Running an orthopedic practice, or any medical practice for that matter, requires a delicate balance of business and clinical expertise. Orthopedists want to focus on providing the highest quality medical services possible, but at the end of the day, they also have a business to run. This can cause several issues within the orthopedic practice. Today, we will go over some of the most common business challenges for orthopedic practices and how to go about managing these problems.
One of the most common business challenges seen in orthopedic practices is mistakes in coding. The coding process is extremely important to ensure an orthopedic practice is paid for their services. Mistakes during the coding process will threaten the lack of efficiency and getting paid in full. Under coding (i.e. not coding for all of the services rendered) leads to underpayments and ultimately costs your orthopedic practice a ton of money. Over coding (i.e. coding for the incorrect services rendered or for more than what was actually performed) is a huge compliance issue and can lead to external audits and very heavy penalties.
How to Resolve: Have internal audits conducted every quarter or so to see where medical coding mistakes are occurring and how to best rectify these errors. Ensure your practice is either investing in certified professional coders who have extensive experience in Orthopedics, and the ability to stay ontop of industry and payor policy changes as updates to the codes are commonplace and constant; or consider outsourcing this function to an expert at Orthopedic Revenue Cycle Management. This involves highly skilled professionals managing the entire RCM and collections process for your orthopedic practice.
Among orthopedists, collecting payments is a common source of headaches. Collections are never fun, but it is important if you want to continue serving patients and keep the lights on in the office. Issues collecting payments source from denials of claims, patients refuting bills, and patients disregarding notices to pay medical bills.
How to Resolve: If claims are being denied, determine the reason “why” and then file an appeal. Do not allow denials to pile up or be ignored and eventually written off. This is the one of the easiest ways to drive down profitbailty of your practice althewhile appearing to have a healthy A/R. By fully understanding why the claim was denied, tracking and trending those denied claims, your practice can be more proactive about managing and appealing those dinials while minimizing and altogether eliminating preventable mistakes in the future.
On the patient side, evaluate your current process and policies. They may be allowing room for error and revenue loss. Consider implementing software the automates this process and provides for a clean and easy solution to capturing patient payments at the time of service. Some revenue cycle management organizations, like HIS, now deploy technology as a part of their full revenue cycle management service providing for a full and comprehensive approach to protecting and maximizing revenues for your practice.
We often hear orthopedic practices discuss the feeling of not having enough time in the day.. Between balancing back to back appointments, documentation and coding on each patient visit, insurance claim submission, surgical coding, day-to-day office management needs, etc. there are items that unfortunately are neglected. Most orthopedists open a practice so that they are able to help more patients and are understandably less enthused with the paperwork of managing a business. This becomes a huge problem if important business management tasks are forgotten or pushed to the bottom of the priority list.
How to Resolve: Ensure your orthopedic practice is well staffed with both exceptional orthopedic clinicians and business-minded administrators. Your staff needs to know exactly what aspects of the revenue cycle they are responsible for managing in order for your practice to operate as efficiently as possible. You could also seek orthopedic practice management and consulting – a service that ensures your orthopedic practice is being managed at full efficiency so that you can focus on best serving patients.
Bringing in an Orthopedic Revenue Cycle Management company like HIS can completely turn around your struggling orthopedic practice. Our professionals have over thirty years of experience in orthopedics. We’re here to help you and your team run a more efficient and profitable practice so that you can continue to serve patients with the utmost care and compassion. Contact us today to discuss your options and explore how HIS practice management and consulting or RCM services can resurrect your business providing for a foundation for steady profitable growth!