Orthopedic Billing Services in the USA
Recover your lost cash and unpaid claims into revenue by outsourcing orthopedic billing services to eClaim Solution. We use advanced technology and AI tools to ensure accurate medical coding and capture missing patient demographics, reducing denials and maximizing your reimbursements so that you can focus more on patient care.
Book A Free Consultation
Why Orthopedists Need to Outsource Medical Billing Services?
Orthopedic billing is a complex process because it requires accurate coding for each treatment. From evaluation management to treating patients with spinal surgery, each code differs from the others, requiring precision in every assigned code because a minor error can lead to denials. That’s where outsourcing orthopedic billing services occurs, as it maintains patient records, checks insurance coverage, and ensures payer compliance on each claim to improve reimbursements.
Another reason for choosing third-party billing is that orthopedists face challenges in the medical billing process due to the evolution and regulatory changes in payer policies. Here are some common billing challenges orthopedists, clinics, and large hospitals face throughout the revenue cycle management;
- Multi-Level Spine Coding Errors
- Global Period Bundle (90-Day Rule)
- Authorization/Documentation Gap
- Lack of Trained Orthopedic Billing Experts
- Laterality Errors (Missing Left/Right Modifiers)
Our Core RCM Services to Maximize Your Revenue
Every orthopedist deserves to be paid on time without any stress. Whether you work independently or in a hospital, our revenue cycle management services help you earn payments for every surgery you perform. Our orthopedic surgery billing services are tailored to meet the CMS guidelines, payer-specific policies, and codes, reducing the chances of denials and maximizing reimbursements.
Here’s what our comprehensive RCM services offer for optimal results;
Our team of experts handles orthopedic insurance verification, including co-pays, deductibles, and insurance coverage plans, whether they’re active or expired. It helps avoid minor issues that can become major ones, leading to payment delays.
We handle the complex medical coding process for orthopedic surgeons, ensuring that every assigned CPT, ICD-10, and HCPCS code fully aligns with OP notes to meet the first-claim acceptance rate.
Our professional medical billers generate claims electronically and submit them to the clearinghouse within a specified timeframe (usually 90-180 days).
Our experts efficiently handle your orthopedic billing denials without any stress or delays. We identify the root cause, check the category of denials, fix the issue promptly, and resubmit it to the payer, so you never wait long for payment.
With us, your accounts receivable (A/R) days are always matched at an industry-leading level because our team continuously follows up on claims until they are processed. As soon as we receive payment, we post it to your EHR/PM billing portal.
Credentials checks are as essential in the orthopedic billing process as your payments. Without it, the payer won’t pay you for surgeries. Our credentialing experts verify your orthopedic surgeon registration, NPI enrollment and verification, educational credentials, and all essential documents to make sure nothing blocks your cash flow.
Our team of experts handles orthopedic insurance verification, including co-pays, deductibles, and insurance coverage plans, whether they’re active or expired. It helps avoid minor issues that can become major ones, leading to payment delays.
We handle the complex medical coding process for orthopedic surgeons, ensuring that every assigned CPT, ICD-10, and HCPCS code fully aligns with OP notes to meet the first-claim acceptance rate.
Our professional medical billers generate claims electronically and submit them to the clearinghouse within a specified timeframe (usually 90-180 days).
Our experts efficiently handle your orthopedic billing denials without any stress or delays. We identify the root cause, check the category of denials, fix the issue promptly, and resubmit it to the payer, so you never wait long for payment.
With us, your accounts receivable (A/R) days are always matched at an industry-leading level because our team continuously follows up on claims until they are processed. As soon as we receive payment, we post it to your EHR/PM billing portal.
Credentials checks are as essential in the orthopedic billing process as your payments. Without it, the payer won’t pay you for surgeries. Our credentialing experts verify your orthopedic surgeon registration, NPI enrollment and verification, educational credentials, and all essential documents to make sure nothing blocks your cash flow.
Our Advanced Billing Solutions for Orthopedics Clinics & Hospitals
No need to invest time in manual work, spending time to understand the complex op-notes to create claims! eClaim Solution brings advanced software and AI tools that not only reduce administrative workload but also minimize errors. Whether you’re an orthopedist who works independently or in a large healthcare organization, our experts have covered every part of your billing carefully, so you get paid by payers without delays. By implementing AI technology in orthopedic billing, we streamline the financial workflow and maximize reimbursements.
AI-Powered Coding
Our AI coding assistant suggests the perfect CPT, ICD-10, and HCPCS codes based on the op-notes. Moreover, it detects incorrect modifiers and mismatched patient information and notifies of prior authorization needs before claim submission.
Automated Claim Scrubbing
We automate claims processing by capturing every error and missing data to ensure a fast, smooth billing process.
