Orthopedic Practice Management

Something that is often overlooked is Charge Capture. I’m generally astounded at the lack of internal controls in place to account for and reconcile patient visits per day when we bring on a new client.

If there’s not reconciliation in place, our experience has shown that charges are being lost. Most practice management information systems will allow you to generate an encounter report, which can be used to complete this reconciliation.

Even worse than the lack of controls in place for office visits, is the lack of controls in surgery. Orthopedists tend to have their own way of doing things, and margins used to be much larger allowing for slip-ups in the revenue cycle management. However, we no longer have these luxuries, so consistency and centralization are of key importance these days.

At HIS, we work with our clients on implementing standard operating procedures with the doctors in their medical practice. This involves getting everyone to use the same charge form for hospital visits, ER visits, and consultations. We encourage our clients to enter surgeries into their practice management system, so we are able to generate the same encounter and reconciliation reports to account for all of the surgeries that are being generated. The timeliness of when the physician generates a surgery to when it hits the billing has an effect on your cash flow and profitability.

  • Physicians should submit their surgical charges no later than 5 days after a surgery is performed.
  • Hold physicians responsible for complying with the billing procedures set in place.
  • Failure to comply should result in their paycheck being held until compliance is achieved.

If you have the surgeries scheduled, you can then very easily run reports out of your practice management system. For our clients, we produce a report that basically calls out the doctors to say one doctor in this practice is submitting with 3 days after surgery, another doctor is submitting within 45 days after surgery. Quite frankly, the doctors love that, especially the ones that are at the 3 to 5 days because then they turn to their partners and say, “What’s the matter with you? Why can’t you get your surgeries in?” So, we use that as a very effective tool called a “peer group measure” that we send out on a regular basis to our clients so that the doctors themselves can get on each other to get these charges in.