Background on a Case Study to Improve Orthopedic Billing
Orthopedic practices work in a very specialized area of medicine that demands very careful clinical care and billing. Orthopedic billing is distinct from billing for primary care or other specialties because it involves accurate treatment records, comprehensive codes for procedures and injections, and careful handling of sophisticated payer requirements. Even little mistakes in orthopedic billing and coding can cost a lot of money, cause payments to take longer to arrive, or cause problems with compliance.
In today’s healthcare industry, where earnings are low and rules are severe, excellent orthopedic billing solutions are not only great to have; they are essential for survival and success. Orthopedic clinics need to improve their revenue cycle management (RCM) so they can stay financially healthy, obey the rules, and give patients good care without worrying about money.
The Issue
Several orthopedic medical clinics got in touch with RekhaTech because they were suffering the same money problems:
Mounting refused claims: The company was losing a lot of money since claims were routinely denied because of erroneous codes, not enough paperwork, or missed deadlines.
- More accounts receivable (AR): Many practices had difficulties with AR that was more than 120 days old, which made it impossible to get cash flow.
- Manual payment posting and reconciliation: Posting payments and reconciling them by hand led to mistakes that generated disparities that led to incorrect financial reports and lost money.
- Limited in-house capacity: The orthopedic billing teams in-house were good at what they performed, but they didn’t have the specialized knowledge or time to discover the basic problems and put in place efficient remedies.
These challenges could not only impair the clinics’ capacity to make money, but they could also impede them from improving patient care and clinical research.
The Answer
RekhaTech, a well-known and trusted orthopedic billing company, came in to reform the way these practices make money. We took a whole-system approach and worked together to give in-house teams more power and improve the way things were set up.
- Hiring Orthopedic Billing Specialists
We gathered together a group of orthopedic medical billing and coding specialists who know a lot about CPT codes, how to apply modifiers, and the rules that each payer has for orthopedic procedures like joint replacements, fracture care, and arthroscopic surgeries.
- A Complete Look into the Aging Bucket
The first thing we did was look closely at the aging bucket. Our orthopedic billing experts put the oldest unpaid claims at the top of their list so that money would start coming in right away. We restored the practices’ finances back to normal by systematically aging AR, which lowered the number of days in accounts receivable by a lot.
- Claims Denied Resolution
Managing the orthopedic revenue cycle is always hard because of denied claims. We took a thorough look at the most common reasons for refusal, like issues with prior authorization, incorrect modifiers, or not enough operative reports. We helped with orthopedic billing solutions by creating workflows to deal with denials, swiftly resubmitting corrected claims, and changing the way things are done to stop future denials.
- Easier Payment Posting
It’s very vital to post payments appropriately so that everything is transparent and money is monitored correctly. We built a system for payment posting that made sure all payments, revisions, and denials were sent in correctly and reviewed every day. Our orthopedic billing services focused on good reporting, which helped practice management see how their money was doing.
- Taking Care of Accounts Receivable in Advance
Our team used proactive follow-up strategies like dedicated AR calling, timely appeals, and regular engagement with payers. We were able to minimize unresolved AR and raise revenue collection by following payer-specific guidelines and using our knowledge of how orthopedic billing works.
- Bringing Together Compliance and Best Practices
Orthopedic billing compliance must be done correctly to avoid fines and protect the practice’s good name. Our specialists taught our in-house teams how to follow the rules by going over the right way to code, the right way to write documentation, and the most recent changes to the legislation. These best practices not only fixed problems with the revenue cycle straight away, but they also gave staff the skills they needed to keep making adjustments over time.
The Outcome
RekhaTech’s help made a major difference that could be seen:
- Less Denied Claims: The practices saw a substantial decline in denied claims, which returned money that had been lost and improved cash flow.
- Faster Revenue Collection: Cash flow was a lot better when AR days were cut down and the invoicing process was made faster. This meant that practices could spend more money on patient care and growth.
- Better Billing Accuracy: Systematic payment posting and thorough claim audits cut down on errors and inconsistencies, which made financial records clearer.
- Strengthened In-House Teams: Our orthopedic billing teams gained new skills and best practices by working together, which set the stage for continuous operational excellence.
- Better Patient Experience: Clinics could spend more time on patient care, scheduling, and clinical quality by streamlining their financial procedures. This made patients happier.
What Clients Have to Say
The orthopedic offices were really delighted with how things turned out and how the partnership functioned. They liked that RekhaTech’s orthopedic billing company worked closely with their own personnel, which made it easier to fix difficulties in the revenue cycle.
Administrators at the practice noted that the consultants from RekhaTech made them feel like they were part of their own team since they were so knowledgeable and dedicated. Working together like this established trust and contributed to long-term improvements in billing processes and the company’s general financial health.
What Makes RekhaTech the Best Choice for Orthopedic Billing?
It’s not just about sending in claims for orthopedic billing; it’s also about learning how orthopedic treatments work, how payments work, and how the revenue cycle works. RekhaTech’s orthopedic billing services are made to fit the demands of orthopedic practices of all sizes, from small clinics to big multi-specialty groups.
Some of the best things about working with RekhaTech are:
- Specialized understanding in orthopedic billing and coding
- A major focus on lowering AR days and denied claims
- Training people and making sure they follow the rules in a proactive approach
- Strong financial analysis and clear reporting
- Ways to get engaged that are flexible and fit the needs of the practice
With our orthopedic billing solutions, practices may enhance their operations, stay within the law, and generate a lot of money, all while focusing on giving exceptional patient care.
To Sum Up
To make money and stay in business for a long time, orthopedic offices need to improve their billing. Many practices have been able to navigate through tough times and see real results thanks to RekhaTech’s all-in-one solution, which combines specialized orthopedic billing services, hands-on AR management, and proactive compliance support.
If your orthopedic practice is having difficulties with denied claims, outdated accounts receivable, or delayed billing processes, collaborating with a professional orthopedic billing organization like RekhaTech can alter the way you make money and provide your team the resources they need to keep expanding.
