7 effective ways to get more out of orthopedics medical billing

7 Effective Ways to Get More Out Of Orthopedics Medical Billing With the Affordable Care Act, new regulations and guidelines of insurance payers, switch to ICD-10, patients unwilling/unable to pay due to high-deductibles, rising costs, bureaucratic tasks, and declining reimbursements, it is no wonder that orthopedic physicians/surgeons are feeling the brunt of the situation. More so, as orthopedics’ is an expensive medical specialty (unlike others) where the operational cost of equipment’s, drugs, injections, and products is usually high, orthopedics’ practices are dealing with high expenses too. To deal with the situation, here are seven easy ways to improve efficiency and profits: 1. the most important aspect in orthopedic billing and coding procedures is to be updated with the latest coding rules. Codes have been added, revised and deleted in the areas of biopsies, joint injections, image guidance, ultrasounds, kyphoplasty and vertebroplasty. Lately, new codes have been applied to spine and hip x-rays, paravertebral facet blocks and E/M prolonged service code. Billers and coders must be aware of these changes (codes and modifiers) along with the payment changes for knee and hip surgeries. Fractures that are open closed or percutaneous skeletal fixation procedures are billed and reimbursed differently and are required to be indicated in this manner. Again, in orthopedics coding, coders must cite CPT codes based on RVUs (Relative Value Units). Procedure length, professional liability and surgical facilities are reviewed by Medicare for assigning RVUs. Citing these RVUs ensures accurate payments. 2. Hire a skilled orthopedic s physician assistant who can handle other work such as administering drugs and injections and other smaller surgical tasks. This can ensure than the senior surgeon can concentrate more on patients while increasing patient care. Also consider in-house training for employees for refining/developing skills. Further delegating responsibilities to an employee with logistical experience can go a long way in handling administration tasks well, centralizing the care processes, and leveraging the expertise of billers and coders to enhance revenues. 3. Be social media friendly. Patients often check the reviews and details of a physician before visiting their facility. Also, maintaining a relationship with other primary care physicians can increase visibility and referrals. Focusing on an area of specialty e.g. arthroscopy, it is easier for patients to find the doctor with a unique expertise. Also, as the support teams are aware of their responsibilities, tasks can be automated thereby increasing efficiency and referrals.

Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com

1

4. Maintain apt documentation and records for enhancing reimbursements. With ICD-10 changes, for identifying spinal stenosis or spondylitis, orthopedic s need to document the specific region of the spine; or need to mention the left/right or bilateral number of joint disorders/fractures. For apt billing and coding, they also need to document if the visit is the first, sequential or continuation. Again, the orthopedic surgeon needs to document if one is performing surgeries from the posterior or the anterior lumbar inter-body fusion; to allow the coder to cite appropriate codes for anterior or posterior procedures. Physicians must also document any add-on procedures/services they have rendered during a surgery and bill for the same. 5. Outsourcing transcription and other such tasks can reduce the burden on the internal staff. Also, outsourcing other medical billing and coding tasks or the complete revenue management cycle to an outsourcing agency can improve efficiency while increasing reimbursements due to lesser rejections and denials on claims. 6. It is imperative for the orthopedic billing and coding team to check the reason for denials and ensure they do not occur in future by verifying insurance information of each patient, collecting their accurate information and setting up an automated billing service. Certain CPT codes always occur in denials hence their reason codes are also available. Re-check before sending out claims to the insurance agency. 7. Orthopedic EMR software is expensive and requires employee training. However, it is imperative as it increases efficiency, accuracy of orthopedic billing and coding, allows highest potential of reimbursements, aids in managing administrative tasks and patients receiving accurate bills, ultimately assisting in efficient handling of logistics. Orthopedic billing and coding companies specialize in providing services such as electronic and paper billing, following up with payers, generating reports, performing code audit checks, possessing expert knowledge of CPT codes and modifiers and assigning them appropriately to the highest accuracy for higher reimbursements. Expert teams also improve the revenue cycle management through various procedures such as accurate charge capture, authorize insurances, reconcile accounts, conduct multi-tiered appeal process, and follow compliances for all billing procedures thereby improving efficiency and practice revenues.

Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com

2

Turn static files into dynamic content formats.

Create a flipbook