Today, orthopedic practitioners are able to offer their services to various patients remotely. This is all because of the progression of telemedicine leading to an improvement in healthcare delivery.
However, this is also the reason behind orthopedic medical billing challenges. Orthopedic revenue cycle management is all about accuracy and efficiency. When healthcare providers are unable to achieve this, they struggle to acquire adequate revenue.
So, meeting remote orthopedic billing requirements becomes crucial for healthcare providers and practices. The aim here is to optimize the operational workflow and maximize revenue. Both of these are necessary to continue the practice and offer quality medical care.
It is a well-known fact that medical billing is complex, and dealing with medical specialties like orthopedics is even more challenging. If you are facing similar issues, then you are in the right place!
This blog highlights the important medical billing insights for orthopedic practitioners for a better bottom line and smooth operational flow. With these strategies, you can avoid the hassle of billing intricacies and claim denials.
Orthopedic Medical Billing to Maximize Reimbursement: Key Tips
For smooth orthopedic revenue cycle management, healthcare providers need to focus on maintaining accuracy and efficiency. These two factors can decide the future of a medical facility and enhance the bottom line. The catch is making sure all medical billing steps of remote orthopedics are on point. For this, healthcare providers will also have to reduce manual errors and implement denial management.
Here are some tips to improve orthopedic revenue cycle management:
Need to Master Orthopedic Coding
Mastering specific HCPCS codes for remote orthopedic billing is the first step to reduce coding errors and prevent denials. CPT and ICD-10 codes are crucial to continue the claim filing process. Other than that, missing modifiers is not an option for a productive bottom line.
These codes are complex due to the nature of the medical facility. As healthcare providers don’t provide in-person consultations and conduct physical examinations, coding becomes tricky.
That is why healthcare providers must acquire the appropriate knowledge for the medical billing process. However, healthcare providers are usually busy providing care to patients. So, for this task they can appoint professionals who can deliver the required results.
Insurance Verification is Crucial
Improving the remote orthopedic billing begins with ensuring proper insurance eligibility verification. This is important because if any insurance policy doesn't have a provision of remote orthopedics, the healthcare provider may not receive revenue.
Lack of insurance coverage is a major reason behind claim denials and revenue losses. To prevent such situations, healthcare providers must ensure this step and check coverage for remote orthopedic services.
You must confirm the insurance eligibility and define out-of-pocket costs, if any. As remote orthopedic services are a part of telecommunication, you must also confirm telehealth coverage.
Checking coverage is a step towards reducing claim denials and ensuring adequate reimbursement.
Take Documentation Seriously
Once remote orthopedic care has been delivered, healthcare providers are supposed to continue the medical billing process. They are supposed to complete the step of documentation, which includes all details of rendered services. This data is further utilized for coding and claim filing.
Healthcare providers must take this step seriously and prevent errors and missing details. Any mistakes at this step will directly convert into coding issues and claim denials. When it comes to remote orthopedic services, every detail needs to be recorded with precision.
You can ensure the accuracy of this step by documenting all sessions with the patient (virtual sessions via telehealth). You must be careful while documenting and recording everything from symptoms to treatment plans and alterations in the plan.
Don’t Miss Out on Denial Management
More healthcare providers and practices deal with claim denials. Denials are normal only until they are affecting the financial health of the practice. When such a situation arises, healthcare providers need to focus on recognizing the reason behind denials and recovering the lost revenue.
Proper denial management can not only recover the lost revenue but also improve the administrative process to avoid such denials in the first place. You must implement a strong framework dedicated to finding the root cause of denials and ensure corrective measures.
Preventing denials is related to reducing errors such as inaccurate coding, missing modifiers, incomplete documentation, and delays in claim filing. Once the denials have occurred, there is a need to identify errors, rectify them, refile claims, and reclaim the lost revenue.
Implement Regular Billing Audits
To make sure that all medical billing steps are working efficiently, healthcare providers need to double-check their process. This is a must for remote orthopedic billing as well.
Remote orthopedic practitioners are supposed to implement regular billing audits to reinforce accuracy and efficiency. These audits are meant to check the coding accuracy, prevent payment delays, and ensure strong follow-up.
If you want to redefine your remote orthopedic revenue cycle management, then following regular audits is essential. This can fill the gap between your medical billing process and optimal revenue.
Outsource Remote Orthopedic Billing to Experts
Remote orthopedic billing is not free from complexities and revenue leakages caused by the same. Orthopedic practitioners can take responsibility for medical billing, but it can be tedious and draining. If patient care is the priority, then medical billing can be handed over to medical billing specialists.
They not only solve complex situations of remote orthopedic revenue cycle management but also streamline the operational flow. They meet all compliance requirements, incorporate technological tools to prevent errors, ensure timely submission of claims, and implement robust denial management.
All this helps in reducing errors and denials while optimizing revenue cycle management.
Why Choose Eminence RCM?
Eminence RCM is a medical company providing specialized remote orthopedic billing services to various clients across the USA. We have hands-on experience in dealing with complex orthopedic revenue cycle management scenarios. Our team offers the best solutions to maximize revenue for your healthcare practice.
We effectively manage remote orthopedic billing and coding, leading to adequate reimbursement. Our team is proficient in reducing manual errors, preventing submission delays, and avoiding denials.
Moreover, we ensure complete regulatory compliance to protect sensitive patient data from unauthorized access. Our team makes use of advanced technology to save data, prevent manual errors, and enhance efficiency.
Boost operational efficiency and increase revenue with Eminence RCM!