20+
Years of Experience
500+
Happy Clients
98%
Clean Claim Submissions
Expert Support to Navigate Orthopedic Billing and Coding Complexities
Specialized medical billing and coding expertise is key to ensure efficient revenue cycle management (RCM) for your orthopedic practice. We provide orthopedic medical billing and coding services to meet these specific needs.
With a deep understanding of orthopedic procedures, coding intricacies, and payer requirements, we help you handle your billing challenges, reduce claim denials, ensure compliance, and maximize your revenue.
With experienced certified medical coders and billing specialists and state-of-the-art technologies, we are well-positioned to optimize your claims submission process and ensure you receive the reimbursement you deserve.
We work as an extension to your practice.
Comprehensive RCM for Orthopedic Practices
Our robust orthopedic billing and coding services ensure accurate claim submission, prevent denials, and increase your cash flow.
Insurance Verification
Real-time verification of coverage, plan details, benefits, and deductibles. This reduces risk of claim denials and streamlines billing.
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Prior Authorization
Handling prior authorization for procedures like joint replacement, spinal surgery, imaging studies, etc. Timely approvals prevent care delays.
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Charge Capture
Documenting all billable services to ensure accurate coding and invoicing. This is crucial for timely and appropriate payment for services.
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Coding
Assigning the right medical codes for diagnoses and procedures according to ICD-10 and CPT coding rules. This promotes claim accuracy.
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AR Management
Collecting insurance and patient payments. From resolving payment delays to appealing rejected claims, we optimize revenue recovery.
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Reporting and Analysis
Creating customizable reports to provide insights into your practice’s financial performance. This allows you to make more informed decisions.
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What Makes Us A Trusted Billing Partner?
- Dedicated manager
- System-based claims scrubbing before claims go out
- Comprehensive tracking of underpayments and non-payments
- Support to navigate the insurance appeals process
- Daily, monthly and weekly reports
- Customized TAT
- No long-term yearly contracts
- Cost savings of 30% to 40%
Orthopedic Coding by Experts
Here’s why we’re the ideal choice to be your medical coding partner:
- AAPC-certified coders specialized in ICD-10, CPT and HCPCS coding
- Experts updated on AMA and CMS coding guidelines
- Rigorous quality assurance to minimize errors
- Adherence to all payer and industry regulations
- Advanced software to streamline coding
- Seamless EHR integration
- Real-time reports for performance tracking
- Robust data security for patient privacy
We serve all 50 states
Orthopedic Medical Billing and Coding Process
Here’s an overview of our medical billing process:
1
Patient Registration
Claim Submission
5
2
Insurance Verification
Payment Posting
6
3
Medical Coding
AR Management
7
4
Charge Entry
Denial Management
8
1
Patient Registration
2
Insurance Verification
3
Medical Coding
4
Charge Entry
5
Claim Submission & Tracking
6
Payment Posting
7
AR Follow Up
8
Denial Management
Our Pricing Plans
Reduce administrative hassles and welcome efficiency with our skilled team supporting you. Choose from our flexible pricing plans based on your needs.
Full-Time Equivalent
In this model, services are billed based on the equivalent cost of a full-time employee (FTE) for a specified duration, usually monthly or annually.
Per Verification Billing
Like an FTE model, a person is dedicated to your practice. Perfect for a practice that is busy. They work as an extension to your business.
FTE/Per Verification Billing
This option is ideal for a practice that is unsure about their work requirements. This can have per request pricing for eligibility and other functions.
AR is only FTE
At present, we provide only the FTE pricing model for Accounts Receivable (AR). We are also considering a blended model for AR.
At present, we provide only the FTE pricing model for Accounts Receivable (AR). We are also considering a blended model for AR.
FAQs
Do you follow up on unpaid claims?
Yes, we do. Our billing experts thoroughly evaluate your accounts receivable position and identify denied claims, unpaid claims, and low payments. Claims are re-submitted with any additional information needed. With timely follow-up and appeals, we help accelerate your cash flow and minimize accounts receivable days.
How do you manage patient collections?
Our patient responsibility management services include sending patient statements in a timely manner (sometimes adjusted according to client preference). In addition, we follow up with a demand letter and phone calls. We see that timely follow-up helps in obtaining quicker reimbursement. If for any reason we find the efforts futile, we will work with a collection agency or an attorney for collections if our client feels that step is necessary.
Is your company HIPAA-compliant?
Yes, we are fully compliant with HIPAA rules and standards. Our stringent data security policies are designed to ensure that all patient information remains safe and secure. Security measures are taken in-house as well as during the transfer of files. Our entire workforce is trained on privacy, security, and confidentiality, and all our employees must sign a confidentiality and non-disclosure agreement. Contractual agreements with all business parties are maintained and up-to-date.
To start off, do we have to entrust our whole revenue cycle management to you?
No. We are extremely flexible when it comes to our outsourced revenue cycle management.
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