Orthopedic Medical Billing & Coding Services
Ortho billing is high-stakes: modifiers, global periods, surgical bundles, imaging, DME, and prior auth rules can quickly create denials and underpayments. We code accurately, submit clean claims, and follow up aggressively so you collect what you’ve earned.
- ✓ Surgical Coding + Modifiers
- ✓ Global Period & Bundle Rules
- ✓ Prior Auth + Medical Necessity
- ✓ Denial Management & Appeals
- ✓ AR Recovery for Underpayments
- ✓ Reporting You Can Trust
Daily claims + follow-ups included.
Free Credentialing with Medical Billing
$499 / Month
Call / WhatsApp:
(716) 919-3969
Email:
support@rxcredentialing.com
www.rxcredentialing.com
Orthopedic
Medical Billing Services
- ✅ Smooth transition between EHR/EMR systems.
- ✅ Efficient Electronic Funds Transfer (EFT), EDI, and ERA setups.
- ✅ Claims submission within 24 hours.
- ✅ Prompt follow-up with payers for faster reimbursements.
- ✅ Free CAQH maintenance and provider revalidation.
- ✅ Comprehensive Revenue Cycle Management (RCM) services.
- ✅ Appeals, adjustments, and coding review included.
- ✅ Referral coordination with other practices and specialists.
- ✅ Reimbursement strategies for optimized billing.
What Sets Us Apart
Orthopedic claims are often delayed or underpaid due to modifier misuse, missing authorization, incorrect global period handling, and bundling edits that require clean documentation and precise coding. We run claim scrubbing with specialty-aware checks, track denials by root cause, and work AR consistently so payers don’t “age out” your revenue. If you want additional cash-flow support, we can pair billing with AR recovery services.
Ortho Coding Expertise
Specialty-aware coding support for procedures, imaging, injections, DME, and post-op care—focused on clean documentation.
Modifier + Bundle QA
We reduce denials tied to modifier use and bundling edits by checking claim details before submission.
Authorization & Medical Necessity Support
We help confirm authorization workflows and documentation alignment so high-cost services don’t get denied.
Denials + Underpayment Focus
We manage denials and pursue corrections/appeals using our denial management approach.
How It Works
We implement a structured ortho billing workflow with minimal disruption: confirm your payer rules, align your EHR configuration, then run daily operations (coding support, submissions, rejections, posting, and follow-ups). You get visibility into what’s pending, what’s paid, and what needs action—without hiring and training an in-house team.
Step 1: Intake & Payer Workflow Review
We review your procedures mix, common payers, authorization requirements, and existing billing pain points.
Step 2: EHR / Clearinghouse Configuration
We confirm provider details, NPIs, taxonomy, EDI/ERA, payer IDs, and charge setup for clean claim creation.
Step 3: Daily Coding & Claims Operations
Charge entry, coding support, claim scrubbing, submission, rejection fixes, payment posting, and patient balance workflows.
Step 4: Follow-Ups, Denials, Reporting
We work AR daily, resolve denials, track underpayments, and provide reporting to prevent repeat issues.
Have Other Questions? Get in Touch
Our team is here to help you understand every part of the billing process, from claim submission to reimbursement. Whether you need clarity on workflows, payer rules, or how our services fit your practice, we make the entire experience simple, transparent, and stress-free.
Our onboarding process is completed within 3–5 business days, provided all required information is supplied.
Yes — we work with nearly all popular platforms such as Tebra, OfficeAlly, eCW, Athena, DrChrono, AdvancedMD, SimplePractice, ICANotes, Optimantra, and more.
Our base plan starts at $499/month and includes free credentialing for solo practitioners. Standard billing plans are 3–5% of insurance collections.
Yes — we offer free credentialing, CAQH maintenance, and revalidation support for billing clients.
All PHI is handled in accordance with HIPAA requirements. Our team uses secure, encrypted systems for file storage, communication, and data access. Access to PHI is limited to authorized staff only, based on job responsibilities, and all activity is monitored.
Insurance Companies We Work With
We work with every health plan in the United States, including Medicare, Medicaid, major commercial carriers like Aetna, Cigna, Humana, Blue Cross Blue Shield, UnitedHealthcare, as well as HMO, PPO, POS, state, and regional plans. Our team ensures seamless credentialing and contracting across all payers.
Straight from the Practices We Serve
What Our Clients
Have to Say
From nurse practitioners to physicians across every specialty, our clients share how we've lightened the administrative load, streamlined their operations, and given their practices room to grow. Their experiences speak for themselves:
Contact us
Have a question or want to learn more about our services? Fill out the form below and our team will get back to you within 24 hours.
