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What are the biggest payer problems for orthopedic practices?

By Admin | May 07, 2021

Question: What is the biggest payer problem in orthopedic practices?

Mihir Patel, MD. Orthopedic Surgeon and Treasurer of OrthoIndy (Indianapolis). Providers focus on the patient first, then finances. Insurance payers focus on finances, then their clients and then patients. Given the incentives are different, the challenge remains on a daily basis to be a patient advocate. Prior authorizations for advanced imaging or routine procedures, which help determine definitive treatment in today's world, is analogous to using a typewriter on a regular basis. Even more challenging, and some would call absolutely crazy, are so-called peer-to-peer calls after the patient is healed from a procedure and is doing well. 

Nitin Khanna, MD. Spine Surgeon and Founder of Spine Care Specialists (Munster, Ind.).​ The pre-certification process is broken. Government intervention is needed that would hold insurance companies accountable for denials of surgery and...(More)

For more info please read, What are the biggest payer problems for orthopedic practices?, by Becker's SpineReview

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