American Association of Orthopaedic Surgeons Announces a Partnership with Gateway EDI for Revenue Management Services

Program will Help Orthopaedic Medical Practices Reduce Claims Errors and Increase Cash Flow

SAN DIEGO, Feb. 18, 2011 /PRNewswire-USNewswire/ -- Today, at its Annual Meeting, the American Association of Orthopaedic Surgeons (AAOS) announced a partnership with Gateway EDI to provide claims processing and revenue management services to its membership. The AAOS Revenue Management Program powered by Gateway EDI will help AAOS members submit their claims faster and more accurately to increase revenue and cash flow.

Medical practices often do not have the staff to manage medical record coding or to navigate payers' complex claims submission processes. As a result, payers reject up to 30 percent of all claims.(1)   This action requires practices to resubmit claims, leading to significant delays in payments.  In addition, payers make inaccurate payments on one out of every five medical claims.(2)  Most practices do not have the monitoring capabilities to catch these errors.

The AAOS Revenue Management Program includes:

• Unlimited electronic claims
• Unlimited paper claims for payers who don't accept electronic claims
• Up-to-date claims status update compiled on one easy-to-reference screen
• Fast electronic verification of a patient's insurance eligibility
• Reimbursement Manager, which tracks down and recoups missing revenue by identifying and fixing denials and underpaid claims
• Management tools that provide all the payment information needed in a secure and searchable format
• Automatic identification of supplemental insurance policies and coordination of secondary claims processing

"Gateway EDI's online revenue management tools help the business side of our office run smoothly," said Dr. Blaine Farless, Cleburne Orthopedics and Sports Medicine in Cleburne, Texas. "The day after claims are submitted, we receive notification of any potential errors. We can easily look at the status of our claims and any remittances that have been received. My office staff also can instantly verify patient eligibility online to avoid calls to insurance companies. Since switching to Gateway EDI, our payment cycle was reduced from 30 to 60 days to two weeks on average."

To learn more about the program, AAOS members can visit www.gatewayedi.com/aaos.

"For solo and small orthopaedic practices, revenue management can be challenging," said Dr. Tom Grogan, MD, Chair, AAOS Practice Management Committee. "The new AAOS Revenue Management Program helps Association members ensure consistent cash flow and greatly reduce underpayments by private payers."

"AAOS members will have a dedicated and knowledgeable account representative to support claims management," said Charlotte A. Martin, president and chief operating officer, Gateway EDI. "In addition, our team will provide around-the-clock personal support and detailed training to ensure medical practice staff will find the adoption of Gateway EDI's tools to be very straightforward and easy."

About AAOS

Founded in 1933, the American Academy of Orthopaedic Surgeons (Academy) is the preeminent provider of musculoskeletal education to orthopaedic surgeons and others in the world. Its continuing medical education activities include a world-renowned Annual Meeting, multiple education courses held around the country and at the Orthopaedic Learning Center, and various medical and scientific publications and online and electronic education materials.  Founded by the Academy Board of Directors in 1997, the American Association of Orthopaedic Surgeons engages in health policy and advocacy activities on behalf of musculoskeletal patients and the profession of orthopaedic surgery. For more information, visit www.aaos.org or www.orthoinfo.org.

About Gateway EDI

Based in St. Louis, Mo., Gateway EDI was founded almost 30 years ago by a physician who was unsatisfied with the claims processing tools available at the time and created new solutions focused on better managing the revenue cycle for medical practices. Today, Gateway EDI serves more than 70,000 physicians with a fully-integrated suite of advanced tools and proactive service team to monitor, catch and fix claims issues before they can impact a practice. For more information, visit www.gatewayedi.com.

(1)  Keegan, Deborah Walker, Larch, Sara M., Woodcock, Elizabeth W., The Physician Billing Process: Avoiding Potholes in the Road to getting Paid (MGMA, 2004).

(2)  AMA's 2010 National Health Insurer Report Card.

SOURCE American Academy of Orthopaedic Surgeons