Your Orthopedic medical practice requires a more specialized understanding of billing and coding in orthopedics, not to mention specific procedures. Similarly. Orthopedic billing is different from general medical billing, where detailed documentation is needed for things like pain pumps, arthroscopies, and ligament reconstructions. Precision starts with how accurately demographics are entered for patients at the beginning, all the way through to reconciling claims at the end; even the smallest error can mean a denial.
We bring over a decade of experience in supporting orthopedic practices, hospitals, and physician offices with orthopedic medical billing services. We strive to simplify the complexity of the medical billing process while maintaining our history of submissions that are error-free and claims collected promptly. Our orthopedic billing specialists team reduces the administrative burden on physicians by minimizing billing errors and promoting cash flow through accuracy and efficiency.
They support your practice through all functions, from denial management to surgery claims of orthopedics. That helps you save precious time on doing even more important things-the patients. We will make your practice financially healthy while following all industry norms and benchmarks by removing obstacles in your workflow and helping in finding solutions for your denied claims early.
| Sports Medicine Procedures | Spine Surgery Billing | Hand Surgery Coding |
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We specialize in billing for sports medicine treatments, including athletic training evaluations and injury management. |
From spinal fusions to herniated disc removals, we expertly handle billing for spine surgery procedures using precise CPT codes. |
Our expertise includes billing for hand surgery procedures, such as tendon repairs and nerve reconstruction. |
| Joint Replacement Surgery Billing | Trauma Surgery Billing | Foot and Ankle Surgery Billing |
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It will be easier for you to get payments for procedures relating to joint replacements, such as hip and knee replacements. |
To get complete reimbursements, we manage billing for orthopedic trauma procedures, such as fracture fixation and wound debridement. |
From bunion corrections to ankle arthroscopy, we handle billing for foot and ankle surgeries with precision for accurate claims and reduced denials. |
High denial rates result from careless errors in modifier usage, failure to comply with any particular insurer’s deadline, amongst others. There’s even more challenges because the first submission of claims for an orthopedic surgery is wrong about 35% of the time; 25% of those first submissions are rejected outright. These denials rank high, indicating that in these services like joint replacement, spinal surgeries, and pediatric services, a rather rigid billing strategy is necessary.
An advanced technology and deep expertise team in orthopedic billing and coding: it’s a practical solution to the challenges, ensuring all activities, from insurance verification to denial management, are handled with precision and efficacy by certified professionals, and the right billing partner will alter your revenue cycle: lesser denials, higher reimbursement for your business, and allowing your in-house team to focus on your patient. You truly minimize errors and emphasize prevention of denials, thus you build a healthy orthopedic practice that is financially sound and sustainable.
Outsourcing orthopedic medical billing and coding simplifies revenue cycle management for orthopedic practices. How it can help your practice
Outsourcing lets you post payments accurately, submit claims electronically or on paper, and manage your receivables. Getting reimbursed faster and keeping cash flowing helps your in-house team do their jobs better.
Verifying eligibility, checking benefits, and getting prior authorization help prevent common mistakes that lead to claim denials. All denied or low-paid claims are appealed quickly and effectively with tasks like denial review and management.
By regularly reviewing and updating your fee schedules, you’ll maximize reimbursements while maintaining billing accuracy.
You can leave all insurance-related paperwork to outsourced billing services, which will free up your practice to focus on patients.
By handling incoming calls and sending referral and authorization alerts, we improve communication and patient satisfaction, helping to solve billing questions quickly.
A detailed look at billing operations helps you see revenue trends, denial rates, and payer performance, so you can make data-driven decisions to improve your finances.
FaqsSome of the frequent causes include coding, failure to document, or misuse of modifier, and failure to verify eligibility before service delivery.
Prior authorization is the process of approval from a payer before offering any services to the patient. These are patients who have under their insurance, joint replacement and spinal surgeries.
Eligibility verification means that the insurance coverage of the patient and the benefits are confirmed, which lowers the probability of claim rejection.
Orthopedic billing requires that the encoder apply the ICD-10, CPT, and HCPCS standards provided to CMS and AMA. Following these standards ensures clear, correct claims and satisfaction of the requirements of the payers.
Payer-to-payer processing times vary; when claims are done correctly, however, they can be processed within 30 days, while errors and missing information drag the timeline.
Denial management helps practices recover revenue, improve cash flow, and reduce rejections by identifying and fixing the root causes.
Procedures like arthroscopies, spinal fusions, and trauma surgeries often involve complex coding with multiple modifiers and require precise documentation to avoid denials
