Orthopedic Practices Revenue Cycle Concerns & Solutions

1. Orthopedic Practices Revenue Cycle Concerns & Solutions The method of orthopedic practice assuring the provider is compensated for the services provided is revenue cycle management. Getting compensated is not the main purpose it is to synchronize the whole process which guarantees your compensation contractually you are bound to receive in an effective way. Revenue cycle management is a vital factor for an orthopedic office. As steady revenue management enables a concentrated, productive, and profitable practice. Numerous concerns present issues for practice & reconsidering the orthopedic revenue management cycle is the most effective way to pull out the possible obstacle. You can find below the Revenue Management Flow in below diagram:

2. To handle the revenue cycle is not a simple task. The concerns are listed below related to the orthopedic practice and guidance for controlling the well being of revenue cycle:  Accounts Receivable This is an important aspect of revenue management cycle to regulate it you will always observe billing pattern with some variations in the dollar amount of charges when notified of the daily routine. There should be a constant charge collected on time. You should be using a range of management reports to look at in this scenario on the daily routine. As monitoring is important not only dollar amounts but also the volume of claims should keenly be observed for any variations. Analyzation of beneficial tendencies as well as denied claim data should be on a daily routine which will benefit your orthopedic practice. Tracking only dollar amounts preferably than the tendencies will

3. cause you to oversight the most imperative component of data. The oversight can cause you not to understand the reason due to which your claims are denied along with many important trends which you can observe and enhance your practice accordingly. The monthly check is also important as you will be able to gain control of any situation getting out of control.  Charge Record And Settlement The majorly overlooked factor is the documentation required to for successful claim of the services rendered. From the process of patient entry to his or her discharge, there is various paperwork involved to record the services provided in this duration and anyone paperwork left can cause an issue in the successful claim. This process is critical for the revenue cycle. With no record or show of documentation for the services rendered, week coding and missed charges are going to hurt your practices revenue cycle. Provided that in present scenario the cases and fees are settled although if there is no settlement of fees payment then it is a revenue loss. The solution to it is to enforce a conventionally working system such as using the alike charge form for ER visits, consultations, hospital visits, and office visits. Furthermore, you can add surgeries in your practice management system to generate settlement records for every surgery being performed. The effectiveness of the surgery performed by the physician to the right point its billing has an impact on the cash stream and beneficial profit for the orthopedic practice. It is important for all physicians to abide by all billing procedures already in place. Also, physicians should give their surgery payment record within five days of the surgery performed. And any misstep to submit will have its repercussions as the paycheck will be kept on hold till the compliance is not achieved.  Durable Medical Equipment DME has always been an issue as when efficiently handled it is an added benefit to your practice, however, majorly the patients are not still fairly charged for DME. Your practice should look into the DME revenue to counteract the loss and examine in contrast with the expenditure paid to the vendor for the equipment or other supplies. Administering the inventory along with regulating DME dispense which you can consider for the benefit factor in your practice. ABN (Advance Beneficiary Notice) should be signed by the patient for the DME billing side so that you not doling out the product for free. It is important to include the document of ABN within the process of registration so it comes in handy as you will have signed ABN when needed. We have organized a webinar on “Billing And Receiving Reimbursement For DME In Orthopaedics” which gives clear understanding that DME

4. is a viable part of the orthopedic practice if it is managed appropriately. The expectations of this conference is that the attendee upon the completion of the conference should have an understanding of assigning codes and modifiers for reimbursement on DME dispensed in the orthopedic office.  Unexpected Insurance Denials Stable revenue cycle management is assured when you zealously follow up on rejections & dismissals. As handling the denials is imperative to maintain the flow of revenue, however, at times this task is not handled appropriately due to the scarcity of assigned support staff or billing staff. Generally, one of the top cause that a claim is dismissed or refused is due to human resource. As it is due to the insufficient paperwork provided which can be due to front office staff or incorrect data submission creating an initial denial. The finest way is to educate your staff to assure their awareness of policies to circumvent and handle the denials. The most essential is they are aware of the rejection percentage and the common problems for denials. This will be necessary for accountability, tracking, and trending purposes.  Insufficient Resources And Small Balances Limited resources are one of the biggest issues in the orthopedic revenue cycle. The approach to huge balances is the focus of handling the revenue cycle with fewer resources. Whenever you observe the revenue sheet or balance sheet you will find small amounts of balances pending which adds up to a huge amount. To look into the same you can allocate the suitable resources to work on the small balances which will bring out an essential change in the balance amounts. Claims should be submitted for reimbursement as soon as possible because when the claim is sent late the possibilities of it being reimbursed is very low. There should be one or two in your team to inspect claims of below $100 is essential and a valuable part to manage your orthopedic practice’s revenue cycle.  Interaction Deficit The key to building a successful orthopedic practice is excellent communication throughout the organization. It’s essential as a leader in your practice to make sure that directors, managers, and supervisors are all making their self-available to listen to their staff and openly communicate. Ask your staff questions about what’s working, what’s not working, and if there is something that needs

5. to be replaced. Keeping everyone in the office aware of what activities and initiatives are on the horizon promotes high moral and a good communication platform. This is essential to building a positive work environment. This can also make the practice’s revenue cycle process much more efficient with potentially avoiding surprises or excommunicated issues, problems, or changes.  Involvement Of Physicians The involvement of physicians is imperative in the revenue cycle which is the growing concern for orthopedic practices as their involvement is really low. It is important that one or two physicians act as a physicians contact so that they can invest an hour for a month to discuss everything happening in the facility and administration of the revenue cycle. For the above scenario, the physicians need to be aware of the components of the revenue management cycle and the difficulties associated. This awareness in the physicians also help them gaining insight into realistic expectations of operating your practice's revenue management cycle. Thriving revenue management cycle is a vital component of running your orthopedic facility or practice. You can successfully run your orthopedic practice by keeping these seven factors optimized within your organization. Reference By:https://www.onlineaudiotraining.com/read-blog/orthopedic-practices-revenue-cycle- concerns-and-solutions