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1. Begin the transition to ICD-10. Healthcare providers across the board are struggling to prepare for the conversion from ICD-9 codes to ICD-10. These changes could make billing and coding easier in the future because they allow for a more specific description of the procedures performed, but the implementation of a new system has upfront inefficiencies, especially for small practices. “Small practices will probably have a more difficult time due to a lack of resources and personnel to mitigate these requirements,” says Brad Melis, executive vice president of ChartLogic, a vendor of software for orthopedic practices. “The level of coding that will be required is much more specific and the codes that staff members are going to have to deal with will increase significantly.”
Some practices are looking to professional billing companies to ensure their claims are coded correctly. “We’re anticipating some smaller practices will turn to billing services instead of trying to handle changes for fear that they won’t get it right,” says Mr. Melis. “Most practices understand that you need a quality biller to maximize revenue. These professionals are expensive, but when you double the code set, it becomes obvious that knowledgeable coders will be very valuable.”
Electronic medical records and company vendors are also becoming more proactive in helping physicians locate the right code and transitioning to the new system. “We’ve worked on initiatives to perform cross correlation from ICD-9 to ICD-10 so physicians or coders can pick out familiar codes in ICD-9 and we’ll transfer it to ICD-10,” he says. “Vendors are doing consultations with physicians to make sure they are collecting their money appropriately. All these changes require a commitment from stakeholders to help physicians, because physicians are the ones we depend on. The market is taking an aggressive approach to make sure these initiatives aren’t just thrown at physicians, but they have a resource to go to for help.”
2. Devise a process for dealing with denied claims. When claims are denied, orthopedic practice staff should know exactly how to deal with them. Have a process in place to locate the mistake, fix the error and then have the claim back out the door quickly so denials don’t bump against filing deadlines. “In some cases, when practices receive a denial there is no activity on it because the practice hasn’t staffed someone to take responsibility for denied claims,” says Dave D’Silva, COO at Healthcare Information Services, a company focused on maximizing physicians’ reimbursement and revenue. “You’re leaving money on the table by not fixing or appealing these claims.”
Incentivize your employees to meet national benchmarks. If the staff still has trouble, you might want to consider outsourcing denied claims to achieve the best returns.
3. Start providing ancillary services. It’s very helpful for orthopedic practices to add ancillary services, if they haven’t already, and fully integrate all services to provide the best continuum of care possible. OA includes fully integrated X-ray, MRI and physical therapy services and a surgery center in addition to its clinic, so patients can benefit from several specialists who are all in communication about their individual care.
“The patients understand that their care is communicated from point to point, and they appreciate it,” says Mr. Wipfler. “Ancillaries are a big part of our ability to survive over time, in part because it is more cost efficient as well as improves quality of care as a result of the continuity of care by providers who are all on the same page.”
4. Partner with athletic trainers and open a sports performance facility. There is a big focus on preventative care among sports medicine professionals today and one way to ensure young athletes are getting that message is through a sports training facility, says Angie Van Utrecht, director of operations at Orthopedic Specialists in Davenport, Iowa. The facility should employ athletic trainers and other professionals focused on teaching athletes about age- and sport-appropriate stretching and training. Orthopedic Specialists owns Acceleration Quad Cities, a sports training facility that is part of the Athletic Republic franchise.
Practices looking to become a “one-stop shop” for sports medicine care and treatment should especially consider owning an athletic training facility. Though Acceleration itself doesn’t generate much income, Ms. Van Utrecht says “it is a huge funnel of athletes into our practice.”
The athletic trainers can also become team physicians for local athletic clubs and represent your practice through those responsibilities.
5. Bring on more physicians and specialists to increase services at the practice. Thinking outside the box is critical to achieving success despite the typical market challenges of the day, says Robert S. Bray, MD, a neurological spine surgeon and founder of DISC Sports and Spine Center in Marina del Rey, Calif. While some orthopedic and spine surgeons have spent a great deal of time defending surgical treatment as the only true method of care, DISC has embraced alternative care providers as patient demand has dictated.
“Athletes want soft tissue therapy, acupuncture, rehabilitation facilities, injury avoidance and biomechanics specialists as well as athletic trainers — not just a physician who will perform a knee scope,” says Dr. Bray. “Incorporating all the different specialists has been the thrust of DISC for the past four years. You need to perform minimally invasive, top-quality surgery for your patients, but almost more than that you need the ability to provide all types of care.”
6. Give your waiting room a make-over. Since patients often spend time in the waiting room, this is a significant opportunity to show off your practice and market your different services. Compile five minute video clips from all of the practice physicians discussing their subspecialty and the latest technology in their field. Spine surgeons can talk about minimally invasive procedures while knee surgeons might talk about new techniques for joint replacement. “If you’re going to spend money on marketing, the most important place to do that, at first, is in the waiting room,” says Peter Althausen, MD, an orthopedic surgeon at Reno Orthopaedic Clinic and chairman of the board of directors of The Orthopaedic Implant Company. “If you market yourself as ‘top in technology,’ you want to show your patients that from the beginning. You also want to make sure your waiting room is clean, put together and modern.”
Hanging a plaque on the wall with all the physicians’ names and specialties is another way to share about your practice. Patients who come to your practice for joint replacement might have a great experience, but they’ll go elsewhere for their spine surgery or ankle care because they don’t know physicians at your practice can treat those conditions. Hanging a plaque in the waiting room that includes each physician’s certification is a relatively inexpensive way to communicate the diverse range of conditions practice physicians treat. Patients will also remember these conditions when their friends need orthopedic care. “The patient might come to the practice for their shoulder, but their friend might need a knee replacement and they’ll remember to send them to your practice,” says Dr. Althausen.
7. Create a practice website. Orthopedic practices have traditionally relied on word-of-mouth marketing and primary care referrals to attract patients. However, many of today’s patients are tech-savvy people who rely on the Internet for their information, even when it comes to choosing where to receive their medical care. “When patients get referrals, they want to look up the practice website,” says Ted Epstein, Director of Sales at Medical Web Experts. “If you don’t have a website or have an unattractive one, you are at risk of losing your referred or potential patients.”
The Internet can be a successful tool for practice marketing because physicians can track the website’s effectiveness. Webmasters can use analytical tools to track how many times the website is viewed every month and which pages receive the most views. “Physicians are analytical and we can provide data that backs up the marketing,” says Mr. Epstein.
8. Implement best practice policies and hold surgeons accountable. Have a written set of practice policies that all physicians agree to uphold. When a surgeon breaks the rules or goes against the policy, make sure you hold them accountable for their actions. “You want policies that reward people for doing the right thing, not for people to get away with doing the wrong thing,” says Daniel Murrey, MD, MPP, a spine surgeon and CEO of OrthoCarolina. “Surgeons don’t want to see others getting away with doing the wrong thing. Our physician leadership is willing to call people out when they don’t follow our policies. This is uncomfortable for a lot of physician groups, but it’s a key to our success.”
Related Articles on Orthopedic Practices:
How to Grow an Orthopedic Practice: 4 Business Principles of DISC Sports and Spine Center
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