Orthopaedic Full Revenue Cycle Management

At FTGU, we believe that a systematic approach to Secondary Claims Management (SCM) is a key component of our ability to recover lost revenue and maximize revenue potential. This methodology, combined with our expertise in the Orthopaedic field and experience in getting insurance claims paid, is what makes FTGU uncharacteristically successful.

With SCM, we apply the same systematic approach to ALL unpaid insurance claims. It is the logical completion of the Claims Management Lifecycle that we have successfully applied to aged claims. The focus of SCM is tracking denied claims from the very first “zero pay.” We assign a denial code to every zero pay and immediately begin the process of tracking denied claims as we work to get them paid. Clients receive a monthly report identifying the actions FTGU has taken to recover unpaid insurance claims. FTGU works every unpaid insurance claim a minimum of once every 45 days. With this type of approach, Clients have the ability to:

  • Categorize denied claims and identify negative billing and coding trends (Denials Management)
  • Utilize the denial management reports to correct initial coding “mistakes” and/or EMR templates (Corrective Coding)
  • Identify cash flow risks earlier in the revenue lifecycle
  • Correctly identify balances that should be transferred to patient responsibility
  • Correctly identify balances that should be “written off”

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