Orthopaedic billing requires sufficient documentation pertaining to a patient’s visit. All services performed must be meticulously documented and charged for by the billing staff. Errors such as incorrectly entering patient details or failing to check the patient’s eligibility before submitting a claim might result in a claim being rejected. In addition to permission problems, revenue collection might be hampered by a lack of knowledge of insurer preferences and deadlines. With so many complexities in orthopaedic medical billing, it’s critical for orthopaedic clinics to be adept with these codes for an error-free billing process.
It’s also crucial that your orthopaedic practice is aware of the most common claim denials so that you can prevent them. Duplicate claims or services are one of the most common grounds for denials in orthopaedic practices. The charge exceeds the fee schedule, which is another common basis for claim denials. Make sure your office keeps track of the most frequent denials’ primary causes. After that, you can put procedures in place to prevent future denials.
The following are some of the most effective ways to prevent denials:
- Ensuring that patient information is valid when it is obtained
- Confirming insurance verification is done properly
- Using a billing service that is automated
A few things to keep in mind while billing orthopaedic services –
- Laterality —ICD-10 and newer CPT codes require physicians to document right, left, or bilateral for a variety of diseases, such as fractures and joint disorders.
- Site Specificity – You’ll need to document the precise area of the body for many of the diagnoses your orthopaedic practise makes.
- Place of Occurrence — ICD-10 and subsequent coding changes need orthopaedic procedures to be more specific. Your office will be required to produce verification of where accidents occurred by payors.
- Type of Encounter – Orthopaedic physicians must document with sufficient specificity to allow coders to determine if the patient encounter was an initial one, a second encounter, or a sequela encounter.
Outsourcing As a Solution
Although recruiting and properly educating an in-house billing staff can help you avoid costly fees and penalties, the orthopaedic billing process is far too complex for an in-house team to handle. Outsourcing your orthopaedic billing and coding needs to a technologically advanced offshore medical billing company like Info Hub is one way to relieve burden on your personnel while also increasing reimbursement.
In many cases, outsourcing your practice’s billing and revenue cycle management lowers costs while increasing revenue. It can also save time for your employees when it comes to appealing or re-filing disputed claims. Outsourcing your billing can save you money, effort and time by avoiding the delays that can arise with an in-house billing staff due to unavoidable circumstances, vacations, and employee turnover. Overall, practises that work with a revenue cycle management business to handle billing and accounts receivable (A/R) see more revenues, decreased overhead costs, and better profitability.
Regular audit reviews, account monitoring, and follow-up with insurers are all part of Info Hub’s orthopaedic billing services. You will receive frequent reports outlining productivity, quality, and new revenue prospects while working with us. To fulfil the billing needs of orthopaedic providers, our qualified medical billing experts use industry standards and modern tools. It’s critical that your practice gets compensated fairly for the valuable services you provide. Your billing must be accurate and a timely order so that you are properly reimbursed.