Comprehensive Orthopedic Medical Billing Services
Billing in orthopedics involves more than just CPT codes. With complex procedures, time-based codes, surgical bundling, and ever-changing payer rules, you need a team that understands the clinical and coding intricacies.
At PCH Health, we provide end-to-end orthopedic medical billing solutions tailored for orthopedic surgeons, sports medicine clinics, physical therapy groups, and multi-provider practices.
By outsourcing orthopedic billing services to our experienced team, you reduce administrative stress, speed up reimbursements, and stay ahead of compliance regulations.
Orthopedic Coding Specialists
Our AAPC-certified coders are experts in procedures like arthroscopy, joint injections, trauma surgery, and spinal fusions, ensuring accurate claims from day one.
HIPAA-Compliant Billing Systems
We protect your patients’ sensitive information with robust data security protocols and HIPAA-compliant infrastructure.
Surgical & Post-Operative Billing Expertise
We manage the entire episode of care, from pre-op authorizations to post-op global period billing and documentation.
Real-Time Authorization & Verification
We handle insurance verifications and pre-authorizations for MRIs, physical therapy, durable medical equipment (DME), and surgeries to prevent claim rejections.
Our Orthopedic Billing Process
Eligibility Verification & Benefit Checks
We confirm the patient's coverage and plan limitations before services are rendered, preventing downstream issues.
Orthopedic-Specific Coding & Charge Entry
Our team codes accurately for fracture care, spinal procedures, pain management, and imaging services like X-rays and MRIs.
Clean Claim Submission
Claims are submitted within 48 hours, fully documented and optimized for payer-specific requirements.
Denial Management & Appeals
We track and analyze all denials, respond quickly, and appeal with detailed documentation to recover maximum revenue.
Payment Posting & Patient Statements
We ensure accurate payment posting and generate clear, easy-to-understand patient statements with follow-up support.
Why Choose Our Orthopedic Billing Services?
Orthopedic billing requires deep clinical knowledge, constant tracking of coding updates, and familiarity with surgical billing rules. At PCH Health, we deliver specialized, high-performance orthopedics medical billing to help your practice stay financially healthy.
Dedicated Orthopedic RCM Team -
We assign orthopedic-specialized billers and coders who understand your procedures and billing patterns.
Seamless EHR & PM System Integration -
Whether you use Athena health, Allscripts, Modemed, or another system, we integrate seamlessly with your workflow.
Scalable for Groups & Clinics -
From solo orthopedic surgeons to hospital-based orthopedic groups, our services scale to meet your needs.
Transparent Performance Dashboards -
Get full visibility into claims, denials, AR days, and more, so you can make informed business decisions.
Benefits of Outsourcing Orthopedic Billing Services
Faster Payments
With our expert coding and clean claims, your revenue cycle shortens—and cash flow improves.
Fewer Denials
We pre-empt denials through correct coding, documentation reviews, and detailed pre-authorizations.
Reduced Administrative Overhead
Offload billing complexities and reduce your in-house staffing costs by outsourcing orthopedic billing services to specialists.
Better Compliance & Audit Readiness
We stay up to date with CMS, Medicare, and commercial payer changes to keep your practice audit-ready.
Our Impact in Orthopedics Medical Billing
<48
Hours turnaround for claims
>98%
First-pass acceptance rate
<6%
Average claim denial rate
<28
Days in A/R