6 Techniques for Maximizing Revenue Cycles at Orthopedic PracticesWritten by Laura Miller | December 09, 2010
Managing an orthopedic practice's revenue cycle is essential to keeping the business running effectively and efficiently. Here are six techniques industry leaders use to maximize their orthopedic practice's revenue cycle.
1. Payment plans or alternative payments. Melody Winter-Jabeck, administrator at Ravine Way Surgery Center in Glenview, Ill., says if patients find they are unable to pay the rising cost of deductibles for surgery, ASCs should communicate early and often payment plan options or some other flexible payment arrangement to patients. Not offering up alternative payment methods or plans from the start can push back payment collection by a significant number of days, directly affecting the ASC's A/R. "We are currently looking into setting up payment plans or some sort of financing in cases where there is a financial issue for the patients," Ms. Winter-Jabeck says. "The trend we're seeing is that more and more of the financial responsibility is being put on the patient with higher deductibles and out-of-pocket fees."
From "5 Best Practices to Improve Your ASC's Revenue Cycle."
2. Include payment tracking software. After a physician enters into a contract with a payor, he or she often assumes the contracts are met. However, payors sometimes underpay on contracts and losing this money can make a big difference to the practice. Dave Wold, CEO of Healthcare Information Services, says one of his clients recently identified over 500,000 underpayments while another discovered 100,000 instances where the payor stopped paying for a second procedure when contract guidelines stated the payor would. Payment tracking software allows the physician to enter in different negotiation schedules and then run the payments through to ensure the payor is meeting contract guidelines with each claim.
From "4 Technologies to Improve Orthopedic Practice Revenue Cycle Management."
3. Deal with claims immediately. Curt Mayse, a principal with LarsonAllen, says that practices should focus on getting their collections out of the door immediately following a patient visit. "These should be sent within minutes or hours, not days, of a visit," he says. "This way, the practice will get their reimbursements or denials back quicker from insurance companies." When practices receive a denial, Mr. Mayse says that they should not sit on this information. "The business office should pass the reasons for the denial on to the front-end to communicate to them why the claim was denied." By improving the communication between these two parts of the practice, offices can cut down on repeat mistakes and improve their overall collections and billing.
From "Improving and Maintaining Profitability in Orthopedic and Spine Practices: 12 Areas of Focus."
4. Have physicians learn to speak "code." For most accurate billing results, Wendy Owens-Frierson, CHM, CHI, CPC, CPC-I billing products manager with Avisena, recommends physicians use the "coding" language in their reports instead of describing the procedure as a narrative. "When physicians are not using the coding language, there's a loss in revenues," she says. "The documentation is key in selecting and capturing all the appropriate and billable codes." By becoming familiar with common codes for each step of the procedure, physicians can better relay the procedure performed to the coders which results in more accurate billing practices and increased revenue.
From "5 Tips for Increased Accuracy in Orthopedic Practice Coding."
5. Elect staff members to monitor finances, particularly pre-collection and billing functions. Elect staff members to monitor finances. These specialists' primary role is to meet with patients before surgery to pre-collect copays, deductibles and co-insurance amounts and work out payment plans as needed, Ann Margaret McCraw, CEO of Midlands Orthopaedics Surgery Center in Columbia, S.C., says. Delegating specific responsibilities, such as pre-procedural collections, to staff members helps ASCs collect in a more efficient manner. "Our financial account specialists collect both for our professional practice and ASC, so our patients don't have to make separates trips for different bills," she says. "These staff members are trained to have those sensitive conversations with our patients and know how to interpret statements, EOBs and explain deductibles. So it helps our ASC and practice because the payments from one patient are all funneled to a specialist, and it's nice for our patients because it alleviates confusion on their part as they navigates bills from both entities."
From "6 Ways to Increase Profitability at Your Orthopedic-Driven ASC."
6. Negotiate supply costs with vendors. Practice staff should keep track of inventories and supply costs so when contracts are expired, the administrators can negotiate competitive vendor prices. This means practice administrators should keep track of all the supplies, down to every pencil, so that they can see where the high costs are, says Patrick Hinton, executive director of the Jacksonville (Fla.) Orthopaedic Institute, and then know whether those costs can be negotiated down. "There are a lot of costs that are fixed and there isn't a lot you can do about that," he says. He also recommends keeping the number of facilities in check so the practice doesn't duplicate or replicate staff and equipment.
From "6 Best Practices to Create a Thriving Orthopedic Practice."
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