Tips for Orthopedic Revenue Cycle Management

Orthopedics Revenue Cycle Management

Revenue Cycle Management Tips for Orthopedic

As specialists in orthopedic revenue cycle management, we understand the importance of a strong and efficient revenue cycle for the health and stability of an orthopedic practice. A robust revenue cycle encourages strong cash flow, maximizes reimbursements, keeps your practice compliant, and increases efficiency and profitability.


Take a look at a few of the these tips for orthopedic revenue cycle management:

Stay Up-to-Date with Government Regulations and Payer Policies

This is the most basic principle to revenue cycle management – the bare minimum. It is important that whoever is managing your revenue cycle is 100% up-to-date on new government regulations and policies specific to your practice, otherwise problems will begin to arise immediately.

Manage ALL Phases of Orthopedic Revenue Cycle (This title is misleading as we don’t really cover “all phases” of the revenue cycle)

The revenue cycle begins even before the a patient calls to make an appointment and extends beyond the point at which the final payment for all services rendered is  received. It is important for all phases of the revenue cycle to be managed accordingly, beginning with your front desk staff  answering the phones and directly interacting with patients at your orthopedic practice. They should focus on taking down all insurance information ACCURATELY and efficiently.  We encourage the utilization of an electronic insurance eligibility and estimation tool to ensure coverage as well as provide the ability to collect time of service payments whether it be copay, deductible, or co-insurance. Services provided to the patient need to be documented correctly according to the latest payor guidelines and to the highest degree of specificity needed in an efficient manner and with the utmost precision. And if you receive a denied claim, they need to be reviewed, resubmitted, or appealed and done so in an aggressive, proactive manner.

Look Towards the Future

For successful management of your revenue cycle, we must look towards the future. Your revenue cycle should be creating a healthy financially stable environment for an orthopedic practice. A RCM provider should be able to provide the accurate and necessary information for an orthopedic practice to make informed decisions for the future. Financial forecasting the effects of  payor (this is an industry specific spelling) policy and government regulations on your practice’s reimbursements will help your practice better plan for the future.

Don’t Handle RCM Yourself

You have an orthopedic practice to run.  When attempting to handle the entire revenue cycle while also providing top-notch orthopedic care – things often  slip through the cracks. Partner with the professionals at HIS, where we will handle the business side of your practice while you focus on doing what you do best. Contact HIS today to learn more about our RCM services.