Orthopedic Revenue Cycle Management

Orthopedic Revenue Cycle Management

Revenue cycle management is just as fundamental as any process to the success of a business, including orthopedic practices. Whether you run a small or large orthopedic practice, you need to develop processes and policies from the get-go that generate revenue on a consistent basis. Healthcare companies strive each day to deliver unmatched patient care and may sometimes put their billing practices on the back burner. That’s where a physician management firm, such as Healthcare Information Services (HIS), comes into play. We take care of the financial side of your organization, so you can focus on providing top-notch orthopedic services. 

Orthopedic Revenue Cycle Management Services

HIS provides a suite of revenue cycle management services for orthopedic practices across the United States. We have 225 healthcare professionals, including 65 certified professional coders, to keep your practice compliant and profitable. Our primary focuses include:

Claims Submission

A claim must go through a multi-step process before it can be considered eligible for reimbursement. Using a number of criteria, the claim must be validated – it is recommended that you utilize spreadsheets to interpret codes more accurately. Then, the claim moves forward to be either approved or denied. 

Cash Posting

Once a claim has been submitted and reviewed, it becomes available to be paid by the patient. It can be useful to implement a system for electronic payment, so your orthopedic practices can receive reimbursements more efficiently. 

Denials Management/Resolution

When a claim is filed incorrectly, it is denied by the insurance provider. It is important to keep track of claims denied for services performed at your orthopedic facility so you can identify patterns of negligence and prevent them in the future. 

Appeal Management/ Resolution

Once a claim is denied, you should submit an appeal within seven days of receiving the denial. HIS will assist you in formulating an argument backed by evidence, which may require a deep-dive into all related documentation. Be sure to follow up after submitting an appeal to understand the effect it had, if any. 

Coding Services

HIS provides orthopedic practices with high-quality coding services, including coding education and consulting. Our medical coding team is led by Lynn Anderanin, HIS Senior Director of Coding Education and Compliance, and a CPC, CPPM, CPC-I, COSC, and an AAPC Approved ICD-10-CM Instructor. 

It is important to educate your staff on proper coding regulations and standards, so they can be confident in filing claims and minimize the frequency of denials. This will save your business a significant amount of time and money in the long run. 

Why Choose Healthcare Information Services?

At HIS, our main goals for your business are to maximize reimbursements, improve efficiency, and increase profitability. With trained professionals and over 30 years of experience in revenue cycle management for orthopedic practices, you can trust us to deliver measurable results for your practice. We value the relationships we establish with our clients and will work directly with you to implement industry best practices based on your unique needs.

Expert Revenue Cycle Management for Orthopedic Practices

At HIS, we know orthopedics better than anyone else. Along with optimizing your revenue cycle, we’ll set you up for long-term sustainable growth so you can continue providing exceptional care to patients year after year. The experienced team of executives at HIS ensures that we maintain our values of service, courtesy, and professionalism – so we guarantee you will always be in good hands. 

Our team will continually go above and beyond, ensuring that you are fully satisfied with each service we provide for your orthopedic practice. Contact us today to talk with one of our specialists and learn more about how HIS can propel your business forward!

Ortho RCM Analysis

Are you leaving money behind? Our team of experts will take an in-depth look at the functions of your orthopedic practice’s revenue cycle to ensure you’re operating as efficiently as possible.