Managing a successful orthotics business and its billing operation is quite a challenge. As there are many orthotics providers continues to struggle with reimbursement problems, significantly affecting the financial stability and sustainability. Moreover, this year in 2023, factors like increasing claim denials, shifting medical codes, and reduced Medicare reimbursements are affecting reimbursements more than ever. In fact, are the top factors that are negatively affecting the reimbursement are -
Rising Claim Denials: it is true that most health professionals experienced a 5 to 15% increase in claim denials, amounting to billions of dollars in lost reimbursements across the U.S. And the reason can be due to staff shortages, insufficient clinical experience, growing backlogs, inadequate technology and unaware of billing regulation etc. Addressing these challenges however is possible and evitable and it begins with a comprehensive understanding of denial patterns, identifying and rectify the root causes with careful attention.
Dramatic Changes in Medical Codes: With nearly 400 changes in the Current Procedural Terminology (CPT) in 2023, creating confusion for all as well as more chances of billing and coding mistakes. Thus staying informed and aware of all the necessary changes is vital to avoid claim denials or delays and in order to minimize errors and reduce administrative burdens.
Reduced Medicare Reimbursements: as the Medicare reimbursement cuts were lowered from 4.5 to 2%, it is best that the providers focus on enhancing efficiency to optimize revenue cycle management with the help of automating processes, streamlining workflows, optimizing staffing levels and identifying improvement areas and more in fact will help in improving the bottom line
Low Collection Recovery Rates: Ensure transparent pricing, flexible payment options, and effective communication to improve collection rates.
Payer Underpayments: Addressing payer underpayments requires a proactive approach, including analyzing current contracts, negotiating better terms, and monitoring payments. This is why you need professional help who can leverage revenue cycle management tools and software to not only track and manage payer contracts, claims, and payments but ensures a seamless orthotics billing transaction as well.
In fact, today having an operational partner managing your orthotics billing is not only a convenient means to optimize the revenue cycle management and improve financial stability through technology, BUT outsourcing from Sunknowledge further helps you in focusing on patient care while the expert guarantees billing efficiency, better bottom line, and data-driven solutions.
Navigate reimbursement challenges and enhance financial health, Sunknowledge can help you overcome all your reimbursement challenges, prevent future denials and improve financial outcomes in no time.
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About the Author
William Jones Joined: May 7th, 2019 Articles Posted: 46
