Decreases in reimbursement amounts for orthopedic services and procedures are causing surgeons to come up with new adaptations, including implementing automation and reeducation practices.
To keep a positive cash flow, surgeons have had to cut down on administrative staff, as well as making sure their staff are fully trained on proper coding and billing techniques.
Ask Orthopedic Surgeons is a weekly series of questions posed to orthopedic surgeons around the country about clinical, business and policy issues affecting spine care. Becker’s invites all orthopedic surgeon and specialist responses.
Next question: Are you concerned about the long-term implications of AI in surgical planning or documentation?
Please send responses to Cameron Cortigiano at ccortigiano@beckershealthcare.com by 5 p.m. Central time, Monday, July 28.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: How has payer behavior changed in the last year, and how are you adapting?
James Andry, MD. Orthopedic Surgeon at DISC Surgery Center at Carlsbad (San Diego): As reimbursements diminish and scrutiny of claims goes up, we have been forced to automate our business processes and strategy to maintain a positive cash flow. This has resulted in the elimination of front-office positions, but these adjustments are unfortunately necessary in order to stay in practice. To help preserve our staff, we have benefited from joining TriasMD’s physician-first network of ASCs, which helps negotiate better reimbursements for our services.
David Kugelman, MD. Joint Replacement Surgeon of Rothman Orthopaedics (Philadelphia): CMS reimbursement cuts for [total knee arthroplasty] and [total hip arthroplasty] have made thorough, accurate documentation across pre-op, peri-op and post-op phases more critical than ever. Our team is prioritizing education on proper coding and billing strategies to ensure we’re appropriately capturing the full scope of care provided, as underbilling remains a common and costly issue.
