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Streamline Your Prosthetics & Orthotics Billing with Proven Strategies

Overcome P&O Billing Challenges &
Improve Your Revenue and Cash Flow

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P&O Billing Tailored for Your Practice

Prosthetics and Orthotics billing (P&O) is a time-consuming and complex process and requires providers to devote a significant amount of time to reimbursement. Being a very specialized and niche area, P&O billing requires billers to have adequate understanding and knowledge about prosthetics and orthotics items. DMEPOS billers at RCM Workshop have deep insight and experience to handle the nuances of prosthetics & orthotics billing and are dedicated to delivering the best outcome to augment your revenue goal. 

With our industry standard best practices, metrics driven process management and our quality first service delivery approach, our dedicated service for prosthetics and orthotics billing is an ideal solution for your revenue cycle. When you outsource orthotics and prosthetics billing to us, we treat every claim during the billing cycle as important, and our expert billers methodically work on and meticulously track every claim till closure so that you get correct and timely reimbursement for your services and supplies.  

Unbeatable Service, Quality & Price

ACCURACY
0 %
TURNAROUND TIME
< 0 Hours
COLLECTION
0 %
PRICE
Starting from $ 1100 /Month

Challenges

Challenges in Prosthetics & Orthotics Billing

A key challenge in P&O billing is relative lack of understanding and knowledge in prosthetics and orthotics among the billers. So experienced billers who have worked on P&O billing can only add value to the revenue cycle. With experienced coders and billers in prosthetics and orthotics, RCM Workshop ensures better outcomes and an improved revenue cycle. 

Prosthetics and Orthotics providers encounter distinctive compliance challenges due to the nature of their practice. Coverage restrictions, unique regulatory requirements, and coding complexity are common challenges that characterize P&O reimbursement processes. We have a robust compliance program to navigate the complex regulatory environment and conduct regular training on compliance requirements and changes in guidelines.
Reimbursement challenges continue to be the biggest concern for P&O practitioners due to more denials and delays in payments. With our coding & billing expertise in prosthetics & orthotics domain, optimized billing process, and meticulous support for documentation, we guarantee exceptional outcome of your revenue cycle.

OUR PROCESS

Our Prosthetics & Orthotics Billing Process Workflow

Considering the high dollar value of average prosthetics and orthotics claims, our P&O billing is appropriately tailored to create and track claims till closure to avoid any revenue leakage in the billing process. Our end-to-end P&O billing process covers every billing task from pre-billing services such as order intake, eligibility verification, prior authorization, and order fulfilment to post-billing services encompassing claims creation, submission, payment posting, denial management, and AR follow-up. Our billing experts follow up with the doctor’s office and patient, confirm orders, schedule delivery, and coordinate with patients, ensuring a seamless DME revenue cycle. 

We prioritize extensive quality audits and reviews, and meticulously organize documents at every stage of the revenue cycle to achieve timely and high-quality outcomes. Our analytics driven approach helps us monitor, measure and manage every billing process based on key performance indicators (KPI). Our metrics driven reporting tool captures and reports every aspect of process performance – productivity, quality and $ collections in a transparent way and gives you full control over your billing process.

Order Intake

Capture and document the details of equipment orders, patient, provider and insurance information after receipt of Rx / Order.

Eligibility & Benefits Verification

Confirm patient primary and secondary insurance and benefits coverage for DME and supplies, and check authorization requirement for the DME.

Prior Authorization

Initiate request for prior authorization with the payer, follow-up to check status till closure and finally update the system with approval reference number.

Doctor’s Office Follow-up

Regular follow-up with ordering physician’s office to gather various documents like Rx, CMN etc. to fulfil DME specific billing requirements.

Delivery Scheduling & Arrangement

Coordinate with supplier and patient for delivery of DME and generate delivery tickets and communicate with patient.

Order Confirmation

Verify all order details and patient information, and confirm DOS after receipt of Proof of Delivery.

Code Review & Charge Entry

Check accuracy of HCPCS Level II codes and modifier and assign corresponding and appropriate charges to the codes.

Documentation Audit and Review

Gather all documents needed as per DME specific guidelines and thoroughly review those before claim submission.

Claims Edit & Submission

Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.

Payment & Denial Posting

Carry out both auto as well as manual posting for payments received and conduct reconciliation against claims.

Denial Management

Analyse and categorize denial claims according to denial codes, $ amount and payers, and resubmit claims after correction.

AR Management

Based on aging report, track and monitor unpaid claims; follow up with payers to gather status for claims, and their resolution.

Patient Collection

Sending patient statements and follow-up with patients for final and outstanding payment.
Tailored to your specific needs, you have the flexibility to entrust us with either your entire billing or select any combination of our Urgent Care billing services. Rest assured, our seamless integration ensures smooth operations without causing any disruption to your billing workflow.

BENEFITS

Outcomes Guaranteed

Our orthotics and prosthetics billing follows industry standard best practices and assures a consistent and exceptional outcome. Our methodical and diligent approach in performing billing tasks at every stage of the billing cycle, from intake to claims submission and collection, ensures improvement in financial outcome and full compliance. 

Efficient insurance verification

>99% clean claim submission

Efficient authorization management

<24 hours turn-around time

Efficient coding & code review

>25% increased reimbursement

Efficient denial management

<5% claims denials

Efficient claims tracking & AR follow-up

<40 days AR & reduced aging

Correct documentation

< improved compliance and less denials

WHY US?

Why partner with us

Our P&O billing service is designed to integrate flawlessly into your current billing framework, catering to all your billing requirements seamlessly. Leveraging our profound expertise and specialization in orthotics and prosthetics billing, alongside extensive experience in P&O revenue cycle management services, we, at RCM Workshop, guarantee meticulous and precise handling of your billing procedures. Our team operates as an extension of your existing setup and our unwavering commitment to your operational requirements ensures an improved revenue cycle and a steady cash flow. Outsource P&O billing services to us today for unparalleled outcomes. 

Guaranteed Improvement in Reimbursement and
Cash Flow

Reduction in denials <5%

Reduced bad debt &
AR aging <40 days

100% data security
& HIPAA compliance

On demand scale up
of operation

Significant Reduction
in Cost > 75% Savings

Simple & No
Cost transition

Flexible & Unbeatable
Pricing Plan