Revenue Management for Stronger O&P Clinics

We conduct a deep-dive verification, reviewing insurance medical policies, coverage requirements, and documentation. We confirm whether the prescribed device is covered, assess risk based on claim and payer, and flag documentation gaps early before costs are incurred.

For payers or devices that require pre-authorization, Flywheel reviews clinician and physician notes to confirm accuracy and completeness. We secure approvals and prevent costly backtracking by anticipating what insurers need upfront.

Once a device is delivered, Flywheel manages the claim from start to finish:

1. Scrub: Review all codes and documentation for accuracy.
2. Documentation Support: Provide carrier-specific guidance to address any gaps.
3. Code Optimization: Recommend compliant ways to strengthen claim justification.
4. Submission & Follow-Up: File clean claims with the goal of payment within 30 days.

We actively track claim status, verify receipt, and respond to payor requests before denials occur, often shaving weeks off the payment timeline. Clinics receive same-day updates on high-value denials and see routine updates reflected online.

If a claim is denied, Flywheel investigates the cause, reviews relevant notes and policies, and manages appeals through every allowable stage. Whether its a clerical denial, medical necessity, or heading to an ALJ hearing, we offer carrier-specific expertise.

Weekly WIP meetings complement our AI insights, combining hands-on claim reviews with operational coaching. Together, we resolve blockers, spot patterns, and identify opportunities to keep claims moving efficiently. A well-run WIP discipline also ensures each claim is reimbursed on time, while addressing individual and general issues to improve processes for all claims.

Flywheel’s AI tools analyze patterns in delays, denials, and referral activity to identify process improvements and deliver next steps. We provide hands-on coaching to help clinics implement recommendations with ease and confidence.

Flywheel’s dashboards bring full transparency to the RCM process. Clinics can see exactly where handoffs occur, how work is progressing, and the value being created at every stage. By clarifying roles between your team and ours, we streamline collaboration and improve outcomes through shared workflows.