For orthopaedic billing teams, revenue cycle management (RCM) requires far more oversight than the standard medical claim. Unlike other specialties, orthopaedics is notorious for shifting fee schedules and coding changes. A 2022 report from the Centers for Medicare and Medicaid Services (CMS) calculated more than $131 million in projected improper payments in the orthopaedic surgery specialty. Approximately 25% of those errors were the result of incorrect coding.¹

Even with experienced in-house staff, there’s a good chance that billing and coding details will fall through the cracks, especially if your team is processing high volumes of patient claims. This translates into inaccurate claims that, even if accepted later on, delay time to payment and slow your cash flow. And while your bottom line may feel the impact of faulty RCM most acutely, your patients will undoubtedly notice billing errors and inefficiencies — and they likely won’t be happy about it.

Why RCM Matters to Your Patients

Covering the cost of medical care can be stressful enough for patients. Adding any level of confusion or inaccuracy to the equation can quickly degrade the patient experience. Because attracting and retaining patients is crucial to your bottom line, it only makes sense to implement a stress-free billing process that minimizes patient dissatisfaction and keeps cash flowing.

A recent healthcare consumer survey sheds light on what patients are looking for in the billing process. Among the 2,000 American patients surveyed, 38% reported feeling confused by their medical bills.2 Moreover, when asked about frustrations with the medical billing experience, the top responses included:²

• Not understanding what they’re being billed for (29%)
• Unsure of whether or not they can pay their bill (27%)
• Not receiving their bill until weeks after the rendered service (24%)
• Questioning if their bill will match the estimated patient responsibility (20%)

These challenges are only amplified in the orthopaedic space, where errors and claim-related delays often slow the revenue cycle. For orthopaedic practices looking to get ahead — or at least trying not to fall behind — taking advantage of opportunities for RCM improvement may prove to be a revenue- and practice-saving move.

Drive Satisfaction With Patient-Centric Billing

While evaluating the health and status of your revenue cycle, consider the role patient preferences play in helping your practice get paid. A 2022 healthcare payments report found that 73% of patients wish to pay their medical bills online.3 In fact, 77% of the respondents now expect their providers to offer virtual and self-service payment options.3 Considering nearly two-thirds of providers send out two or more statements before collecting a full patient balance, catering to patient expectations is a must for practice profitability.³

Tackling the revenue cycle is a big enough challenge for your billing team. Staying current on patient expectations and making the necessary changes may exceed your team’s bandwidth. When you partner with billing and coding experts dedicated entirely to the orthopaedic revenue cycle, you give your patients the convenience, clarity, consistency, and accuracy they need to successfully move through the billing process. Connect with an orthopaedic billing specialist today to learn how Med USA’s end-to-end RCM solution can help your practice increase patient satisfaction for a stronger bottom line.

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Sources

1. 2022 Medicare Fee-for-Service Supplemental Improper Payment Data.. (2022). U.S. Department of Health & Human Services, Centers for Medicare and Medicaid Services. https://www.cms.gov/files/document/2022-medicare-fee-service-supplemental-improper-payment-data.pdf 
2. Nearly 40% of Americans Confused by Medical Bills.. (2022). AKASA. https://akasa.com/press/nearly-40-of-americans-confused-by-medical-bills/ 
3. Trends in Healthcare Payments Thirteenth Annual Report.. (2022). J.P. Morgan. https://storage.pardot.com/279102/1679615220zJlNLKz3/Trends_in_Healthcare_Payments_Annual_Report_2022.pdf