Why are claims denied in most of the orthotics and prosthetics billing? Many questions arise among industry experts and researchers. After an entrenched analysis, many loopholes have been discovered. Prior Authorization is an imperative part that is often missed out by the nascent billers.

To encounter these threats of revenue loss in orthotics and prosthetics billing, proper monitoring and analyzing of filing a claim and handling its rejections & denials are mandatory. O&P billing requires an intuitive understanding of reimbursement rules of Medicare, Medicaid, and other commercial plans. Similarly, it requires comprehensive adherence to quality and staying well-informed of the sizeable number of change event in repayment regulations and coding & documentation pre-requisites.

Prior authorization approval is the leading constituent to commence and complete the process. To assess, prescribe, design, fit, monitor, provide therapy, and educate regarding the use and care of an appropriate orthotics/prosthetics devices needs detailed attention. Hence, proper execution of billing clears all aging accounts receivable enhancing revenue cycle management process.

Let’s take a brief glance, how to effectively outsource orthotics and prosthetics billing:

~ To identify the reason behind claim denials. It shouldn’t be perceived as a simple back-end financial solution. Rather, it should be inspected and analyzed as an end-to-end revenue cycle process in Orthotics and Prosthetics billing.

~ En route denials to the appropriate personnel, it requires system enhancement. The crux lies here; outsourcing expertise provides the key solution to it. Proper trained and educated O&P outsourcing personnel are the pros to fix the denial issues with an apt presence of mind.

~ The strategy should focus on intelligent denial management outsourcing. The approach should be designed to take care of the DME business and how to optimize its revenue generation.

~ O&P billing outsourcing looks at client’s preferences with sheer flexibility and customization. Adequacy and segregation among the outsourcing professional help to generate lost revenue.

~ Tracking, trending, and reporting of data which should be systemically monitored to lay a significant emphasis on revenue cycle through O&P billing.

Effective management of O&P multiplies cash flow and leads to sound financial health and flexibility of a business body that is done by the intervention of an effective healthcare revenue cycle management service provider.