Orthopedic Billing & Coding Services

Orthopedic Billing Services

Orthopedic surgery, known as Orthopedics, encompasses the medical domain focusing on Musculoskeletal system conditions—comprising bones, joints, ligaments, tendons, and muscles—that significantly influence movement and daily functionality.

Complexities in Orthopedic Billing

Orthopedic billing hinges on meticulous documentation pre, during, and post patient visits. The billing team’s meticulous documentation and accurate service charges are crucial. Oversights like incomplete patient demographic entry or insufficient prior verification of patient eligibility could lead to claim rejections. Besides authorization errors, unfamiliarity with insurer preferences and deadlines can impede revenue collection.

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Orthopedic billing, compared to other specialties, is intricate and necessitates a deeper comprehension of providers’ services. Nearly 30% of orthopedic surgery claims contain errors, with a quarter of medical claims facing rejection. Such elevated denial rates can jeopardize revenue, patient care, and potentially threaten the orthopedic practice’s financial viability.

While hiring an in-house billing team and proper training can mitigate severe penalties, the complexities of orthopedic billing surpass the capabilities of an in-house team. Outsourcing billing & coding to technologically empowered firms like SPECIALIZED BILLING can alleviate stress on your staff and augment reimbursement prospects.

Expertise in Orthopedic Medical Billing & Coding

At SPECIALIZED BILLING, our extensive client base spans all 50 states and encompasses diverse hospitals, physician practices (inclusive of orthopedics), and medical billing entities. Our coders adeptly handle ICD-9/10, CPT, HCPCS coding aligned with CMS and AMA guidelines, boasting certification from the American Academy of Professional Coders (AAPC). We pride ourselves on a decade-long tenure in orthopedic billing & coding.

Best Practices in Orthopedic Billing & Coding Services

We grasp the intricacies embedded within orthopedic medical billing, precisely billing for procedures like pain pump insertions or plc reconstruction and arthroscopies. Our certified coders collaborate 24/7 to circumvent issues arising from misapplied modifiers, concurrently educating your in-house billing personnel on avoiding such errors. Our expert orthopedic billing team works rigorously to curtail claim denials while augmenting reimbursements, streamlining processes to expedite accurate billing for orthopedic services. Anchored in modern technology, our approach fosters data-driven solutions to curtail denials and heighten revenue.

Our expertise spans:

– Foot and Ankle Surgery

– Hip and Knee Surgery

– Shoulder and Elbow Surgery

– Trauma Surgery

– General Orthopedics

– Orthopedic Oncology

– Spine Surgery

– Bone Health Center

– Hand Surgery

– Pediatric Orthopedic Surgery

– Sports Medicine

– Osseointegration Clinic

Benefits of our Orthopedic Billing and Coding Services

We infuse excellence, knowledge, and precision into orthopedic billing and coding services, forging a defect-free revenue cycle for your practice. Ranging from patient demographics entry to account reconciliation, our medical billing process offers value. We streamline billing, coding, claim submission, and payment posting, ensuring consistent accounts receivable follow-up and prior authorization to avert claim denials. Our claim denials management team prioritizes denial prevention, aiming to shift your focus from managing denials to preventing them.

The specialists we provide are:

– Certified by the American Association of Professional Coders (AAPC)

– Proficient in various medical billing software

– Well-versed in coding software

– Competent in applying standard CPT, HCPCS procedure and supply codes, and ICD-CM diagnosis coding as per CMS guidelines

– Successful in processing medical bills with leading carriers and negotiating with Medicare and state-specific Medicaid policies

Our clients typically experience over maximum revenue improvement and a minimum reduction in denials through our expert application, stringent processes, and exceptionally trained team.