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Specialty — Orthopedics

Medical billing and RCM for orthopedics practices

Orthopedic revenue concentrates in surgical episodes, which means a single coding or authorization failure is worth more than a month of office visits.

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An orthopedic physician explaining an X-ray to a patient
Denial drivers
Authorization, global period
Coding pressure
Bundling, modifiers 58/78/79
Where A/R ages
Surgical claims
Underpayment risk
High
The challenges

What actually costs orthopedics practices money

Global surgical periods

Visits inside the global period billed incorrectly generate denials and, worse, unbilled legitimate work.

Modifier discipline

Staged, related and unrelated procedures each need the right modifier, and payers audit them.

Implant and hardware billing

Invoice-based reimbursement rules differ by payer and are frequently underpaid.

Workers compensation and third-party liability

Different rules, different timelines, and A/R that ages fastest of all.

How we work a orthopedics account
  1. 1 Surgical claims reviewed before submission, not after denial
  2. 2 Global period tracked per patient so nothing is missed or wrongly billed
  3. 3 Implant reimbursement checked against invoice and contract
  4. 4 Separate workflow for work comp and liability A/R

Other specialties

View all
A primary care physician talking with a patient in a bright exam room Primary Care A physician listening to a patient’s heart with a stethoscope Cardiology A therapist in a counseling session with a client in a bright office Behavioral Health A physical therapist working on a patient’s shoulder in a sunlit clinic Physical Therapy A dermatologist examining a patient’s skin with a dermatoscope Dermatology A psychiatrist in a consultation with a patient in a modern office Psychiatry

How healthy is your orthopedics revenue cycle?

We will review your denials, A/R and payer performance and tell you what we find.

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  • No obligation, and you keep the findings either way
  • Under two minutes to request
  • No patient information needed to start
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