Outsource Orthopedic Billing Services to Optimize Revenue through our Orthopedic Revenue Cycle Management in the U.S.

The key benefits of outsourcing orthopedic medical billing include

1. Fewer billing errors due to expertise in Medical Billing and coding domains in Orthopedic Billing
2. Quicker payment postings and reduced administrative burdens .
3. Optimized reimbursement rates with a reduction in claim denials resulting in improved revenue collection 

Overall, outsourcing orthopedic medical billing can lead to increased efficiency, improved revenue, reduced administrative burdens, and enhanced compliance, allowing orthopedic practices to thrive.

An orthopedic billing service can enhance revenue collection through various methods:

1. Competent coders ensure accurate coding, reducing claim rejections and denials.
2. Efficient billing services promptly submit claims, resulting in quicker reimbursements.
3. Proficient management of claim denials and appeals maximizes revenue recovery.
4. Ensuring compliance with billing regulations prevents revenue loss due to non-compliance issues.

Certainly, here are some examples of common orthopedic billing errors and how our service aids in their prevention:

1. Errors in procedure or diagnosis codes can cause claim rejections. Our certified coders ensure precise coding, thereby reducing the chances of mistakes and rejections.
2. Inadequate patient information can result in claim denials. We collaborate with healthcare providers to guarantee thorough and accurate documentation, thereby minimizing denials.
3. Misapplication of modifiers can lead to reduced payments or claim rejections. Our specialists educate in-house billing personnel on the correct usage of modifiers to prevent mistakes.

When a claim is rejected, we conduct a thorough examination of the reason for the denial, whether it stems from coding errors, inadequate documentation, or other issues. We take appropriate measures to rectify the specific problem and prepare comprehensive appeal submissions, in order to construct a compelling case for claim to be reconsidered.

Common Current Procedural Terminology (CPT) codes used in orthopedic billing include:

1. 20610 – Arthrocentesis, aspiration, or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa).
2. 27447 – Total knee arthroplasty (TKA), with or without autograft or allograft.
3. 99213 – E/M service for an established patient with an expanded problem-focused history, examination, and medical decision-making.
4. 73030 – Radiologic examination, shoulder; complete, minimum of two views.
5. 72040 – Radiologic examination, spine, cervical; minimum of two views.

Common modifiers used in orthopedic billing include:

• -50 (Bilateral Procedure): Indicates that a procedure was performed on both sides of the body during the same session.
• -59 (Distinct Procedural Service): Indicates that a procedure was distinct or separate from other services performed on the same day.
• -LT (Left Side): Specifies that a procedure was performed on the left side of the body.
• -TC (Technical Component): Identifies that only the technical component of a service was provided by the physician.

To stay current with alterations in orthopedic billing and coding regulations, we implement various approaches:

1. Ongoing Training and Vigilante Monitoring: Our billing and coding experts participate in regular training sessions and workshops.
2. Membership in Relevant Associations: We are members of pertinent industry associations and organizations, such as the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA).
3. Advanced Coding Software: We utilize sophisticated coding software that undergoes regular updates to integrate the most recent changes in orthopedic billing and coding regulations.

1. We strictly adhere to the Health Insurance Portability and Accountability Act (HIPAA) regulations, implementing policies and procedures that safeguard the privacy and security of patient data.
2. We employ advanced and secure electronic health record (EHR) systems and billing software with robust encryption and access controls to protect patient information from unauthorized access or breaches.
3. We establish formal agreements with our clients, known as Business Associate Agreements (BAAs), outlining our commitment to maintaining the security and confidentiality of patient data.

We offer comprehensive reporting and analytics to help you track the performance of your orthopedic billing

1. Detailed financial statements that provides an overview of revenue, collections, and outstanding balances, allowing you to assess the financial health of your practice.
2. Reports that categorize outstanding balances by the age of the invoice, helping you identify and prioritize collections efforts.
3. Tailored reports based on your specific needs and preferences, allowing you to focus on the metrics that matter most to your practice.