4 Cost-Saving Technologies for Orthopedic Practices

Practice Management

Here are four technologies that can save orthopedic practices time and money.

1. Ultrasound technology. Orthopedic surgeons can use the ultrasound technology for diagnostic purposes and injection guidance. The technology enables physicians to see their patients' anatomy in real time for diagnosing an injury or placing an injection. "It's painless and there's no radiation involved," says Ben DuBois, MD, an orthopedic surgeon with Grossmont Orthopaedic Medical Group in La Mesa, Calif. "Patients are able to see their anatomy on the screen at the same time you are, which allows them to become involved in their care."

Despite its dual purpose, many physicians are only comfortable using the technology for image guidance because it's easier to train on. "These surgeons are seeing the structure and the needle and they can watch the needle go into the space where it's supposed to," Dr. DuBois says. "Their comfort level is higher with this because the learning curve is less steep than if they were using the technology for a diagnostic exam."

Both the diagnostic and injection guidance uses of the ultrasound technology are CPT billable procedures, which mean they can be another source of revenue for the practice. Additionally, the diagnostic ultrasound cost 60-70 percent less than an MRI of a similar body part, which brings down the total cost of care. The technology does have a steep upfront cost from purchasing the equipment — which can range anywhere from $30,000-$60,000 — and training for appropriate use, but these costs are quickly recovered by the extra revenue it generates. "The reimbursement for the use of the ultrasound more than off-sets the monthly cost of the machine," says Dr. DuBois.

2. Electronic health records. Michael Rauh, MD, an orthopedic surgeon at UB Orthopaedics & Sports Medicine in Orchard Park, N.Y., uses EHR in his practice in combination with voice recognition programs to dictate directly into the EHR. This eliminates the costs associated with traditional transcription and can make workflow more efficient. "From a cost standpoint, we have more than 30 physicians in our group and we measure the cost of transcription per patient across the board," he says. "We found that those who are non voice recognition users cost about $6.52 per patient. Those who continue to use the technology are reporting an average of $2.34 per patient. One of the partners found it costs him $1.06 per patient, and another reports an average of $0.63 per patient. It's a huge cost savings on the front end transcription. Those who are using this technology are also billing at a higher level because the claims are documented appropriately. When there is a lower cost per patient and a higher rate of reimbursement, it ends up doubly benefiting us."

3. Revenue cycle software.
There are software programs available for orthopedic surgeons to decipher codes, check patient eligibility and payment tracking. "If the physician hasn't upgraded his or her practices' technology, there is a good chance he or she is leaving money on the table," says Dave Wold, CEO of Healthcare Information Services. Coding software also allows the physician to design individual payor edits and regulations to ensure claims are appropriately filed and will not be returned. This eliminates the need for manually entering codes into the claims. For the best results, Mr. Wold suggests physicians speak with certified coders about key words to use in their reports for improved accuracy during the transcription between codes and physician documentation.

On the back end, after a physician enters into a contract with a payor, he or she often assumes the contracts are met. However, payors sometimes underpay on contracts and losing this money can make a big difference to the practice. Mr. Wold said one of his clients recently identified over 500,000 underpayments while another discovered 100,000 instances where the payor stopped paying for a second procedure when contract guidelines stated the payor would. Payment tracking software allows the physician to enter in different negotiation schedules and then run the payments through to ensure the payor is meeting contract guidelines with each claim.

4. Electronic scheduling programs. Implementing an electronic scheduling program, such as Patient Prompt, will cut down on the number of missed visits and increase patient awareness about their financial responsibility for visits, says Claude Waknine, director of business development at Patient Prompt. Depending on the patient's age and preference, practices can receive a higher rate of successful confirmations by utilizing HIPAA compliant forms of e-mailing or text messages reminding patients about appointments. Successful confirmations occur with a telephone when the patient is instructed to "press one" to confirm their appointment time and does so.

For some patient visits, protocol requires them to have specific information or ability to financially cover a portion of the visit available at the practice. Mr. Waknine says that if the automated message is tailored to instruct these patients on appropriate protocol, they are more likely to have this information available at their appointment.

When a patient does listen to the appointment reminder and confirms the appointment, the practice should be able to immediately populate their schedule with that appointment confirmation. Physicians and practice employees should use a method  that can immediately post results to their calendar and identify the gaps in the appointment schedule and fill them quickly. "When an appointment is set out, Patient Prompt populates the scheduling system in real time," says Mr. Waknine. Research the labor costs for appointment reminder calls, the current no-show rate, rate of missed or cancelled appointments and investigate the technologies that can decrease these numbers.

Related Articles on Orthopedic Practices:

5 Tips for Making Patients Happier at Orthopedic Practices

Dr. Geoffrey Connor: Developing a Boutique Orthopedics Practice

4 Ways Orthopedists Can Form a Relationship With Referring Physicians

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