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!

The post Three Reasons Orthopedic Surgeons Lose Revenue appeared first on MEREM Health.

In fact, if healthcare practices are not careful, they could be losing revenue even as more patients come walking through the door. But why does this occur?

Where Does the Money Go?

There are many reasons behind a healthcare facility losing revenue while still seeing a great number of patients, including:

Inaccurate Coding

One of the most common reasons behind a medical practice losing money is inaccurate (or inadequate) CPT coding input.

Health care is always changing. With that, medical billing codes also continually change. Therefore, if the billing professionals within your medical practice are not staying up-to-date on coding, the revenue can be lost due to denied claims or reduced reimbursement.

However, under-coding can play a large part in revenue lost, too. Many times, if the billing department is unaware of what occurred during a patient’s exam or surgery, they can “undercode” for the services used because they just don’t know what exactly went on within the exam room.

It is estimated that a medical practice loses a minimum of $10,000 each year due to only undercoding. Thus, it is vital for the lines of communication to be open within a medical practice, especially when it comes to quarterly coding education and reimbursement protocols.

Poor Billing Practices

Within a healthcare facility, every department needs to follow best practices, especially billing. When poor billing practices occur, the result can take a huge toll on the medical practices’ finances.

Most of the time bad billing happens not because the people within the billing department are purposely making mistakes. But, just like in coding, if your employees are unsure about the what they are supposed to be doing in billing, financial losses in your medical practice can (and will) happen.

It’s critical during the interview process that you are using professionals who are competent in medical billing to fill your positions within the department. In addition, receptionists and other positions should be able to properly know how to file patient insurance and services so that the billing department receives accurate information to help prevent billing issues, as well.

Insurance Plans

Unfortunately, even if you perform the two tasks above well – bill correctly and code accurately – loss of revenue can still occur. How? Because of the insurance plan your medical practices do business with daily.

While some insurance companies are great about their reimbursement practices, other insurance companies will hesitate to reimburse what is due or might have a low reimbursement schedule.

If you happen to work with one of those insurance companies, it is easy for payments due to your medical practice to fall further and further behind in payments until they usually stop paying you altogether, resulting in loss of revenue. Therefore, be careful of the insurance companies you do business with to ensure they are not the reasons behind your loss of revenue within your practice.

Is your business losing money? Contact the professionals at Merem Health to learn about our consulting, outsourced billing, collections, and revenue cycle management services.

The post Is Your Healthcare Facility’s Revenue Moving in the Wrong Direction? appeared first on MEREM Health.

Optimizing Patient Collections

Long gone are the days of $25 co-pays and $250 deductibles. With the increasing prevalence of high deductible insurance and patient cost-sharing plans, it has never been more important to the financial health of your practice to have an efficient patient pre-collections program in place. Less than 50% of these up front balances are ever recovered, placing a great burden directly on a clinic’s revenue due to “bad debt.”

At this year’s mid-year mark, can your practice afford your current record of unpaid bills in write-offs?

3 Steps Toward Optimizing Patient Collections

Clinical staff play a key role in patient collections. At Merem Healthcare Solutions, we work with our client partners to develop a Patient “Pre-Collections” strategy that is both aggressive and fair. Following these three tips will help your clinical staff to develop a Point-of-Service (POS) collections process to effectively collect more money up-front.

1. Constantly update a record of unpaid bills and review it with upcoming appointments.

Typical patient collection efforts only go as far as issuing statements and generating “bad debt” reports of accounts that need to be turned over to collections.

We can provide you with custom reports such as a payment plan list, to aid in POS collection efforts and to ensure patients meet their terms

2. Clearly communicate with your patients that outstanding bills are expected to be paid prior to their clinic visit.

When you can discuss these matters prior to the procedure date, patients are more likely to be receptive and proactive rather than distracted or caught off guard and agitated about any unexpected financial obligations. Also, you will help patients to better prepare financially for their visit and open the opportunity to provide payment options prior to sending to collections.

With MEREM Health, you will have the added support of a patient collections representative to support your billing team. Our patient collections reps work diligently to collect patient balances in full or to make payment arrangements within 90 days and will help you identify and transmit delinquent accounts to a third-party collections agency of your choice.

3. Train your clinic staff to prompt the patient for payment

This is a guaranteed technique in the effort to increase practice revenue but it requires a strategic and passionate approach. As you inform patients’ preemptively of what they will owe for their care, the more likely you are to get paid.

Discussion of a patient’s financial obligation should begin prior to receiving treatment. Many consumers lack a clear understanding of their insurance coverages and are often unable to determine their financial responsibilities themselves.

Keep explanations simple in order to help ensure patients understand what is expected of them and help avoid confusion or discourage them from listening to or reading information. Also, be sure your staff are prepared and available to answer any questions.

For more information about our Patient Pre Collections Services, visit our website. www.MEREMHealth.com

MEREM Healthcare Solutions is a Birmingham, AL-based company that has been providing exceptional medical billing and coding services to physician practices and ambulatory surgical centers since 2008. We pride ourselves on not just maintaining, but exceeding, the level of accountability, communication, and customer service that is valued in traditional, on-site billing departments.

Please check out our other blog posts, or contact us to learn more.

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