Why Choose Us for Your Orthopedic Medical Billing Services
If you want to increase your cash flow, minimize paperwork, and enhance focus on patients, then you should choose the right orthopedic billing company that can handle everything for you.
Fortunately,you have found us! With over 10 years of experience in healthcare billing services, we serve 25+ medical specialties, including yours. From patient registration to payment posting, our orthopedic billing experts handle everything precisely and smartly.
24/7 Billing Support
Whether you need assistance with your claims tracking or payment follow-up, our billing specialists are available 24/7, ensuring to resolve your queries.
Affordable Pricing
By partnering with us, you’ll get full RCM services at affordable prices, tailored to your unique goals and needs, with no hidden charges at all.
Certified Medical Coders
Outsourcing orthopedic medical billing services to us means you gain access to certified medical coders who stay up to date with every change in codes from specialty-specific payers, ensuring clean claim submissions.
Stay Compliant With Our Exceptional Medical Billing Services
By choosing us, you will always remain compliant with HIPAA regulations and specialty-specific policies, and you will never need to worry about data breaches, thereby preventing the high costs of penalties and fraud.
HIPAA-Compliance
Data Security
Prevent Frauds
Orthopedic Billing & Medical Coding Services in the USA
The most complicated part of billing is coding, and fortunately, we have mastered it! After submitting millions of claims over the years, our orthopedic billing and coding services help many orthopedists with the critical coding phase, achieving a 98% clean claim ratio.
Diagnostic Coding Expertise (ICD-10-CM)
We know the difference between the Laterality and Encounter type ICD-10-CM codes. For example, our experts use S83.242A, which precisely defines the tear of the medial meniscus in the patient’s left knee.
Specialized Procedural Coding (CPT)
From general musculoskeletal codes (20000 – 20999), Spine (Vertebral Column) (22010 – 22899), and Upper Extremities (23000 – 25999) to the Lower Extremities (26000 – 28899), Arthroscopy (29800 – 29999), our professional coders use valid and exact CPT codes.
Supply & No-Physician Coding (HCPCS Level II)
We know when to apply J1030, E0114, and L1832 in insurance claims to ensure clear, clean medical documentation, which helps prevent claim rejections.
Modifier Coding
By mastering the global period modifiers (-24, -58, -79) and the physical status & technical modifiers (-TC, -26, -F1 to -F9 / -T1 to -T) in orthopedic billing, our experts use the exact one based on OP notes.
Results That Drive Revenue for 1k+ Orthopedists
Increase Revenue
Denial Reduction
Precise Medical Coding
Accurate Claim Submission
Hours Turnaround Time
Specialized Billing for Every Orthopedic Subspecialty
Why do you need to worry about your orthopedic subspecialty billing when you have us! eClaim Solution is mastering subspecialties to help every orthopedist get paid on time, while focusing on patient treatment without administrative stress.
- Orthopedic Surgery Billing
- Sports Medicine (Athletic injuries and arthroscopy)
- Joint Replacement (Adult Reconstructive Surgery)
- Spine Surgery (Cervical, thoracic, and lumbar conditions)
- Hand and Upper Extremity (Shoulder to fingertips)
- Foot and Ankle
- Pediatric Orthopedics (Growth-related and congenital issues)
- Orthopedic Trauma (Complex fractures and acute injuries)
- Orthopedic Oncology (Musculoskeletal tumors)
- Shoulder and Elbow
- Hip and Knee Preservation (Non-replacement joint surgery)
- Orthopedic Rehabilitation and Physiatry (Non-operative care)
Trusted by Orthopedic Practices Nationwide
No matter where you reside in the United States, you can receive our professional orthopedic billing services at transparent prices. We cover the major areas in the USA, including Texas, Pennsylvania, New York, Michigan, and Illinois. Whether you need help with claim denials resolution or follow-up regarding payments, our experts are always here to assist you.
Frequently Asked Questions
General medical billing involves claim submission with a focus on state-specific coding and payer rules, making it quite easy. On the other hand, orthopedic medical billing is complex due to unique coding rules (surgeries, implants, injections), specialty-specific and state-specific policies, which make it distinct from general medical billing. Moreover, it has subspecialties that make it more complex, requiring experts’ billing services to ensure accurate, faster reimbursements while reducing the denial rates.
The most commonly used CPT codes in orthopedic billing are E/M codes, surgical procedure codes, diagnostic and imaging codes, and the essential modifiers that ensure accuracy and prompt payment from insurance companies.
Outsourcing orthopedic medical billing & medical coding services to us can help you reduce claim denials by up to 15–20%. By staying up to date with healthcare regulatory changes, payer-specific policies, and upcoming changes in medical codes, we lower denial rates and streamline reimbursement processes, helping orthopedic practices grow.
The cost of orthopedic billing services depends on your practice size and requirements. However, eClaim Solution offers the most affordable rates across the USA, with no hidden charges, to ensure your practice earns more.
