Add muscle to your revenue management

What are your top three concerns about your practice? If you’re like most physicians and practice executives, financial performance will probably rank among them.

For most practices, pressures on reimbursement and increasing costs—particularly in the area of collections—are constantly straining their ability to cover practice expenses. Even though the economy is beginning to recover, increasing the effectiveness of your revenue management function will remain a major area of concern.

All too often, practices do not have resources to code correctly or the knowledge to comply with payer protocols. Additionally, most practices (even large group practices) lack information to recognize when payers do not pay, pay late, or make inadvertent or intentional reimbursement errors.

Help from AAOS
To help AAOS members control costs, submit clean claims faster, and get paid faster, the American Association of Orthopaedic Surgeons (AAOS) has signed an agreement with Gateway EDI for claims clearinghouse services.

“If you are a solo or in a small practice, getting a handle on revenue can be challenging; the new AAOS Revenue Management Program powered by Gateway EDI helps you focus on your busy practice, while keeping cash flow running smoothly” said Thomas J. Grogan, MD, chair of the Practice Management Committee.

Gateway EDI’s “Tools” and “Best Practices” will help you submit your claims faster and cleaner. The result: increased revenue and decreased days in accounts receivable. For example, the average rejection rate for Gateway EDI clients is 5 percent or less. And, as you submit claims, proactive activity monitoring ensures that the information is accurate, helping you avoid delays in reimbursement due to edits and reducing the number of costly rejections.

Finally, participating in this new program can help you keep small payment errors from becoming big revenue problems. The difference between what is expected and what is paid can add up to significant revenue issues if left unchecked. Reimbursement Manager from Gateway EDI easily identifies denials and underpaid claims.

It works!
“Gateway EDI’s online revenue management tools help the business side of our office run smoothly. The day after claims are submitted, we receive notification of any potential errors. We can easily review the status of our claims and any remittances that have been received. My office staff also can instantly verify patient eligibility online to avoid long calls to insurance companies,” said Blaine L. Farless, MD, of Cleburne Orthopedics and Sports Medicine in Cleburne, Texas.

“As a result, we’ve had fewer claim rejections and quicker payments. In fact, since switching to their tools, our payment cycle went from an average of 30 to 60 days down to 2 weeks. Overall, Gateway EDI’s tools give me peace of mind, which enables me to focus on serving my patients.”

Who’s behind the program?
Gateway EDI is based in St. Louis. Gateway EDI’s entry into medical office automation began in 1983 when a practicing physician began to search for a computer system to meet the administrative challenge of delivering high-quality care at a reasonable cost. After much research and review, he was still dissatisfied with the alternatives available and chose to develop, design, and write software from the perspective of the physician and office staff.

“For more than 20 years, Gateway EDI has helped orthopaedic practices manage their revenue cycles and get paid quickly,” said Charlotte A. Martin, Gateway EDI’s president and chief operating officer. “We understand the challenges that face orthopaedic practices today, including administrative costs that consume 15 percent of every dollar spent on healthcare and the hassle of collecting from patients who are now taking on more responsibility for healthcare payments. That is why we are proud to partner with the AAOS to provide members with discounted pricing and advanced tools to address the revenue management challenges.”

Additional information about the Revenue Management Program is available at the Practice Management booth in Academy Row, Sails Pavilion, near the AAOS Resource Center. Stop by to learn more about the program and to talk with Gateway EDI representatives.

After the meeting, contact Steven Fisher, manager of the AAOS Practice Management Group, at or (847) 384-4331 for information.