Orthopedic Billing & Coding Services
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Orthopedic Billing & Coding Services
Orthopedic surgery or Orthopedics is the branch of medicine dealing with the conditions of the Musculoskeletal system - the bones, joints, ligaments, tendons, and muscles that are so essential to movement and everyday life.
Complexities in Orthopedic Billing
Orthopedic billing depends on proper documentation before, during, and after a patient visit. The billing team needs to carefully document and charge for all services provided. Errors like incomplete patient demographics entry or not prior- verifying the patient's eligibility could result in a rejected claim. In addition to authorization errors, not knowing insurer preferences and deadlines can also hamper revenue collection.
Compared to other specialties, orthopedic billing is complex and requires a deeper understanding of providers' services. Nearly 35% of orthopedic surgery claims are incorrect, out of which 25% of medical claim gets rejected. Such high denial rates can lead to compromised revenue & patient care while bankrupting your orthopedic practice.
Although hiring an in-house billing team and properly training your team can help avoid severe fees and penalties, the orthopedic billing process is too complex to be sustained by an in-house team. One way to reduce stress on your staff and increase reimbursement is to outsource your billing & coding requirements to a technologically empowered billing company like MBW.
Medical Billing Wholesalers' orthopedic billing services include regular audit checks, account analysis, and follow-up with payers. While working with us, you will receive regular reports detailing productivity, quality, and new revenue opportunities. MBW's expert medical billing professionals use industry best practices and advanced software to meet orthopedic providers' billing needs.
Medical Billing & Coding Services Expertise in Orthopedics
At MBW, we have a client base that spans across all 50 states, covers a wide range of hospitals, physician practices (including orthopedic practices), and medical billing companies. Our coders are proficient in ICD-9/10, CPT, HCPCS coding guidelines provided by CMS and AMA, and are certified by the American Academy of Professional Coders (AAPC). It would be fair to state that we have a decade of experience in orthopedic billing & coding.
Applying best practices for Orthopedic Billing & Coding Services
We understand the nuances involved in orthopedic medical billing, such as correctly bill pain pump insertions or plc reconstruction and arthroscopies. Our certified coders work with you 24/7 to prevent problems caused by incorrect use of modifiers, as well as educate your in-house billing specialist on how to avoid them.
Our professional orthopedic billing experts work to prevent claim denials while increasing reimbursements. We do this by focusing on efficient, streamlined processes that decrease the amount of time needed to correctly bill orthopedic services. We have built an approach anchored on modern technology and a team that focuses on providing data-driven solutions to reduce denials and increased revenue. Our expertise in Orthopedics includes but is not limited to:
Foot and Ankle Surgery
Hip and Knee Surgery
Shoulder and Elbow Surgery
Trauma Surgery
General Orthopedics
Orthopedic Oncology
Spine Surgery
Bone Health Center
Hand Surgery
Pediatric Orthopedic Surgery
Sports Medicine
Osseointegration Clinic
Benefits of our Orthopedic Billing and Coding Services
We bring excellence, knowledge, and accuracy to orthopedic billing and coding services while building a revenue cycle devoid of defects for your practice. With patient demographics entry, insurance verification, insurance authorizations, coding, billing, and reconciling of accounts, our medical billing process can add value to your organization.
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Our orthopedic billing and coding services are manned by AAPC-certified professionals, ensuring high accuracy and compliance with the latest CMS guidelines. This adherence to standards reduces the risk of errors and non-compliance issues.
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We specialize in creating a flawless revenue cycle for your practice, incorporating patient demographics entry, insurance verification, and authorizations. This results in a smoother, more efficient billing process, minimizing delays and increasing the speed of revenue generation.
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Our dedicated claim denials management team focuses on shifting from managing denials to preventing them. This proactive approach significantly reduces claim denials and improves overall financial performance.
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Our team is proficient in a range of medical billing software including Lytec, Medic, Misys, Medisoft, and NextGen. This versatility allows for seamless integration with your existing systems, ensuring a hassle-free transition and operation.
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We have a proven history of effectively processing medical bills with leading commercial carriers like United Health, WellPoint, Aetna, Humana, and others. This experience ensures that claims are handled efficiently and reimbursements are maximized.
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Our team is well-trained in coding software such as EncoderPro, Flashcode, and CodeLink, enabling accurate and up-to-date coding, which is crucial for minimizing errors and rejections.
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Typically, our clients experience a substantial increase in revenue (over 30%) and a notable reduction in denials (minimum of 10%). This improvement is a direct result of our expertise, rigorous processes, and a well-trained team dedicated to the financial health of your practice.
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