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Worker's compensation: how do orthopedic surgeons fare?

Eric C Makhni1, Richard Li, Charles S Day

  • 1Columbia Presbyterian Hospital, New York, USA.

American Journal of Orthopedics (Belle Mead, N.J.)
|July 8, 2011
PubMed
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Workers' Compensation (WC) reimbursement yields higher revenue than Medicare, but varies by subspecialty, particularly for spine procedures. Payment timelines also differ significantly based on encounter type and billing complexity.

Area of Science:

  • Orthopedic Surgery
  • Healthcare Economics
  • Reimbursement Analysis

Background:

  • Reimbursement for Workers' Compensation (WC) patients remains understudied.
  • Understanding revenue characteristics for WC patients is crucial for healthcare providers.

Purpose of the Study:

  • To investigate the revenue yield and payment timelines for orthopedic surgery patients covered by Workers' Compensation.
  • To compare WC reimbursement with other major payors like Medicare.

Main Methods:

  • Retrospective analysis of WC patients in an orthopedic department (March 2007-June 2008).
  • Comparison of revenue yield and total payment time based on visit type, subspecialty, payor, and Current Procedural Terminology (CPT) codes.
  • Analysis included 816 clinic visits and 436 procedural encounters.

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Main Results:

  • Overall WC revenue yield was 49%, exceeding Medicare's 31%.
  • Spine procedures showed significantly lower yields (37%) compared to other subspecialties (54%-64%).
  • Time to payment was longer for procedures (101 days) than clinic visits (63 days), influenced by charge posting time and CPT code volume.

Conclusions:

  • Negotiated WC revenues are generally higher than Medicare but exhibit significant variation by subspecialty, with spine cases yielding the least.
  • Payment processing times for WC patients are variable, particularly the time required to post charges.
  • These findings highlight the need for tailored financial strategies in managing WC patient accounts.