Enhancing Orthopedic Practice Efficiency with Automated Billing Solutions

Did you know? According to Medscape Physician Compensation Report 2023, Orthopedic service providers spend over 14 hours per week on administrative tasks, including documentation and billing.

This is because orthopedic practice includes a wide range of services, from treating fractures and joint issues to man aging chronic conditions like arthritis. Patient care involves multiple consultations, diagnostic tests, and physical therapy sessions.

Orthopedic services can be pretty complex, and so can their billing and coding requirements. Manually processing these claims leads to errors due to incorrect coding, underbilling, or overbilling, ultimately leading to claim denials.

Automated billing solutions can address these challenges by streamlining the billing process, ensuring accuracy, and improving financial health. Let’s explore its benefits and how it enhances your orthopedic practice.

What are Automated Billing Solutions?

Automated billing solutions are software systems that streamline and automate the billing process. It is particularly helpful for orthopedic service providers due to the high volume of data, complex coding for treatments, numerous doctor visits, and frequent communications with the insurance companies.

These billing solutions leverage technology to automate processes, such as insurance verification, coding, claim submission, and payment posting. This reduces the time and effort required to manually handle all these error-prone and time-consuming tasks.

Core Features of Automated Billing Solutions

When a patient visits an orthopedician, this system captures the patient information and billing codes, verifies the insurance details, generates claims and submit them to insurance companies. It also tracks progress, and manages follow-ups and resubmissions.

Here are some of the key features to look for in an automated orthopedic billing solution.

• Insurance verification: Verifies patient insurance coverage, eligibility, and deductibles.
• Automated charge capture: Automatically records and codes services provided during each patient visit, ensuring billing accuracy.
• Claims management: Electronically submits claims to the insurance providers, ensuring timely submission.
• Payment posting: When the payment is received, the system automatically posts them to patient accounts.
• Reporting and revenue cycle analytics: Provides detailed reports and analytical insights into the financial performance.
• Compliance management: Ensures compliance with the ever-changing regulations, reducing legal risks and penalties.
• Billing and communication: Generates patient bills and manages communication regarding outstanding balances, claim status, and more.

Benefits of Automated Billing Solutions for Orthopedic Practices

1. Accurate Coding and Documentation

In orthopedic practices, treatments can vary significantly – from a simple routine checkup to a complex knee-replacement surgery. It also has varying codes based on laterality, open/closed procedures, specific body parts, fracture types, and more.

Automated billing solutions will ensure that the coding and documentation are accurate, reducing the chances of delays or denials in reimbursements.

2. Streamlined Workflow

Automation reduces manual tasks, such as insurance verification, coding, and claim submission. It can also make the claim process faster, reducing your administrative burden and freeing up your time for patient care. It also minimizes errors and enables faster billing cycles, quicker payments, and smooth operations.

3. Reduces Administrative Costs

For orthopedic services, the time and resources spent on administrative tasks are higher due to complexity in billing for various procedures, therapies, and follow-up care. Automated solutions can reduce this cost by minimizing manual data entry and the potential errors that lead to costly claim resubmissions and denials.

4. Faster Claim Processing

Orthopedic services are often rendered in multiple stages – initial consultations, surgeries, rehabilitation, etc. Each and every stage requires accurate and timely claim processing for faster reimbursements. Automated solutions can expedite this process and ensure financial stability.

5. Improved Revenue Cycle Management

Automated orthopedic billing solutions can offer real-time data analytics about revenue cycle, helping track denied claims, payment delays, and gain insights into the financial strength. This helps the providers to optimize their revenue cycles and increase profitability.

6. Improves Patient Experience

Orthopedic care is often expensive and requires numerous consultations and treatment plans. The patients should be clearly communicated about billing and insurance. Each claim will take longer waiting and processing times. Automated systems can ensure faster processing and better communication to patients, improving patient experience.

Factors to Consider When Choosing an Automated Billing Solution for Your Orthopedic Practice

Choosing the right billing solution that meets the unique needs of orthopedic services are crucial to ensure efficiency, compliance, and financial health. Here are some key factors that should be considered.

1. Integration with EHR Systems

The billing solution should seamlessly integrate with the existing systems to ensure that there are no data duplications and errors. In orthopedic practices specifically, detailed patient histories and treatment plans are essential, and hence, this integration is crucial.

Why it matters: Integrating with the existing systems reduces administrative burden and improves accuracy and overall efficiency.

2. Specialized Orthopedic Coding

The software should be customized specifically for orthopedic billing due to the complex system of coding and modifiers. For example, a simple “knee pain” has various subcategories within the ICD-10 codes, based on the cause and location of the pain.

Why it matters: A robust and customized orthopedic billing solution reduces the chances of coding errors and helps capture all billing opportunities.

3. Analytics and Reporting

The solution should monitor your financial health and provide comprehensive reports on key metrics, like claim denials, payment timelines, and other trends. It helps you identify areas of improvement and make informed choices.

Why it matters: You can proactively manage your finances and improve profitability.

4. Customization and Scalability

Each orthopedic practice is unique – you could specialize in sports medicine, joint replacement, or general orthopedics and so should the billing solution. Moreover, as your practice grows, the billing solution should accommodate the growing number of patients and complex billing needs.

Why it matters: By choosing a scalable solution, you can avoid frequent system changes and updations.

5. Support and Training

Proper implementation and ongoing support is a key feature to look for while choosing the software provider. Check if the provider offers comprehensive training and responsive customer support even after implementation. It helps in reducing potential downtimes.

Why it matters: Ensures effective use and faster resolution of potential issues.

Enhance Orthopedic Practice With Atlantic RCM

With specialized expertise in orthopedic coding and state-of-the-art technology, AtlanticRCM ensures improved efficiency, accuracy, and profitability. We are experienced in handling the complexities of orthopedic billing, ensuring accurate coding, on-time claim submission, and payment processing.

Contact AtlanticRCM to learn more about how our automated billing solution can optimize your orthopedic billing and overall financial health.

Atlantic RCM is one of the leading multi-specialty medical billing companies in USA that serves 25+ major medical billing specialties. Our experts work across your practice in billing, collections and account receivables management, to help you succeed.

Get in touch with the leading medical billing outsourcing company to learn more. Call us at (469) 501-1500 or write to us Info@atlanticrcm.com