Three Reasons Orthopedic Surgeons Lose Revenue

If there is one thing we understand at MEREM Healthcare Solutions, it ‘s practice profitability. We’ve been working to improve the revenue cycle for orthopedic doctors a long time, and we want to share some of the revenue cycle setbacks they’ve overcome.

We know from experience that so much income goes overlooked and undiscovered when it comes to medical billing and coding. However, there could be other revenue cycle components going on too.

When MEREM Healthcare Solutions was founded, we began by working with orthopedic healthcare executives as a solution to their on-going billing and coding problems. We’ve been working with orthopedic doctors and specialty health care clinics, and we have identified three obstacles that have helped them increase revenue and improve their practice performance over the years.

Bottom line: We want you to have a more profitable orthopedic practice and we can help you do that.

Could Your Orthopedic Practice Be Losing  Revenue?

Here are three common reasons why orthopedic practices lose money and 3 simple solutions that MEREM Health offers to make practices more profitable.

Reason 1.

High Volume Doesn’t Always Translate to Higher Revenue

We’ve learned that orthopedic surgeons are trained to think that the more surgeries they perform and the more patients they see, the more money they earn; however, this isn’t always true.

It is all about your RVUs. It is hard to keep the practice running on hammer toes or debridements.

• What if you are just missing out on RVUs due to your dictations?
• What does your payer mix look like? If all of your surgeries are being performed on Medicaid patients or a commercial payer with lower reimbursements than your revenue is sure to be lower than expected.

Solution: It is important to have certified coders experienced in Orthopedics reviewing each and every op report and office visit note.

At MEREM Healthcare Solutions, all of our coding staff are certified by the AAPC with years of Orthopedic experience. Many have been recognized for their specialty coding expertise through AAPC specialty certifications including COSC (Orthopedic Surgery). Additionally, we have a staff of practice consultants that can help you review your payer mix through a Revenue Cycle Audit and offer unique solutions for your orthopedic practice to maximize your time in the OR and in the clinic.

Reason 2.

Claims Consistently Denied Due to Inaccuracy

Billing is directly tied to your profitability. Income needs to consistently flow into the practice, which means your coding needs to be correct.

When there are mistakes in the billing and coding processes it could hold up claims for a long period of time. Even the best medical coders can make mistakes and, if they are overwhelmed, much can go overlooked.

Solution: Perform audits on a regular basis. When was your last coding audit?

Medical auditing can provide areas of improvement for your coding staff. Even well-trained staff can make mistakes. An audit can recognize under coding, bad unbundling habits, and code overuse. Once a coding audit is complete, your medical coding staff will then be able to bill appropriately for documented procedures.

Interested in A FREE tool to help you improve your current revenue process. Whether you currently handle your billing and coding in-house or outsource to another company, MEREM Healthcare Solutions can provide you with an unbiased industry comparison and revenue cycle audit report to assist physicians and practice managers with improving their practice performance.

Reason 3.

Inefficiency Due to Performing Too Many Procedures Outside of Your Specialty

More patients don’t always equate to more profits as we have already determined. If you’re performing surgeries you don’t specialize in, you’re likely to be much less inefficient with your time. This is where ultra-specialization comes into play.

Solution: Focus specifically on doing and being known for the procedures you are best at and refer out or perhaps join-in with other surgeons who specialize in other procedures.

Also, as you become more profitable and your practice grows, MEREM Healthcare Solutions can also help with credentialing any new provider enrollments with payors in your network and hospital privileging. Medical Credentialing is one area of the revenue cycle process where mistakes can cost your practice 10’s of thousands of dollars just by overlooking one letter or notice. Common credentialing errors cause scheduling delays, fluctuation in the revenue cycle, and much more. It’s important to take the appropriate amount of time necessary for credentialing, instead of waiting a month before a new physician arrives.

Let Us Handle Your Billing and Coding Needs

The day-to-day operation of running a busy orthopedic practice comes with many different challenges:

• Keeping up with appointments,
• Creating a reliable staff,
• And monitoring the expenses of running your practice.

We can take at least one thing off of your long-running list of day-to-day concerns AND make sure your practice remains profitable. Our team of professional coders and billers have the exact experience you need and we happen to specialize in orthopedics and surgery. Call MEREM Health today for a quote (205) 329-7519 or contact us to request a consultation.

MEREM Healthcare Solutions provides exceptional medical billing, coding and credentialing services to orthopedic surgeons and sports medicine physicians, hospitals, and outpatient centers. Take advantage of our coding expertise today!

Schedule Your Free Revenue Cycle Audit Today!