Contact: (215) 525-1929
Orthopedics RCM

High-Performance Orthopedics
Medical Billing & RCM

From clinic visits and imaging to joint replacements, sports medicine, and spine surgery, our orthopedic billing workflows protect your high-value procedures while keeping patient balances clear and manageable.
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Services for Orthopedics

End-to-End Billing for Orthopedic Practices & Surgery Centers

Our orthopedic RCM services support clinic, hospital, and ASC settings—covering injuries, fractures, joint replacements, spine procedures, sports medicine, and post-op follow-up care.

1

Patient Registration, Eligibility & Authorizations

Protect revenue by aligning benefits and authorization before surgery.

  • Accurate demographic & insurance capture at intake
  • Eligibility & benefits checks for clinic, hospital & ASC services
  • Prior auth and referral tracking for surgeries & imaging
2

Orthopedic Coding & Global Period Management

Sub-specialty coders handle complex procedures and post-op rules.

  • Fracture care, joint replacement & arthroscopy coding
  • Spine, trauma, sports medicine & upper/lower extremity procedures
  • Global period tracking & correct use of modifiers for related services
3

Imaging, Injections & In-Office Procedures

Ensure that high-frequency in-office services are fully captured.

  • X-ray, ultrasound & image-guided procedure billing
  • Joint injections, aspirations & casting/splinting
  • Durable medical equipment (DME) & bracing workflows
4

ASC, Hospital & Implant Billing Coordination

Align professional, facility, and implant-related charges.

  • Coordination across hospital & ASC billing teams
  • Implant and hardware documentation support
  • Professional vs. facility billing guidance
5

Claims Submission & Ortho AR Management

Turn busy surgical schedules into predictable cash flow.

  • Daily claim submission for clinic visits & procedures
  • High-dollar claim tracking & underpayment review
  • Systematic workflows for secondary & worker’s comp claims
6

Denial Management & Analytics

Fix recurring denials around medical necessity, implants & edits.

  • Denial analysis by payer, procedure & location
  • Appeals for bundling, modifier and medical-necessity denials
  • Ortho-focused KPI dashboards & optimization plans
Orthopedics Workflow

How DigitixMD Integrates with Your Orthopedic Practice

Our workflow is built around surgical schedules, clinic follow-ups, and multi-location demands—keeping documentation, authorizations, and billing tightly aligned.
  1. 1

    Orthopedic Revenue & Denial Audit

    We review your procedure mix, payor contracts, denials, and AR by location and provider to uncover underpayments, auth-related revenue leakage, and global-period issues.

  2. 2

    EHR / PM Integration & Ortho Template Setup

    We connect to your EHR/PM (Epic, Athena, NextGen, eClinicalWorks, etc.) and configure orthopedic templates for procedures, implants, imaging, and global period tracking.

  3. 3

    Daily Charge Capture, Coding & Scrubbing

    Clinic visits, surgeries, imaging, and in-office procedures are coded and scrubbed daily—validating approach, laterality, level, implants, and modifiers before claims go out.

  4. 4

    High-Value Claim Protection & Denial Prevention

    We give extra attention to complex surgeries and high-dollar procedures, preventing denials tied to missing auths, incorrect global-period billing, and bundling edits.

  5. 5

    Ongoing Optimization & Ortho Reporting

    Your account manager reviews collections per case, procedure-specific denials, AR by payer and location—and recommends actionable improvements for your entire ortho service line.

*Performance improvements depend on your baseline processes, payer mix, and case complexity. Our free audit gives realistic projections before you commit.

Orthopedic Services We Commonly Support

Engagement models that match your structure

Choose full-service orthopedic RCM or targeted support for coding, surgery center billing, denials, or multi-location reporting.
Full-service ortho RCM Coding-only support Denial & underpayment projects ASC / Hospital coordination
Why Choose Us

A Billing Partner That Knows Dermatology Inside & Out

Dermatology blends medical necessity, procedure-heavy schedules, and growing cosmetic demand. We help you manage that complexity while giving your team more time to focus on patients.

✔
Dermatology-trained RCM team

Our coders and AR specialists work daily with dermatology practices, staying current on lesion-based coding, Mohs-specific rules, and payer policies that affect your reimbursements.

✔
Compliance-first, revenue-optimized

We align documentation, coding, and billing with payer guidelines and industry standards—helping you capture legitimate revenue while minimizing audit risk.

✔
Clear metrics for derm practices

See revenue by procedure type, provider, location, and modality, plus denial breakdowns that matter in dermatology—so you can grow confidently.

Frequently Asked Questions
(FAQs)

Do you support clinic, hospital and ASC orthopedic billing?
Yes. We work with orthopedic groups that operate in clinic, hospital, and ASC settings—coordinating professional claims, facility billing, and implant documentation as needed.
Can you manage global periods and post-operative billing?
We actively track global periods, ensuring related post-op visits are handled correctly and that distinct services are billed with appropriate modifiers when allowed.
Yes. We support worker’s comp and auto claims, including documentation requirements, adjuster communication, and separate workflows from commercial and government payers.
How is pricing structured for orthopedic practices?
Most orthopedic clients use a percentage-of-collections model aligned to surgical volume, clinic visits, and payer mix. Multi-location or large groups can choose hybrid or customized pricing after our initial review.
Can you work alongside our in-house billing or surgery schedulers?

Absolutely. We often partner with internal teams, handling coding, denials, and reporting while your staff manages scheduling, pre-op calls, and check-in/check-out workflows.

How quickly can we go live with DigitixMD?

After your free orthopedic revenue audit, most practices can be fully onboarded within 2–4 weeks, depending on EHR access, payer enrollments, and data migration needs.

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