How to Optimize Revenue Cycle Management for Orthopedic Practices

1. How to Optimize Revenue Cycle Management for Orthopedic Practices Orthopedic billing can be coined as the method of accurately invoicing the orthopedic services that have been provided by various orthopedic healthcare and medical service providers and organizations. This is a very important segment for the healthcare revenue cycle management and this also makes sure that the healthcare providers in the orthopedic services should give proper level of compensation to all of the patients. Many of the doctors regardless of being specialists are making the entrance in the field of healthcare to care for and support people. Nevertheless, a significant part of any medical practice is in the management of the business scenario of things. Whether you are an orthopedic doctor and running a small and private level of practice, or if you are an administrator of a network of clinics, the management of financial issues like RCM or revenue cycle management, can be very crucial for you.

2. A proper rcm cycle in the orthopedic practice can work on • Improved level of referral conversations Reducing the level of cost Increasing the efficiency of the opera ions Eliminating the redundancies Make sure to have the appropriate level of reimbursement Having the increased level of patient collections Having improvements in the engagement of the patient What are the Factors of RCM that can cause Complications in orthopedic Healthcare Facilities? • • • • • • In the orthopedic medical service process the methods are more complex and thus, they should be accurately translated into appropriate levels of codes. The people who will work should have perfect knowledge of both the coding and orthopedic guidelines. The choice of a wrong code can lead to the denials of the claim and underpayment. The regulations and codes that govern orthopedic billing and coding can be the subject of various updates and keeping an eye on those changes is added with new codes, and rules of billing and they also need the proper education and training. In addition, various insurance companies examine the necessity of medical services in orthopedic practices. Some of the orthopedic services also need the primary level of authorization from the different insurance companies before they are done. This process will take much of the time and thus, it should be handled properly and carefully. How to Improve Your Revenue Cycle Management in Orthopedic Practice Focus on Collecting Payment at the Point of Care Having the patients pay for orthopedic care can be at the time when the services are rendered and help support the people to have an improvement in the cash flow. This also prevents the neglectful level of payments or late payments. Nevertheless, for the collection at the point of care, the orthopedic clinics will require the important tools and the tools they

3. will use for assigning the patient to visit the codes fast. They also have to work on the submission of the charge tickets to the ACH or the automated clearing house or ACH. This also works for the processing of the payments of patients. Providing the Patients the different Options for Paying for Services The patients can have different levels and forms of making the payment that they can use. Some of these options can be checks, cash, debit, or credit cards. Being able to make the process of the various forms of the payments makes this easy for them to collect them at the time of care. This also allows the patients to easily pay for the care in general and they do not have the specific level of process of payments. Using the Automated Clearinghouse for the Process of Claims The days when the claim submissions were done by manual submission using snail mail have gone. The submission of the manual charge ticket by the use of the paper form takes too much time in the current process. In the orthopedic practice of the current day use of the PM or practice management works with the automated system of clearing house and they help to improve the collection. Applying EHR or Electronic Health Records Technology to Capture and Visit Data In orthopedic medical billing practices to be able to submit a claim the orthopedists need to have a precise level of accounting in the visit of the patient. Without having thorough data the evaluation assessment, and management the establishment of the codes for the various visits cannot be done. This may lead to the over or under-billing for the visits of the patients. This can also trigger the billing codes and audits and/or disputes of payment from third parties. Various EHRs help support the medical experts, assistants, and nurses to capture the critical details of the visits and make a big report that will combine the notes of the visit and orders of the images. Read also Enhancing Your Home Wi-Fi Signal: Practical Tips and Solutions

4. Accounts Receivable Too many of the days have been adjusted on the receivable of the account. When one looks at the patterns of the billing there should not be inconstant with the volume of the charges that are being posted daily. There can be consistency in the charges of the timeline that are being turned in. Durable Medical Equipment In revenue cycle management for orthopedics, durable medical equipment or DME can always be a challenge. If someone has effective management of the DME, this can be added to the levels of profitability in the practice of orthopedics. For most of the patients who are not getting the charges for the durability of the medical equipment, this can be prevented by tracking the revenue of the DME and making the comparison with the direct expenses that have been paid to all vendors from the suppliers. Using the payment tracking software After a physician makes the entrance into the contract of a payor, he/she can have the assumption that all contract needs are met. Nevertheless, the payors sometimes work on underpayment of the contract, and losing the money can become a big level of difference in the orthopedic practice. The orthopedic practitioners should work on the given metrics The Fist Pass Resolution Rate The rate of denials The net collection rate The cost of collection The days in accounts receivable Steps to manage RCM in orthopedic practice • • • • • Providing training: management should work on the steps to give the proper level of training to all of the staff. They can do so to become more expert in coding and billing This

5. will also help streamline the process of revenue p and this also eliminates unneeded processes. Specialized level of services: in orthopedic medical billing orthopedic doctors can give their all services to different kinds of specialized sectors. They can make the connection with various kinds of sports bodies and provide their specialized services to sportspersons who often have muscular injuries. Eradicating costs: the other vital step can be removing all extra costs. Any of the expenses that have been incurred should not have significance either or can be a loss in revenue. Outsourcing the billing services: a smart level of move will be the outsourcing of the orthopedic billing and coding. With an ICD transition that is coming up for the billing can see a bit of hiccoughs and will make sense to give this responsibility to a different expert who can make the needful changes. Getting paid in the first attempt: many of the chances are that if a claim has been rejected then the chance of getting paid is greatly reduced. Orthopedics should work on making the surety that they will have the team who will get the claims right the first time. In the orthopedic medical practice, the RCM can be managed in the given steps Step 1: Designing your RCM Work Model Step 2: Make the alignment of your RCM Staff. Step 3: Registration of patient Step 4: verification of the Patient’s Eligibility Step 5: Prior level of Authorization Step 6: deductibles and Co-payment Step 7: Coding of Services Step 8:submission of Claim

6. The use of a practice management or PM solution that is incorporated in an automated clearing house process helps to have proper improvement in the levels of collection. Instead of waiting for days for the claims to be sent, processed, and approved or rejected, the orthopedic physicians can submit the claim electronically and they also get the response quickly. Managing the revenue cycle management for orthopedics effectively in the medical practice can be difficult for their success. As the reimbursement from the payers of government can be projected to continue the decline, the third-party payers can work on fee-for-service contracts and they can have more purchases in this. This should also manage the revenue cycle efficiently and should be predominant in orthopedic practice. To make the order of the revenue cycle management appropriate the medical practice should continuously monitor every aspect of the revenue cycle management for the schedule of the zero balance in the account. Conclusion Having and running an orthopedic medical billing practice can be agitated and this, on top of the management of the profitable revenue cycle can be too much. One needs a partner for billing on whom he/she can trust and faith and who will help constantly. There is also a need for profitable cash flow. This can be one of the only few medical billing companies that offer a performance guarantee within various levels. With the new technology and codes that have already added power to your reimbursement, there is a need to take the viable resources to one place. These resources will add more value to the process of your reimbursement. As an orthopedic physician, you can save a significant level of all resources by working with a remote working company on your RCM or revenue cycle management. Source URL - https://pmumalins.net/how-to-optimize-revenue-cycle-management-for- orthopedic-practices/