Orthopedic Billing Services
Are you struggling to manage the billing and coding needs of your orthopedic practice efficiently? Is this struggle leading to claims delays or denials? You will need a specialized billing partner to address these recurring challenges. We provide HIPAA-compliant orthopedic medical billing services to ensure accurate billing and timely reimbursement for the services rendered.
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How We Streamline Orthopedic Medical Billing For Your Practice
Our services are tailored to meet the unique billing needs for orthopedic surgeries, joint replacement surgery, arthroscopic surgery, fracture repair, spinal surgery, osteotomy, and more. We cover end-to-end billing for these services, including coding and billing to electronic claims processing and payment processing. Our services comply with various regulations such as HIPAA and coding mandates set by AMA and AAPC. Here are the steps we follow to streamline your billing service:
- Integrate digital tools such as EDI, EHR, EMR, and PCS with orthopedic billing technology ecosystem to obtain real-time patient data for seamless electronic claims processing.
- Verify the patient's insurance coverage (provider information, registration numbers, effective dates, expiration dates, provider address, etc.) before scheduling the appointment.Â
- Fulfill pre-authorization needs from insurance payers before the orthopedic practice starts attending patients. This step is crucial to avoid any payment and reimbursement-related confusions after the medical procedure is done.
- Conduct real-time claims scrubbing to ensure billing codes accuracy (10021-69990 CPT code range, ICD-10, HCPCS Level II Codes, DRG codes, Evaluation and Management (E/M) Codes, revenue codes, and others).
- Submit clean claims to insurance payers such as government programs (Medicare, Medicaid), private insurance companies (Aetna, Anthem, Humana), Workers' Compensation, Tricare, Veterans Affairs (VA), Self-Pay, etc.
- Adhere to pertinent regulatory guidelines while handling various billing models, including value-based payment, fee-for-service, capitation, episode of care, telehealth etc.
- Perform a comprehensive claims review by analyzing Explanation of Benefits (EOBs), identifying reasons for denials, resolving any disputes, and initiating the appeals process when necessary.
- Analyze EOBs to calculate and report out-of-pocket expenses such as deductibles, copayments, and coinsurance to avoid any unbilled payments from the patients.
Our Comprehensive Orthopedic Medical Billing Services
- Insurance verification and eligibility checking
- Coding and documentation review
- Claims Submission
- Electronic Payment posting
- Denial management
- Accounts receivable (A/R) and follow up
- Patient billing and collections
- Credentialing and enrollment services
- Compliance and regulatory support
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Local Client Testimonials
During your consultation, some of the issues we can discuss are:
- The current orthopedic billing services for your practice.
- Inefficiencies and challenges in the current process and how we help you overcome them.
- How do we use AI-based automated billing and advanced strategies to reduce errors and boost efficiency?
- Latest trends and technologies we adopt in medical billing to enhance productivity.
Why Choose Invensis as your Orthopedic Medical Billing Company?
We are a seasoned orthopedic billing service provider with more than 25 years of experience in assisting various orthopedic medical centers. This includes general orthopedic centers, specialized orthopedic clinics (arthroscopy, joint replacement, fracture fixation, orthopedic surgery, cartilage restoration, osteotomy, physiotherapists, musculoskeletal system), orthopedic research institutes, sports medicine clinics, and others. We built a team of experts consisting of CPC-certified coders, CPB-certified billers, CPMA-certified auditors, RCM specialists, AR specialists, etc, to deliver our services. The joint effort of our team has helped our orthopedic clients maintain a near 98% clean claims rate, up to a 45-day reduction in A/R days, denials below 8%, and an estimated 95% net collection rate (NCR).
Benefits of Outsourcing Orthopedic Medical Billing Services
1. Reduced Administrative Burden:
Managing orthopedic medical billing can be a complex and time-consuming task for healthcare providers. It requires specialized knowledge of medical codes, insurance policies, and billing regulations, which can divert attention from patient care. Orthopedic billing services outsourcing can help alleviate this burden and free up valuable resources for healthcare providers.
At Invensis, we offer customized orthopedic medical billing services to meet the particular needs of our clients. Our team of experts has extensive experience in the orthopedic billing field and can handle all aspects of the revenue cycle, from claim submission to denial management. We use advanced technologies and proven methodologies to streamline billing processes, reduce coding errors, and ensure timely payments.
2. Improved Accuracy:
Orthopedic medical billing requires a high level of accuracy to avoid claim denials and revenue loss. Any error in coding or documentation can lead to delayed payments or even potential legal issues. Outsourcing the task to a third-party service provider can ensure improved accuracy and minimize the risk of errors.
At Invensis, we understand the critical importance of accuracy in orthopedic billing services. Our team of experts is highly trained and skilled in orthopedic coding, documentation, and billing regulations. We use advanced technologies and industry best practices to identify and correct any coding or documentation errors, resulting in timely and accurate claims submission.
3. Faster Reimbursement:
Effective management of medical billing is critical for the financial success of orthopedic healthcare providers. Outsourcing orthopedic billing & coding services to a third-party billing service provider can help improve the speed and accuracy of claims processing, leading to faster reimbursement and reduced revenue cycle times.
We understand the unique challenges orthopedic healthcare providers face in managing their billing processes. Our team of billing experts is well-versed in the complex coding and billing requirements specific to orthopedic procedures. Our orthopedic medical billing services use advanced software tools to ensure that claims are submitted accurately and promptly, with minimal errors or delays.
4. Access to Technology:
Technology has revolutionized the healthcare industry in many ways, and orthopedic medical billing is no exception. Advanced tools and software can significantly improve billing accuracy, reduce errors, and streamline the revenue cycle process. But, purchasing and managing the software with a team will be tedious. Orthopedic billing outsourcing can help easily access these technologies.Â
Invensis offer orthopedic billing services that use advanced technologies and software. Our team of experts uses the latest billing software and tools to ensure seamless billing operations. With our comprehensive approach, we help healthcare providers to optimize their revenue cycle management, increase billing accuracy, and reduce denial rates.
Trends in Orthopedic Medical Billing
1. Increased use of electronic health records (EHRs):
With the shift towards digitization in healthcare, EHRs have become the norm in orthopedic medical billing. EHRs help providers capture and manage patient data more efficiently, improving billing accuracy and faster reimbursement. We implement advanced EHR systems in our orthopedic billing services to improve billing accuracy and productivity, leading to increased efficiency.
2. Increased scrutiny on medical necessity:
Payers are becoming more stringent in their coverage determinations, requiring providers to provide extensive documentation to prove medical necessity. As a result, orthopedic practices must ensure that their billing practices align with these requirements. Orthopedic medical billing services from Invensis fulfill the requirements of payers, which reduces the rate of claim rejections.
3. Integration of billing and clinical data:
Orthopedic practices are increasingly integrating their billing and clinical data to improve the accuracy and efficiency of their billing processes. This allows them to identify billing errors more quickly and reduce the risk of claim denials. We at Invensis understand this and integrate both billing and clinical data through advanced techniques to remove any discrepancies to achieve immaculate billing.
What Our Customers Say
We have been working with Invensis for the past two years, and they have helped us overcome many revenue cycle management challenges. The team often walks the extra mile to ensure that our needs are met.
Invensis has been our revenue cycle management healthcare outsourcing partner for the past 5 years. They have always delivered on their commitments, whether it is meeting our Service Level Agreement (SLA) or improving our billing process.
Invensis has been a great partner providing quality medical coding and billing services. The team is extremely responsive to every query we pose, and the turn-around time for deliverables is always as committed.
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