Orthopedic billing services

Orthopedic Billing and Coding

Orthopedic billing and revenue cycle processes pose a challenging time to the providers for accountability of every procedure and diagnosis administered. Billing teams often grapple with the aspects of the orthopedic billing process leading to a lot of complex situations and loss of revenue opportunities. To fast-track the revenue reimbursements an orthopedic biller and coder should remain abreast with the ever-changing billing and coding guidelines which call for an overhaul on the part of in-house teams trying to keep up with them. QWay Healthcare specializes in providing comprehensive orthopedic medical billing services and streamlined processes so you can continue focusing on providing quality-driven patient care.

We cater to the following branches and divisions amongst many others:

  • 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
  • Osseointegration Clinic

Steps followed in Medical Billing Orthopedic:

  1. The patient’s insurance eligibility and demographic verification are undertaken to ensure that the services by the providers are covered by the payer terms. Coverage issues if any are encountered are appraised to the provider beforehand.
  2. The invoices and other documents provided by the customer will be coded in accordance with HIPAA guidelines using our understanding of CPT, ICD, and HCPCS protocols. Our certified coders understand the complexities of the procedures and safeguard against under and over-coding.
  3. Coded charts are converted into bills by billing teams and charge entry is carried out according to the procedures and diagnoses administered to the patients.
  4. Following the completion of the Orthopedic medical billing services, we will conduct a billing audit to confirm that the quality is satisfactory which will result in a reduction of the time needed for claim verification and reimbursement.
  5. Finally, claims are submitted to the payers in the prescribed format and timely manner for reimbursements. Claim rejects and denials if any are closely monitored and inspected according to a strategic and set framework.

Services we offer for Orthopedic Billing and coding:

  1. Patient demographics and verification services: We understand the growing complexities of patient data gathering and organizing if wrongly entered can lead to rejections and denials of claims from the payers. Our teams interact with patients to verify the details entered and check for insurance eligibility for the services to be provided.
  2. Orthopedic coding services: Our team of AAPC-certified specialists will use the most recent tools and software to make sure that our practice complies with customer expectations and industry standards. They are knowledgeable about the most recent ICD coding system, insurance claim requirements, and terminologies. You can benefit from optimum collections for the services you gave to your patients thanks to our expertise in orthopedics coding.
  3. Claim submission services: Our teams create a process and follow standard procedures and metrics to ensure that the claims are submitted in a timely manner. Quality teams undertake audits to make sure that the patient details are filled in correctly to bill and process the claim hassle-free.
  4. Denial management services: Often due to denied healthcare claims thousands of dollars are lost due to the lack of a strong framework of denial management policies and procedures. Our denial management teams investigate the root cause and check for errors to submit a clean claim ensuring timely payment.
  5. AR follow-up services: Due to new and changing payer plans, co-insurance agreements, patient co-pays, and an increase in patients with high deductible health plans, the nature of AR has grown significantly complex. In order to comply, the healthcare provider must revamp and reevaluate its revenue cycle management. Our team of specialists and skilled professionals adhere to the established standards through diligence and quality checks, staying current with today’s complex procedures.

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