For those of you who are not trained medical billers and coders you should know that the process can be quite complex for orthopedic practices. Codes and specific modifiers required for obtaining maximum revenue with orthopedic billing are constantly changing which has resulted in a unique set of billing challenges for this specialty. To make matters worse, orthopedic fee schedules are getting reduced every year – so it is really important to stay on top of things to avoid losing revenue.
We have found that a lot of practices are finding it really difficult to conduct operational functions without implementing the latest technology for medical billing and coding procedures. In addition preparation for ICD-10, compliance to HIPAA and other reforms have put additional pressure on providers.
Here are some things that you need to know:
– CPT Manual introduced various coding changes and revisions in 2013 that directly affect orthopedic reimbursement.
– Because there were 500 code changes in Category I codes orthopedic coding has become a lot more complex.
– There was a complete overhaul of nerve conduction study codes. Now there are two set of new codes for shoulder and elbow revision that were added along with a new spine fusion code.
– If you have a varied mix of payers, workers compensation and personal injury liens can lead to inaccurate coding, increase in denials and a delay in claim submissions.
– Due to an increase in number of patients your documentation requirements have also increased which means that you will be asking for more time and effort from your staff to handle reimbursement collection.
– Practice costs have also increased which can potentially cause disruptions in cash flow of orthopedic practices.
I guess what I am trying to say is that even though these changes will benefit orthopedic billing and coding in the long run you need to keep in mind that your practices with limited resources will be hit the worst. You are going to face challenges in meeting the rising requirements in order to maintain profitability at your practice.
So – all of this leads me to my next point, which probably will not be too surprising.
At this point the bottom line is that outsourcing your billing requirements will ease the financial pressure. The unique set of challenges that orthopedic practices face can be solved with extensive knowledge of complex rules that medical billing and coding companies possess – just like Park Medical Billing. Accuracy in claim submission and timely payments can be achieved by outsourcing your billing and letting the experts deal with all the headaches.
Outsourcing will help you eliminate the headache of hiring or training new staff – and will also do the following:
– 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
Our medical billing company has a strong team of well-trained coders and billers who are experienced in handling orthopedic medical billing. We will handle your revenue cycle management so that you can concentrate on providing quality healthcare.