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Medical Billing And Revenue Cycle Management Solutions For Orthopedics Facilities

In orthopedic facilities, provide medical services for the diagnosis, treatment, and prevention of conditions affecting bones, joints, muscles, ligaments, tendons, and nerves. At StafGo Health, we offer specialized medical billing and revenue cycle management (RCM) services developed for orthopedic practices and surgical centers. Orthopedic billing involves high-value procedures that are complex in nature, surgical complexities, and accurate coding that requires high precision and expertise. At StafGo Health, we streamline the entire billing process from insurance verification to claims submission, ensuring that your practice improves collection, reduces AR days, and remains compliant.

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Key Procedure Codes Management in Orthopedic Revenue Cycle Management

Orthopedic billing involves procedural and evaluation codes that should be applied accurately to get proper reimbursement, and the StafGo Health team ensures key surgical CPT codes are applied correctly, including 29881 (arthroscopy of the knee with meniscectomy), 23410 (repair of rotator cuff), and 27245 (treatment of hip fracture with intramedullary fixation), 27447 (total knee arthroplasty) and 27130 (total hip replacement). Our team ensures proper application of fracture care using codes like 25607 (closed treatment of distal radius fracture) and 26600 (closed treatment of metacarpal fracture). Physical therapy and follow-up is billed with the codes 97010–97799 with precision and accuracy.

Why Outsource Medical Billing And RCM To Stafgo Health For Your Orthopedics Practice?

Several complex billing scenarios occur in orthopedic practices, such as surgical bundling rules, complex modifier usage, pre-authorizations, global period tracking, and much more. At StafGo Health, we are skilled in managing the orthopedic revenue cycle and also understand the complexity of procedures followed in it. By outsourcing to us, your practice has the benefit of faster reimbursements, reduced administrative burden, and expert compliance with payer requirements firsthand. With StafGo Health as your partner, you will have a dedicated team who will focus on managing your revenue while you can focus on the best care of your patient and earn brand value in the market.

  • Complex Procedure and Modifier Usage—A wide spectrum of complex procedures is involved in Orthopedic care, like joint replacements, fracture care, etc, and for their billing, very precise coding and use of correct modifiers is required. Mistakes in this billing can result in denials or underpayments.
  • Global Surgical Period Management - Management of the Global Surgical Period is also a task for Orthopedic Practices. Some surgeries have "global periods" in which follow-up care is included. So, billing for other rendered services within this span of time and using the wrong modifier can lead to claim rejection.
  • High Volume of Prior Authorizations - In Orthopedic billing, there are some procedures like MRIs, injections, etc., which usually require prior authorization from the insurance company. Rejection or holdup in this can lead to delays in patient treatment and affect your reimbursement rate. 
  • Frequent Medical Necessity Denials - Frequent medical necessity denials are one of the prevalent challenges in Orthopedic billing. Claims are denied when the medical necessity of services is not proven due to a lack of complete or sufficient documents.
  • Patient Responsibility and Payment Collection - Due to the rise in high deductibles and co-insurance plans, patient financial responsibility increases. In case of poor communication and payment systems, this can result in unpaid bills and collection problems.
  • Specialized Coding for Orthopedic Procedures - Our coders are well-versed in the application of accurate codes and modifiers for complex orthopedic services. Our team ensures the use of the correct modifier and precise documents to reduce the chances of denials
  • Expert Management of Global Surgical Periods- Our team at StafGo Health ensures the post-op visits are monitored and recorded properly, and also the unrelated services are billed separately with the right modifiers so that your claims remain compliant.
  • Fast & Accurate Prior Authorizations - Our proactive team helps you to reduce the time-consuming task, which is prior approvals for surgeries. Fast & Accurate Prior Authorizations can prevent treatment delays and ensure proper reimbursement.
  • Medical Necessity & Documentation Support - Our dedicated team provides comprehensive assistance to your staff in clearly documenting medical necessity. We will also provide audits and training to improve your charting compliance.
  • End-to-End Patient Billing & A/R Management-  Our team provides an end-to-end patient Billing solution to orthopedic practices. From the verification of benefits to following up on denied claims, we provide complete patient billing support.

Why Choose Stafgo Health For Your Practice Needs

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