March 28, 2023

Case Study: The Institute for Orthopaedic Surgery & Sports Medicine

The Institute for Orthopaedic Surgery & Sports Medicine (the Institute) is one of South Florida’s premiere destinations for orthopedic care. Read more about how HealthMe helped the Institute comply with the No Surprises Act.
Case Study: The Institute for Orthopaedic Surgery & Sports Medicine

Background

The Institute for Orthopaedic Surgery & Sports Medicine (the Institute) is one of South Florida’s premiere destinations for orthopedic care with highly experienced, board-certified orthopedic surgeons who specialize in a wide variety of specialties.  Treating people of all ages and helping to restore function lost due to injury or disease, they provide the full spectrum of services incorporating the clinical, educational, and investigational aspects of athletic injuries and orthopedic care.

Situation

The population growth in Fort Myers, Florida is one of the fastest in the nation attracting new business, working families, retirees, students, and tourists.  As such, the practice has seen rapid growth, and is especially busy during high season.  Serving a broad population of patients—many who have high insurance deductibles, out-of-network insurances, or do not currently have insurance, office staff was often deluged with patient calls about pricing and billing.  This process was time-consuming and inefficient.  With their two locations, there were additional concerns about overcoming the burdens and expectations of No Surprises Act (NSA) compliance and the requirements to provide Good Faith Estimates (GFE) that now impact every orthopedic practice.

Approach

The Institute determined they needed to take a leadership position in providing clear and transparent pricing while developing a strategy for self-pay patients. Consistent with their mission of helping patients get back to the life they love, they are firm in their belief that patients deserve to know what the fees are going to be up front.  The Institute committed to identify a solution to help them comply with the NSA requirements, clearly post transparent prices, and meet the expectations of today’s healthcare consumer. They were seeking a solution with a partner who is aligned in their trust that patients can better handle medical expenses if they are prepared in advance with transparent pricing, and that the complexities of insurance shouldn’t deter patients from needed care.

Solution

The Institute developed a partnership with HealthMe to quickly build and deploy an online marketplace for orthopedic evaluations and procedures—with transparent pricing clearly posted on their web site.  For even greater patient benefit and to streamline internal process, the Institute was able to highlight “bundled pricing” for office visits, procedures, and imaging.  Concurrently, they launched HealthMe’s methodology to provide GFE’s to patients which automates a highly labor-intensive process–reducing staff time from 90-minutes to 90-seconds for each GFE. With a focus on pre-payment rather than chasing bad debt and collections, self-pay patients simply purchase the package online, and then come in for their pre-paid appointment.   Together with HealthMe, the Institute has removed the complication from compliance while increasing top-line revenue from the growing number of self-pay patients.

“Without HealthMe, NSA and GFE compliance would have been impossible. They are a life saver.” Charlynn Mercer, Practice Administrator, The Institute for Orthopaedic Surgery & Sports Medicine

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