WHY ORTHOPEDIC SURGEONS SHOULD OUTSOURCE MEDICAL BILLING

You’re busy.

As a doctor, especially as a specialist, you are busy seeing patients, diagnosing patients, assessing treatment options for patients, and performing surgeries on patients most of your days. You rely on your staff to handle the day-to-day administrative tasks, so you can focus on your patients.


WHAT IS AN ORTHOPEDIC SURGEON?

An orthopedic doctor is a physician who has additional training in the treatment, prevention, diagnosis, and repair of disorders, injuries, and diseases related to the musculoskeletal system. This system entails everything that holds you together: bones, ligaments, tendons, muscles, cartilage, and other connective tissues that bind and hold the organs and tissues together. Orthopedic doctors use both surgical and non-surgical means to treat these areas. Examples would include trauma, spine disorders, sports injuries, degenerative diseases, infections, tumors, or congenital disorders.

In fact, orthopedics as a modern specialty started just over one hundred years ago as a result of congenital disorders. Orthopedics comes from two Greek words, “orthos” (meaning straight) and  “paideion” (meaning child). This is also why orthopedics is also spelled orthopaedics. The word was coined in 1741 by French physician Nicholas Andry. However, orthopedics has been around since primitive times (basically since bones were broken). The Egyptians, Greeks, and Romans began to study orthopedics systematically. Not much progress was made in the Dark Ages, but recently the field of orthopedics has exploded due to the prominence of exercise in our society as well as the advancements in technology such as the invention of the X-ray in 1895.

Note how the word “child” is used in the word orthopedics. This is because for many, many years, orthopedics only treated children with spine and limb deformities. Through the use of exercise, manipulation, and splinting, children’s deformities were corrected. Surgery for orthopedics came into play in the early 1900s.

However, during World War I and World War II, the need for surgeons who specialized in bones and what held them together exploded. Orthopedic surgeons became proficient in amputations, internal fixation, and wound care. Now orthopedic surgeons even specialize in orthopedic trauma, pediatric orthopedics, joint replacement, and oncology.


TWO KINDS OF ORTHOPEDIC TREATMENTS

Non-surgical treatments:

  • Medication
  • Exercise
  • Other rehabilitative or alternative therapies such as physical therapy

Surgical treatments include:

  • Arthroscopy – uses a camera to visualize inside the joint
  • Fusion- using rods or internal devices to fuse bones together
  • Internal Fixation – used to hold broken pieces of bone together with either plates, screws, or pins
  • Joint replacement – a damaged joint is removed and replaced by an artificial joint, which can be either a partial replacement, total replacement, or a combination of those replacements
  • Osteotomy- the correction of bone deformity by cutting and repositioning the bone
  • Soft tissue repair – repair of tendons or ligaments

Oftentimes, both surgical and non-surgical procedures are utilized for the patient. With so many varied procedures available, the need for a specialized medical coding and billing is essential.


WHAT IS MEDICAL CODING AND MEDICAL BILLING?

At Comprehensive Healthcare Revenue Management, we are specialists, too. We specialize in medical coding and billing in order to maximize the revenue cycle management process. Medical coding is taking a physician’s services and translating them into medical codes that correspond with those services for easy submittal to insurance companies. For every injury, diagnosis, and medical procedure, there is a corresponding code. As you can imagine, there are thousands and thousands of codes for the thousands and thousands of medical procedures, outpatient procedures, diagnoses, and surgeries.

These codes serve as a universal language between the doctor’s services and the insurance company. There are currently two sets of coding procedures: the International Classification of Diseases, or ICD, codes, which correspond to a patient’s injury or sickness, and Current Procedure Terminology, or CPT, codes, which relate to what functions and services the healthcare provider performed on or for the patient.

Once these codes are performed, the medical biller comes into play. The medical biller takes this universal language and submits them as claims to insurance companies. A claim is a bill for services rendered. The insurance company then processes the claim, determines how much of the claim it will pay based off of the patient’s insurance program, and then returns the claim with its portion to the medical biller. The medical biller specialist then determines the patient portion and bills the patient directly for whatever is left unpaid.

Sounds complicated, right?  And this isn’t even surgery!

WHY YOU NEED TO OUTSOURCE MEDICAL BILLING AND MEDICAL CODING

As you can imagine, with so many steps, there are multiple opportunities for errors. An error can occur at any one of these steps, resulting in undocumented services, wrong codes entered, and overall a delay in the revenue cycle management process, which results in a delay in payment to the physician, or even worse, payment denial. In sum, a medical biller specialist has many functions, but overall, the biller is in charge of making sure the healthcare provider is properly reimbursed for their services. This is foremost the task.

For the aforementioned reasons, you need a professional medical billing and medical coding specialist company to maximize your insurance claims and decrease insurance denials. A professional medical coding and medical billing company such as Comprehensive Healthcare Revenue Management who specializes in revenue management cycles will lower your overall costs as they save you money throughout the revenue cycle management process. We’ll make your job easier so you can focus on your patients.


ORTHOPEDIC SURGEON MEDICAL BILLING

Orthopedic surgeon medical billing is just as specialized as the surgery itself. This specialization leads to orthopedic surgeon medical billing as having one of the highest incorrect claim submissions.  At Comprehensive Healthcare Revenue Management:

  • We put a lot of training into our medical billing and medical coding staff, so that they will be very familiar with the orthopedic industry and be able to bill appropriately for it.
  • This specialized orthopedic surgeon medical billing training decreases the amount of denials by the insurance companies and speeds up the revenue cycle, resulting in a huge cost savings for our orthopedic surgeon medical billing clients.
  • As orthopedic surgeon medical billing specialists, we are thoroughly versed in the denied claims process, and we expedite any denials with appropriate appeals.
  • We answer all the technical, specific questions about diagnoses and procedures for the orthopedic surgeon staff and clients, including details of the revenue cycle management process.
  • Orthopedic surgeries often entail multiple procedures, which can result in underpayments by the insurance companies. Tracking these underpayments in orthopedic surgeon medical billing can increase collection by 7 to 10 percent.
  • We use the latest in user-friendly medical billing software and medical coding software to streamline our processes and make medical billing as efficient as possible.

THE COMPREHENSIVE HEALTHCARE REVENUE MANAGEMENT DIFFERENCE

We embrace transparency in all that we do, so when you or your staff has a question, we have an answer. We are experts at negotiating with insurance companies, including Medicare and Medicaid. As a top medical billing and coding company, Comprehensive Healthcare Revenue Management excels at streamlining your medical coding and medical billing and seeking efficiencies in all areas of the revenue cycle management process.

CHRM both analyzes your data to see where we can improve our processes and performs audit checks on the codes used. We keep abreast of coding updates and implement them as soon as possible. We pride ourselves in being the Top Rated Local® medical billing specialists and medical coding specialists.

More orthopedic surgeries performed does not necessarily translate into more revenue. If you’re not properly billing for these surgeries, your revenue is actually decreasing when you perform more surgeries. Often, maximizing your revenue cycle and keeping a consistent flow of monies is all you need to have a flourishing orthopedic practice.

Comprehensive Healthcare Revenue Management wants your orthopedic practice to thrive and grow. Let us handle your medical coding and billing. We’ll present you with monthly reports on how we’re doing managing your revenue cycle. Furthermore, our mission is to exceed your expectations, making you raving fans and recommending our services. We welcome honest feedback for ways we can improve. We offer a free audit to see if our services are a good fit for your business and analyze how best we can help. Contact Comprehensive Healthcare Revenue Management today!