims. These are two reasons that have drained the revenue from the orthopedic clinic and many other Orthopedic Practices. Such aspects have leaked some of the viable staff from the current settings. For healthcare providers, the major challenge is changing the current process for Revenue Cycle Management (RCM).

With new codes and technology already adding the backburner to your reimbursement why not take your viable resources to place which would add value to the process of reimbursement. As an orthopedic physician, you can save a significant amount of resources by hiring a remotely working company on your Revenue Cycle Management (RCM).

Orthopedic Surgeon Dr. Brian “There is a significant resource drain in the current system. We are not able to make the best use of our resources, some of our patients are unhappy because the front desk doesn’t reply back. We need to change the way our resources are handled and how our current revenue management system works?”

Dr. Brain approached us to make some changes in the current process they follow while a patient calls in to book an appointment and the further RCM process. Medical Billers and Coders (MBC) made some significant changes in the Admin work rather than in Orthopedic Practice. MBC used some key aspects to reduce the denial rate and free up the staff which has been engaged in the insignificant paperwork. As soon as a patient books their appointment the insurance number is verified by our billers, this reduces the likelihood of errors when the patient comes in on the appointed time and reduces the administrative load.

The next step starts after complete diagnoses and treatment or after the step-by-step treatment where a team of expert coders works on your documentation and notes-audio/ written to provide with the perfect superbill and generate an impeccable CMS-1500.

For Dr. Brain, MBC has reduced the claim denial from 11 percent to 4 percent for his Orthopedic Practice.

The brain also added that “The RCM documentation process is long and tedious; if we start appreciating the process once we understand how the process works. MBC has helped my staff greatly in that forefront; we mentally changed the way we look at an RCM process. Every staff member now knows what their responsibility is and understands the significance of documentation. As a doctor and many of my staff members don’t know much about revenue generation so MBC has provided a platform to explain to us how the reimbursement process works.”

Leveraging new technology to transform the roles of our staff members. Without wasting a significant amount of time on the patient’s eligibility through calling various insurance companies we significantly reduce the time period for scheduling a patient appointment.

As the markets become blended, independent Orthopedic Practices may find it difficult to stay afloat without affiliating with any large organization.