By Ross DeRogatis of Matrix Orthopedics and Nick Cannon of Enovis
Over the past decade, the financial side of healthcare has changed in a meaningful way. The patient is now a primary payer. As high-deductible health plans (HDHPs) and cost-sharing have increased, a larger portion of revenue is coming directly from patients instead of traditional payers.
According to the Kaiser Family Foundation, more than half of insured workers are enrolled in high-deductible plans. That shift has real consequences. Patient balances are harder to collect, especially after the visit. Most practices see a significant drop-off in collections once the patient leaves, which makes the front end of the revenue cycle more important than ever.
For orthopaedic practices, particularly those with procedural volume and DME, this creates both friction and opportunity. Benefit structures are more complex, front desk teams are expected to interpret them quickly, and patients expect clear answers.
Many practices are rethinking when and how they address patient responsibility. Instead of reacting after the fact, they are moving those conversations earlier, supported by better tools and more reliable access to benefit information.
A good example comes from a high-volume orthopaedic clinic that set out to improve consistency in its DME revenue cycle. The goal was straightforward. Get accurate benefit information upfront and make it easier for staff to communicate patient responsibility before services are delivered.
Using a workflow supported by MotionMD® with VeriPro®, the clinic was able to bring clinical ordering, inventory management, and financial workflows into a single system. Instead of managing DME across disconnected processes, staff could move from product selection to benefit verification to patient communication within one streamlined experience.
Within that workflow, VeriPro® provided real-time visibility into patient coverage. Staff could verify eligibility, determine whether a deductible had been met, and estimate out-of-pocket costs before the brace or service was provided. Instead of telling a patient, “We’ll bill your insurance and let you know,” the conversation shifted to, “Here’s what your plan shows, and here’s what you can expect to owe today.”
In practical terms, that meant fewer surprises for patients and fewer delays for staff. Eligibility checks that previously required phone calls or manual portal lookups were streamlined into a single step. Front desk and clinical teams were also more consistent in how they communicated financial expectations, which reduced variation across locations.
The impact was substantial. Collections increased from $93,100 prior to implementation to $700,500 in a partial year, and then to $1.3 million in the first full year. Just as important, patients had a clearer understanding of what to expect, which helped reduce confusion and build trust.
This aligns with broader industry trends. The Healthcare Financial Management Association has consistently emphasized that when patients understand their financial responsibility before care is delivered, both collections and satisfaction improve. Expectations have changed. Patients want clarity, and they want it early.
For orthopaedic practices across Texas, a few things are becoming clear:
- Upfront financial clarity drives better collection outcomes
- Accurate benefit verification reduces missed opportunities and rework
- Simple, integrated workflows make it easier for staff to execute
This is not about turning clinical teams into billing experts. It is about giving them the right information at the right time so they can have straightforward conversations with patients.
As patient responsibility continues to grow, practices that bring clinical, operational, and financial workflows together will be better positioned to adapt. Solutions like MotionMD® and VeriPro® are examples of how that alignment can be achieved in a practical, scalable way. Better transparency improves revenue and the overall experience for everyone involved.
BJ Maack of enovis is pictured speaking at TOA’s 2026 Annual Conference.