We know that surgical subspecialties have different coding and billing needs. We help you master the details for your individualized practice.
Sports medicine
Team physicians and sports medicine specialists help athletes compete at the highest levels. Arthroscopic and reconstructive surgeries of the shoulder, knee, hip, elbow, and more often involve multiple codes. There may be unplanned, intraoperative incidental findings that require extra care in ensuring reimbursment. Payor medical policies on eligibility, conservative treament, and medical necessity also often come into play. And coding changes that dictate what is allowable make reimbursement a moving target. We are proud to serve sports medicine providers through our business office services and analytics.
Joint replacement
Joint replacement surgeries help patients gain mobility, independence, and a life free from pain. These surgeries are often performed on older patients who have Medicare coverage. We help ensure total compliance with Medicare regulatory requirements as well as timely filing to ensure these surgeries are reimbursed as quickly as possible. The same goes for assisting surgeons and advanced practice providers who help with the case. On the facility side, we help maximize reimbursement for implants, and monitor reimbursement to ensure contractual adjustments are taken appropriately. Primary, revision, THAs, TKAs, unis, total shoulders, robotic-assisted, you name it, you replace it, we bill it.
Spine
Spine surgeries are among the most complex and highest-risk cases that orthopedic providers see. Cases that take a half a day, a whole day, or even multiple days can be life-changing for patients, and require the utmost attention to detail to ensure reimbursement and avoid lost revenue. Spine cases may have a dozen or more codes compared to a handful for most other subspecialties, and there are complex rules governing which codes may be billed for which cases for which payors. Our team is well versed in spine surgical coding and assists facilities in ensuring that all necessary authorizations are in place to safeguard reimbursement for ALIFs, TLIFs, ACDFs, scoliosis cases, and more.
Pain management
We support providers who use opioid-sparing techniques to help patients reduce and eliminate pain. The expertise of pain management and rehabilitation physicians, physiatrists, physical therapists, and everyone involved in this specialized care helps patients gain a new lease on life and forestall or prevent surgery if desired. The reimbursement environment for these procedures has become increasingly difficult, and ensuring appropriate documentation for interventions and diagnostics is essential. Our team provides the full spectrum of support from authorization to payments for these patients and providers, whether it be facet injections, spinal cord stimulators, blocks, or any other PM&R procedure.
Foot and ankle
Foot and ankle surgeons perform complex procedures involving many different codes that require expert knowledge to ensure compliance and optimize reimbursement. Our team is well versed in supporting the revenue cycle for foot and ankle surgeons, from bunionectomies and hammertoes to total ankles.