Did you know the Orthotics and Prosthetics market size was valued at $6.76 billion in 2023 and the market is expected to grow at $9.84 billion by 2032? Along with the demand for these services, the complexities in Orthotics and Prosthetics billing are increasing steeply. On the one hand, the patient volume and workload are increasing. On the other hand, the workforce shortage and stratospheric wages are grappling Orthotics and Prosthetics billing with more challenges.
Let’s explore some unique challenges an Orthotics and Prosthetics practice faces.
Challenges in Orthotics and Prosthetics Billing Processes
Due to the nature of the services, the Orthotics and Prosthetics providers face a different set of challenges in billing. Some of the common challenges in Orthotics and Prosthetics billing compliance are-
Getting prior authorizations: An AMA survey states that it takes at least 16 working hours to get prior authorization for an Orthotics or Prosthetic device. As a result, the providers are burdened with tedious paperwork which is hindering the care process. Due to this, your patients face delayed treatments, and the health outcomes are deteriorated. Furthermore, you face the challenges of bad rapport and revenue loss. Your practice loses its financial and functional stability.
Inadequate documentation: To maintain a streamlined billing process, you must consider errorless documentation within the process. A lack of medical histories, examination findings, treatment details, and relevant information can result in claim denials and revenue loss. Your burned-out staff can often make mistakes in this daunting process of documentation and your practice might face the issues of claim denials.
Complex coding: Coding challenges exist in all types of medical billing and Orthotics and Prosthetics are no exception. However, the labyrinthine coding requirements within this field make it more complicated. Furthermore, the CPT codes change yearly. A lack of knowledge regarding the same increases the complexity of the process.
For example, EM services are not separately billable in the case of Orthotics and Prosthetics. The coding for orthotic and prosthetic devices can vary based on whether they are intended for the left or right foot or hand. These intricate details make the coding process complex and there are higher chances of errors.
Bottom Line
Efficient management of Orthotics billing and Prosthetics billing is paramount to maintaining practice quality. Outsourcing to a reputable medical billing partner can resolve billing challenges effectively. Revenue generation stands as a pivotal element for any practice. A trusted outsourcing partner such as Sunknowledge Services Inc. can function as an extension of your operations, delivering top-notch Orthotics and Prosthetics billing and coding solutions to major practices nationwide. With a competitive rate of $7 per hour, they offer comprehensive solutions ensuring 100% HIPAA compliance. Their dedicated team proficiently manages pre- and post-billing services, leveraging their expertise in billing norms and coding regulations. Collaborating with a dependable outsourcing entity empowers you to prioritize patient care while optimizing ROI effectively.