With certified coders and aggressive follow-up, we are a billing team that knows the difference between an arthroscopy and a PLC reconstruction, and codes it correctly the first time.
General billing companies apply general rules. Orthopedic billing demands precision. Correct modifier usage, global period management, bilateral coding, and procedure-specific documentation that satisfies both payer and compliance requirements. Our team is built exactly for this.
We serve orthopedic surgeons, multi-physician groups, ASCs, and hospital outpatient departments. Whether your practice performs 50 procedures a month or 500, we bring the same certified expertise and relentless follow-through.
Our coders hold active AAPC certifications and complete ongoing training in orthopedic-specific coding updates.
We stay current with quarterly CMS updates and AMA CPT revisions so your billing never falls behind regulatory changes.
From -59 to -LT/-RT bilateral modifiers, we apply the right modifiers consistently to prevent avoidable denials.
We maintain payer-by-payer policy libraries so every claim is matched to the correct payer requirements.
Every benefit below is the result of a specific, repeatable process, not a vague promise.
We apply correct modifiers, documentation standards, and payer-specific edits before a claim ever leaves your system. We catch errors that would trigger denials downstream.
Our coders review every operative note and procedure record to capture global period billing, bilateral coding, and add-on codes that are commonly missed.
Our streamlined submission and real-time tracking workflow reduces days in AR, so your practice sees reimbursement sooner, and cash flow stays predictable.
When claims are rejected, we respond with targeted appeals built from operative notes, medical records, and specific payer policy language, not boilerplate templates.
We monitor CMS updates, LCD changes, and payer policy revisions in real time. We adjust your billing protocols before rule changes create exposure.
We handle prior auth verification, claim submission, denial management, and payment posting, so your front desk stays focused on patients, not paperwork.
We bill across every major orthopedic procedure category with procedure-specific coding protocols for each.
CPT 27447
CPT 29881
CPT 27130
CPT 29827
CPT 27428
CPT 29888
CPT 64449
CPT 25447
Our billing workflow is designed to eliminate the gaps where most orthopedic practices lose money.
Before any claim is submitted, we confirm insurance coverage, obtain necessary prior authorizations, and verify procedure-specific payer requirements. This eliminates eligibility-related denials at the root.
Our AAPC-certified coders assign the correct CPT, ICD-10, and HCPCS codes with appropriate modifiers. Every claim is scrubbed before submission to the right payer on the right schedule.
We track every claim in real time, appeal every denial with supporting documentation, and post payments accurately. This maintains a clean audit trail and keeps your AR healthy.
If your question isn’t here, our team will answer it in your free billing review.
Orthopedic billing involves a high frequency of complex surgical procedures, strict modifier requirements, global period rules, and bilateral coding scenarios. Errors in any of these areas lead to denials or underpayments. Experienced orthopedic billers understand the nuance that general billers often don’t.
Yes. We serve private orthopedic practices, multi-physician groups, ambulatory surgery centers, and hospital outpatient departments. Our billing protocols are adapted to specific payer rules and the documentation requirements of each setting.
Most practices see a measurable reduction in denials within the first full billing cycle. Meaningful improvement in collections typically follows within 60 to 90 days as we work down existing AR and establish clean submission patterns.
You receive regular reporting on claim submission rates, denial rates by payer and procedure, days in AR, collection rates, and appeal outcomes. Reports are delivered on a schedule that works for your practice, whether weekly, bi-weekly, or monthly.
Our appeals team works directly with your clinical staff to obtain and organize supporting documentation. We write payer-specific appeal letters and submit complete appeals packages. This reduces back-and-forth and speeds up resolution.
Yes. All Med Claims operations are fully HIPAA-compliant. We use encrypted data transmission, secure access protocols, and signed BAAs to protect your patients’ PHI at every stage of the billing cycle.
Schedule a free billing review. We’ll analyze your current denial patterns, coding gaps, and AR health, and show you what a clean billing operation looks like.