Diversify Orthopedics Billing Practice to Increase Revenue - PowerPoint PPT Presentation

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Diversify Orthopedics Billing Practice to Increase Revenue


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Title: Diversify Orthopedics Billing Practice to Increase Revenue

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Diversify Orthopedics Billing Practice to
Increase Revenue
The term Healthcare Rationing by Hassle as
touted by some surgeons showcases the stress
caused by numerous changes in the healthcare
industry. Orthopedics practice like all others
feels the pressure of high costs, new ICD-10 code
concerns, low and delayed reimbursements,
declining margins, high deductibles,
insurance/payer policy amendments, regulations,
and other reforms. To combat this and survive,
orthopedics billing practice requires
diversification and streamlining to protect and
increase revenues.   Verifying insurance coverage
of in-coming patients, double-checking the
patients demographics, file claims submission in
a timely manner, coding as distinctively as
possible, and outsourcing billing and coding can
certainly increase reimbursements.   Further Ways
To Increase Revenues Are Metrics Denial
Analysis Report Due to denials being costly and
complex, monitoring and reducing them is the key
to improve revenues.
Diversify Orthopedics Billing Practice to
Increase Revenue
The report must comprise denial types, reason and
description codes, claim value, insurer details,
claim resubmission dates, and the result. Claims
Turnaround Time Submit clean claims, scrutinize
claim submission delays, and connect with
insurance companies at regular intervals for
faster payments. The report must encompass
insurer details, claim submission and payment
date, days left to payments, and average
reimbursement TAT. Physician Productivity Due
to numerous bundled programs, physicians could be
at risk of losing payments. Hence, physicians can
set goals/benchmarks against other physicians and
decide probable compensation. Aspects required
are the number of old and new patient visits,
appointments, charges and collections, provider
revenue, and output ratio. AR Analysis Assessmen
t, analysis, and reporting of AR regularly are
imperative. Understanding patient and insurer AR
will further optimize payer performance. Features
that need to be taken into consideration are
claim number and patient details, DOS, CPT,
insurer details, total billed amount and balance,
and AR details.
Diversify Orthopedics Billing Practice to
Increase Revenue
Medical Coding Review Report Orthopedics coding
is complicated. Knowledge of key anatomy elements
and LCD guidelines is imperative to accurate
coding. A coding report consisting of insurer
details, paying and value CPT and rejected codes,
code compliance with NCCI regulations can reduce
DFNB and assist in precise coding. Further
Ways Investments In A Surgery Center To
generate additional income, it is advised that
surgeons invest (buy) in real estate office
building/ASC. Here, the surgeons tend to receive
a higher percentage of compensation for the
procedures they perform. Usually, the charges in
a hospital are higher than ASCs but profits for
surgeons are higher in ASCs. Orthopedic doctors
can also work in mini-clinics for additional
compensation. Addition of Imaging
Services Orthopedic practices can add/purchase
an open MRI (rather than one for extremities) and
offer on-site imaging. Although initial
investments are higher, billing for MRI facility
fees becomes easier and safer from insurance
Diversify Orthopedics Billing Practice to
Increase Revenue
Physical Therapists For added care and an
increase in profits, the addition of a physical
therapist is recommended for the orthopedics
practice. Rather than partnering with physical
therapy organizations, it becomes easier for risk
management when the physical therapist is a staff
member. Electronic Systems and Practice
Management Tracking payment, claims management,
credentialing software, electronic health/medical
records though cost high initially, but ensure
high returns due to cutting of transcription
costs and apt documentation leading to elevated
billing. New Technology/Procedures Orthopedic
practices have to stay abreast of innovative
technologies (in particular for joint
replacements) for providing the best and
continuum care for patients. Orthopedic practices
must check if adding the technology will be a
clinical advantage as it will undoubtedly incur
high costs. Nevertheless, due to the high costs
of implants/high-tech equipment, the orthopedic
practices billing and revenues can make a
difference, while also be beneficial to the
patient by reducing the hospital stay and/or
avoidance of revision surgeries. Orthopedic
doctors and surgeons must be compensated
appositely for the valuable service they provide.
Hence, billing and coding must be done
appropriately as these services are the backbone
of the revenue cycle and the means to flourish in
the unstable healthcare space.
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