Orthopedic Surgery

How often are you faced with denied claims for joint replacements or those slow to be reimbursed because medical necessity is being reviewed or questioned? One of the most challenging aspects of your orthopedic surgery practice these days is when you provide a service to a patient who genuinely needs a joint replacement only to find later that reimbursement has been denied. Substantiating the need for joint replacement surgery requires detail, detail and more detail in order to avoid claim denial and keep your orthopedic revenue cycle management flowing smoothly. The following CMS guidelines are provide to help you avoid claim [...]

Your medical practice is under scrutiny. That's because both state and federal agencies are lowering the boom on overpayments. If there was ever a time when you needed a healthcare revenue cycle management team that understands the intricacies of orthopedic coding, billing and collections, it's now, when CMS has increased audits resulting from overpayments. Since 2010, the federal government's goal has been to cut the Medicare FFS improper payment rate and reduce overall payment errors. Among those areas in the spotlight within orthopedic physician medical billing is total joint replacement surgeries and documentation of their medical necessity. This isn't to say [...]

Among the biggest objectives for any orthopedic surgery practice is to maximize patient engagement and reduce healthcare costs (both for patients and providers). It just so happens one impacts the other. The following Power Your Practice article explains the tie: Though electronic medical record software has helped practices streamline workflows, automate healthcare revenue cycle processes, and better manage patient care, health IT systems cannot revolutionize the healthcare industry on their own. Medical professionals must also make a greater effort to engage patients and make them more active participants in their health. The reason this is important is that patient engagement is [...]

Practice compliance requires vigilance and oversight, which can be a challenge for orthopedic surgery practices today and their corresponding medical coding, billing and collections process. Merging the practice of medicine with the business of healthcare can result in a high wire balancing act that can result in updates slipping through the cracks, especially when there’s a continuous stream of changes. The right orthopedic surgery revenue cycle management process has got you covered. This just in. According to a January 16, 2013 edition of Industry News, “Your practice can no longer brush off breaches of electronic patient health information (ePHI) files if [...]