Improve Orthopedic Collection Process

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Improve Orthopedic Collection Process
Orthopedic practice owners are struggling to
maintain the financial stability of their
practice. There are many reasons for this
struggle as expenses arent declining while
reimbursement from payers isnt increasing. As
per a recent orthopedic billing survey, more than
30 of orthopedic surgery claims are incorrectly
submitted. Such a high portion of rejected and
denial claims could severely affect your practice
revenue. Also, more patients are choosing high
deductible health plans which are leading to high
patient responsibility and hence high unpaid AR
is affecting practice bottom line.    Recently,
office services have increased in orthopedic
practice setup. Office services derived revenue
could contribute more than 50 up to 75 of
orthopedic surgeons total revenue. This
increased portion of office services suggests a
change of approach towards collecting patient
portion amounts. With higher patient co-pays a
patient may have a 60 co-pay for a 100 office
visit, even if insurance has paid its portion, a
better collecting approach is required to collect
the remaining 40 of revenue. In this blog, we
shared a few practical ways to improve your
orthopedic collection process.  Orthopedic
Collection Process Share Procedure Estimate
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Improve Orthopedic Collection Process

• Clearly communicating with your patients for
  their procedure estimates, plays a crucial role
  in your practice collections. Providing the
  procedure estimate is the first step in price
  transparency. You can provide better customer
  service by sharing estimates of their financial
  obligation prior to surgery. You should train
  your staff for better patient communication and
  coordination. 
• Once the decision for surgery is made, your
  eligibility and benefits verification team should
  verify the patients benefits including the
  remaining deductible and remaining out-of-pocket
  expense. Most of the payers will provide
  procedure estimates in real-time. Or you can
  simply call insurance companies and get updated
  patient eligibility and benefits data in
  real-time.
• Try to share the most accurate estimate possible
  to patients to collect the full patient portion.
  When you share an estimate, you have to clearly
  mention that its an estimate and the actual
  charged amount will change as per payer policy.
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• Based upon estimates, most orthopedic practices
  attempt to collect complete patient
  responsibility as a deposit.

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Improve Orthopedic Collection Process

• While other practices try to collect 50 of
  patient responsibility. This percentage depends
  upon the efficiency of your team to collect
  patient responsibility after the procedure. If
  your team is well connected with patients and
  they are confident about collecting the complete
  patient portion then you can collect all at the
  end of the procedure. 
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• A patient who is well informed about his
  procedures and his financial obligation can make
  better decisions about his procedure. Often
  patients cancel surgery at the last minute
  because they are unable to pay their portion.
  Establishing this financial relation and
  discussing prior financial arrangements leads to
  lesser patient outstanding amounts.
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• Collect at the Time of Service
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• Your team should be well informed about the
  dollar value of CPT codes, co-pays, deductibles,
  and overall patient financial obligations. Due to
  this when patient check-in, your staff will be
  well informed about the patient portion and they
  can provide detailed information about services
  offered. 

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Improve Orthopedic Collection Process

• As discussed earlier, a critical step of
  collecting at the time of service is to inform
  patients of their probable charges when they
  schedule their appointment. A sample script could
  be, Based on the reason youre coming in, its
  likely Dr. Stan will obtain X-rays of your knee.
  These X-rays are not covered under your co-pay.
  Based on the information I obtained from your
  insurance company and our contracted rates with
  them, we estimate you will owe approximately
  XXX.
• You should train your staff to read and interpret
  patient eligibility and benefits information.
  Your staff should easily interpret remaining
  deductible, co-insurance, and out-of-pocket
  benefit information. 
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• Measure Efficiency of Collection Process
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• You should have a systematic approach towards the
  collection process whether its the insurance
  portion or patient portion. You can store
  collection process data in terms of various
  report formats. Reporting formats like weekly
  patient/insurance collections, write-off
  amounts-patients and insurance wise, Number of
  denied claims, accounts receivable amounts with
  30-60-90-120 days bucket, and others. As per the
  need of your practice you can set a few
  collection metrics and try to follow them
  strictly. 
• Even though one can have an efficient in-house
  team and train the staff, the orthopedic billing
  process is too complex to handle by the in-house
  team. So, outsourcing your orthopedic billing and
  coding requirements to an experienced medical
  billing company can help you reduce your stress
  on your team and can improve your orthopedic
  collection process.

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Improve Orthopedic Collection Process
To know more about our orthopedic billing and
coding services, contact us at info_at_medicalbillers
andcoders.com/888-357-3226.