How Orthopedic Revenue Cycle Management Increased Revenue by 77%
An orthopedic facility transitioning from in-network to out-of-network reimbursement was struggling with rising accounts receivable, delayed reimbursements and inefficient operations. By strengthening orthopedic revenue cycle management, Coronis Health helped increase its revenue by 77.47%.
Client Profile
Orthopedic facility
- Client
- An orthopedic facility
- Specialty
- Orthopedics
- Scope
- Orthopedic revenue cycle management and billing optimization
The Challenge
Navigating an Out-of-Network Transition
Orthopedic revenue cycle management became increasingly complex as the facility transitioned from in-network to out-of-network reimbursement. Mounting accounts receivable, a growing backlog of patient statements and inconsistent front desk procedures delayed reimbursements and created additional work for staff. Claims processing was further affected by limited training and complex medical systems.
Stronger orthopedic billing services, cleaner claims processing and reimbursement expertise that could reduce denials, improve collections and support a successful payer transition were needed.
The Coronis Health Approach
Coronis Health Strengthened Orthopedic Revenue Cycle Management
Coronis Health strengthened orthopedic revenue cycle management by addressing the barriers responsible for slow reimbursements and high accounts receivable. Workflow improvements, staff education and a dedicated payer specialist helped create a more efficient billing operation and a stronger financial performance during the transition.
- Patient communication — established a centralized call center to manage patient statement inquiries and reduce the administrative burden on staff
- Operational training — strengthened orthopedic practice management through front desk training, updated policies and consistent workflows
- Reimbursement optimization — assigned a dedicated specialist to negotiate with out-of-network reimbursement payers and improve payment performance
- Claims optimization — enhanced orthopedic medical billing through cleaner and proactive claims submission along with regular denial audits accelerating collections and reducing AR
The Results
Improved Revenue and AR Performance
Revenue and AR performance improved by reducing accounts receivable, strengthening out-of-network reimbursement and streamlining billing operations during the facility’s transition to out-of-network care. Dedicated payer negotiations boosted reimbursement performance, and reducing administrative workloads allowed staff to focus on supporting patients and practice operations.
- Accounts receivable: reduced AR by $10 million in six months
- Revenue growth: increased revenue by 77.47%, reaching $2 million to $2.5 million in monthly revenue
- Operational efficiency: reduced patient phone inquiries by 697 through centralized statement support
Disclaimer: All results are based on internal reporting from this specific client engagement and are not guaranteed outcomes.
Why It Matters for Orthopedic Practices
Orthopedic practices transitioning to out-of-network reimbursement may face challenges extending beyond payer contracts. Strong orthopedic revenue cycle management, effective orthopedic billing services and consistent operational processes can support long-term financial stability during periods of organizational change.
Surgical Specialties
See where orthopedic RCM can help transition from in-network to out-of-network reimbursement.
Let's discuss your transformation
Wherever you want revenue cycle operations to go, we can help!
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step 1
Connect
Tell us about your organization, specialty and revenue transformation goals.
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step 2
Evaluate
We'll evaluate your current state and identify strategic opportunities for improvement.
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step 3
Transform
Together we'll implement solutions that improve performance from day one.
