Ep. 45 - Orthopedic Revenue Cycle Deep Dive
Update: 2025-10-07
Description
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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