Recent reforms have changed the complexion of the healthcare industry. Orthopedic group practices are pressurized to maintain a healthy cash flow and improve patient engagement amidst declining reimbursement. Managing the revenue cycle of group practice is expensive, variable, fragmented and complex. But it needn’t be that way anymore.
Pioneering
Progress! Prioritize cultural safety, boost quality, and follow regulations
to amplify financial gains
and community benefits for your orthopedic organization.
Group Practices
Physicians
EMR / EHR Products
Transform your biggest orthopedic medical billing challenges into opportunities
Coverage and benefits are essential when billing for a specialty, especially orthopedic medical billing. To avoid non-covered services and coverage-related denials our patient eligibility verification services can eliminate any complicated relationships between patient and provider.
such as incorrect CMS 1500 form filed entries, patient demographics, CPT codes, provider numbers (NPIs) etc, require time to correct and send as a corrected claim. However, our 24/7 medical billing team will double-check and ensure a 98% clean claim rate.
ICD 10 coding issues result in 80% of orthopedic medical billing problems. Our AAPC certified 5+ years medical coding team will ensure coding-related denials are reduced and save your healthcare organizations from frequent external audits.
From health plans can cause drastic revenue loss. Our accounts receivable experts make sure that every uncollected payment is accounted for elevating your revenue by 40% within weeks using our services.
Results in significant claim denials accounting for almost 65% of bad debts written off. Having our denial management services team by your side will find a quick resolution regardless of the denial reason and receive reimbursement.
Credentialing is not provided by orthopedic medical billing companies that can provide only extent of rcm. This is where we differ our credentialing management services are included for all clients that enroll with us for RCM.
Choose from 4 scalable RCM pricing models to boost profitability, efficiency & get 4 free tailored quotes. Grow your practice by choosing the right revenue cycle management services that are profitable and efficient.
4 Quotes
Download 4 RCM Rate Cards. Choose the Model That Works Best for Your Practice
I’m looking for End-to-End RCM
Streamline your entire revenue cycle from patient intake to denial management.
Download →
I need Partial RCM Services
Outsource only what you need: coding, billing, AR, or denial management.
Download →
I want the FTE Model
Hire from 500+ dedicated billing specialists to work as your extended back office.
Download →
I want to manage the RCM team
Let your practice manager or RCM director build & manage our revenue cycle team.
Download →
80+
Organizations Served
25+
EHR Expertise
10M
Claims
500+
Dedicated Staff
80+
Organizations Served
25+
EHR Expertise
10M
Claims
500+
Dedicated Staff
80+
Organizations Served
25+
EHR Expertise
10M
Claims
500+
Dedicated Staff
80+
Organizations Served
25+
EHR Expertise
10M
Claims
500+
Dedicated Staff
Save 20+ hours weekly with AI-driven task management to boost efficiency and simplify operations.
Prescriptive yet customized revenue cycle management services. Better outcomes with our orthopedic billing services.
We verify coverage, deductibles, and authorizations upfront, slashing denials by 40%+ and accelerating payments. Handle high-volume surgical cases with 99% accuracy.
View Eligibility Verification Solutions
Denial management expert coders tackle denials with 95% overturn rate. Appeal surgically precise claims and ensure zero leakage.
Dedicated ortho experts + automated tracking. streamline ortho approvals, verifying coverage for implants, surgeries & therapies in hours, not weeks.
Explore Prior Authorization ServicesRevolutionize your orthopedic billing with RCM services which cut audits, increase revenue, and improve patient care. Schedule an appointment with our experts to see the difference!
Have a question?
Case Study
We begin by conducting a comprehensive orthopedic revenue cycle audit. Analyzing CPT usage for fracture care, injections, and surgical procedures, as well as payer-specific denial codes. Once we identify root causes, our orthopedic billing experts redesign your workflows, automate follow-ups, and fix coding or modifier errors to recover missed revenue. Most clients see a 25–35% revenue loss within 90 days.
Our pricing model is designed around collections-based ROI, not flat fees. Orthopedic groups that partner with us typically achieve 20–30% higher net collections and reduce administrative costs by up to 40%. By cutting denials, accelerating reimbursements for complex surgeries, and improving documentation accuracy, we generate a measurable ROI that offsets every dollar you invest.
Yes. We’re fully EHR-agnostic and integrate with orthopedic systems like Epic, ModMed, eClinicalWorks, Allscripts, and Athenahealth, etc. Our billing and coding teams log directly into your system to manage claims, payments, and notes — no manual data transfer required. Our analytics dashboard gives you real-time claim, payment, and denial visibility.
Our orthopedic billing division is staffed with AAPC-certified coders and experienced reimbursement specialists who understand every facet of orthopedic revenue cycles. We handle complex surgical coding for spine, joint, trauma, and sports medicine procedures, ensure correct application of modifiers like 24, 25, 57, 58, 59, 79, and LT/RT, and manage both DME and implant billing with precision. Our deep understanding of payer-specific orthopedic rules enables faster reimbursement and minimizes rejections, ensuring you capture every dollar your practice earns.
We establish clear service level agreements that align with your orthopedic practice’s performance goals. Our team consistently achieves a 98% clean-claim rate, maintains AR over 90 days at under 10%, and reduces denial rates by 30–45%. We also guarantee a 24- to 48-hour turnaround time for charge entry. All these metrics are closely tracked and reviewed weekly, with transparent performance dashboards and monthly reports shared with your leadership team for accountability.
Our transition process is designed to ensure a seamless handover without any impact on your orthopedic cash flow. We begin by auditing your existing workflow and AR backlog, then securely migrate open claims and verify data accuracy. During the transition, we run a short parallel billing phase to validate accuracy before assuming full control. Once we take over, we conduct weekly performance reviews and maintain constant communication so your team experiences zero disruption and full confidence in the process.
Transparency is central to how we operate. You’ll have continuous access to real-time dashboards showing claims, payments, and denials at every stage. We provide weekly summaries highlighting reimbursement trends and payer issues, along with monthly executive KPI reviews tailored for orthopedic leadership teams. Our reports are audit-ready, and our pricing is fully transparent; there are no hidden costs or black-box workflows. You’ll always know exactly how your revenue cycle is performing and where improvements are being made.
