For The Love of Revenue Cycle

Ep. 45 - Orthopedic Revenue Cycle Deep Dive


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In this episode of 'For the Love of Revenue Cycle,' we delve into the unique aspects of the orthopedic revenue cycle compared to general Revenue Cycle Management (RCM). The discussion covers four key themes: prior authorization and payer policy awareness, global surgical rules, care settings, and payer types. Practical tips are provided for various stages including scheduling, registration, coding, claims review, payment posting, and AR management. The episode also offers management takeaways and highlights common denials in orthopedics and strategies for avoiding them. The insights are valuable for employees, managers, consultants, and technology partners working within the orthopedic realm. 00:00 Welcome and Introduction 00:50 Orthopedic Revenue Cycle Overview 01:30 Patient Intake and Scheduling 03:16 Registration and Check-In 04:04 Prior Authorization and Payer Policies 05:52 Encounter and Coding 08:27 Claims Creation and Review 09:25 Denials and Resolutions 10:50 Settings of Care 11:57 Workers' Compensation 13:17 Accounts Receivable Follow-Up 16:23 Leadership and Management Tips 17:56 Common Denials and Prevention 19:17 Conclusion and Final Thoughts
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For The Love of Revenue CycleBy Vanessa Moldovan

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