Orthopedic Medical Billing Made Easy – Insights for Busy Practices

Do you want to increase the revenues of your hospital? Every hospital owner wants financial stability and efficiency through their billing systems. It is possible if you focus on every billing department of the hospital separately.

Every billing system has different practices and codes. For example, the orthopedic department has different procedures and patients from the cardiology department. That is why, there will be different codes and billing issues to deal with.

In this blog post, we will explain the importance of orthopedic medical billing. Its challenges and their solutions. Further, we will discuss how innovative technology improves the revenues and efficiency of the hospital, especially for busy practices.

Importance of Orthopedic Medical Billing:

Orthopedic billing is different from other billing systems. It has different procedures and CPT codes for orthopedics. For example:

• 21315: Closed treatment of nasal bone fracture
• 27447: Knee arthroplasty
• 22551: Anterior cervical discectomy and fusion (ACDF)
• 27650: Repair of Achilles tendon, primary, open

These codes are designed and presented by CPT and ICD-10. If hospital staff do not use these codes accurately, the ratio of claim denial increases. Further, if medical billing services do not follow these codes and coding guidelines properly, compliance issues increase.

Billing errors in this department can lead to financial instability. For example, if a biller puts the wrong code in an orthopedic bill, the claim will not be accepted, and payments will be late. Ultimately, it will affect the revenue cycle and overall revenues will decrease gradually.

Common Challenges in Orthopedic Billing:

Do the revenues of your orthopedic department are decreasing day by day? If you feel this loss, then it is time to focus on the billing system of this department. Maybe some small errors are causing big problems.

Some common challenges that are affecting revenue cycle management of orthopedic medical billing are as follows:

Coding Errors:

As you notice above, orthopedic codes are complex and difficult. They are complex and mix numbers for different procedures. Due to workload or busy reception, billers can put the wrong code or the wrong numbers in the billing procedure. It will lead to the rejection of the claim and an inaccurate will be generated.

Further, if the biller puts the code of another procedure, insurance companies will not pay for this procedure as well as for the actual procedure. It will cause financial stress for the patient.

Claim denials:

Claim denial is a routine issue in every hospital organization. It happens when insurance companies continuously reject a claim. Payer companies reject the claim due to many reasons such as:

• Disobeying insurance guidelines
• False Codes
• Inaccurate or incomplete patient information
• The patient is not verified for insurance

All these conditions can lead to the claim denial. When the claim denial ratio increases, it will decrease reimbursement rates. Ultimately, it will affect the whole revenue cycle and revenues will decrease.

Compliance challenges:

Compliance issues affect the credibility and trustworthiness of your hospital. It happens when your staff is not trained or not enough serious to follow the billing and coding guidelines. Compliance issues can occur from the billing as well as coding authorities.

When these authorities state you as non-compliant, you cannot submit more claims for payments. Thus, it impacts your all billing tasks and reduces the cash flow for your hospital.

Slow Reimbursement Rates:

Reimbursement rates determine the time of payments and revenues you are getting with every payment. Reimbursement rates decrease with delays in the claim submission, inaccurate bills, and false codes in the bills. It can also happen if you are not utilizing efficient orthopedic billing solutions in your daily practice.

Solutions for Streamlining Orthopedic Billing:

Do you want to improve the orthopedic medical billing of your hospital? Then, rule out the errors and solve them instantly. A single delay in solving billing errors can lead to the loss of hundreds of revenues.

Some practical solutions that can improve the revenues and efficiency of your hospital are as follows:

Use Specialized Software:

Many billing software are available that can streamline your billing tasks. You should use tools specifically for orthopedic billing because specific tools are also available. You can use Kareo, Athenahealth, and AdvancedMD software to decrease manual errors and speed up billing tasks.

Train your staff:

Regular training of staff is important for efficient orthopedic billing. Hire a staff that is skilled and experienced in managing orthopedic-related billing issues. Then, train this staff according to new guidelines and updates of billing and coding. This strategy will make your hospital non-compliant and efficient in billing tasks.

Check Audits Regularly:

Check the audits for revenues regularly. It will help you optimize the performance for revenues. In this way, your billing staff can focus on those aspects that are the cause of decreasing revenues. Thus, it will improve the RCM of your billing system.

Outsourcing Medical Billing:

It is one of the functional solutions for improving the financial stability of a clinic. You should outsource specialized billing services for your department. You can hire for the whole billing system or only for the orthopedic department.

Medical billing companies can handle the complexities such as claim denials, patient verification issues, and inaccurate coding. They can increase the cash flow and revenues for your healthcare organization.

Role of Technology in Orthopedic Billing:

Give the touch of technology in your orthopedic billing system and see the sparks. Innovative billing tools and EHR systems are beneficial in increasing the efficiency of a hospital. For example, DrChrono and CareCloud are effective and technical billing tools with AI EHR systems.

Some benefits of using technology in the billing system are as follows:

Reduce errors:

These tools find the issues and mistakes in the claims during the billing process. When billers get the early mistakes, they resolve them spontaneously before final submission. In this way, they can decrease errors in the bills.

Moreover, in the busy routine of a hospital, there are a lot of chances of manual errors in the bills. These errors reduce these errors by completing the patient data and incorporating the right codes.

Speed up claims processing:

Orthopedic software can speed up the whole billing process. A tool can do a billing task in half time as compared to what is done by a human. These tools help speed up the claim process because many claims are rejected due to late submission. With the help of billing tools, you can speed up the whole process and submit claims before deadlines.

Decrease Administrative Load:

In the orthopedic department, the medical staff seems to be busy in treating patients. They could not handle the billing tasks appropriately. Billing technology decreases the administrative load on the medical staff so that they can treat the patients with great attention.

Conclusion:

In conclusion, efficient orthopedic medical billing is important for saving time, reducing stress, and maximizing revenue for busy practices. Accurate coding, compliance, and effective claim management are necessary to prevent revenue loss from errors and denials.

Using specialized billing software, training staff, conducting regular audits, and outsourcing billing tasks can streamline processes and improve revenue cycle management. Utilizing technology like AI-powered EHR systems reduces errors, speeds up claim processing, and minimizes administrative burden.

Take the first step toward financial stability. Explore professional orthopedic billing services or tools to transform your practice’s efficiency and revenue growth.