WHAT IS MEDICAL CODING AND MEDICAL BILLING?

Comprehensive Healthcare Revenue Management (CHRM) specializes in medical coding and medical billing services for orthopedic surgeons in order to maximize the revenue cycle management process. Medical coding involves taking a physician’s services and translating them into medical codes for easy submission 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, diagnoses, and surgeries available. 

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

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 the portion they are responsible for to the medical biller. The medical billing specialist then determines the portion that the patient owes, 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. These errors may result in undocumented services, wrong codes entered, and an overall delay in the revenue cycle management process, which results in a delay in payment to the orthopedic surgeon, or even worse, payment denial. In sum, a medical biller specialist has many functions, but their main duty is to ensure that the healthcare provider is properly reimbursed for their services. 

Your orthopedic surgery needs the services of a professional medical billing and medical coding company to maximize your insurance claims and decrease insurance denials. At CHRM, our specialists can help you lower your overall costs throughout the complicated revenue cycle management process. We’ll make your job easier so you can focus on what matters most  — your patients.


ORTHOPEDIC SURGEON MEDICAL BILLING

Medical billing for orthopedic surgeons is just as specialized as the surgery itself. In fact, orthopedic surgeries have one of the highest rates of incorrect claim submissions in the entire healthcare industry.  

At Comprehensive Healthcare Revenue Management, our medical billing and medical coding staff go through extensive initial and ongoing training to ensure they are familiar with the orthopedic industry and are able to bill for it appropriately. This specialized training decreases the amount of insurance denials and speeds up the overall revenue cycle, resulting in huge savings for our orthopedic surgeon medical billing clients. If denials do arise, our specialists are well-versed in the denied claims process, and we expedite any appropriate appeals.

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%. We  use the latest user-friendly medical billing and medical coding software to streamline our processes and make our services as efficient as possible.


THE COMPREHENSIVE HEALTHCARE REVENUE MANAGEMENT DIFFERENCE

We embrace transparency in all that we do, so when 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 practice’s medical coding and medical billing by 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 money is all you need to have a flourishing orthopedic practice.

Comprehensive Healthcare Revenue Management wants your orthopedic practice to thrive and grow. Let us help you achieve this by handling your medical coding and billing needs. We’ll present you with monthly reports on how we’re managing your revenue cycle. We always welcome honest feedback for ways we can improve. CHRM offers 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 to get started!


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 conditions such as spine disorders, sports injuries, degenerative diseases, infections, tumors, congenital disorders, and more.

In fact, orthopedics as a modern specialty started just over one hundred years ago as a result of congenital disorders. The word “orthopedics” derives 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, ancient 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 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 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.

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.


THE TWO KINDS OF ORTHOPEDIC TREATMENTS

Non-surgical treatments:

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

Surgical treatments:

  • Arthroscopy  – uses a camera to visualize inside the joint
  • Fusion – uses rods or internal devices to fuse bones together
  • Internal Fixationuses plates, screws, or pins to hold broken pieces of bone together
  • Joint replacementinvolves partially or totally removing a damaged joint and replacing it with an artificial joint
  • Osteotomycorrects bone deformity by cutting and repositioning the bone
  • Soft tissue repairinvolves repairing tendons or ligaments

Oftentimes, both surgical and non-surgical procedures are utilized. With so many varied procedures available, a medical coding and billing specialist is essential. Contact us today to get started with your free assessment!