Oct 7, 2025
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