How to bill correctly for your Orthopedic Practice?

You are an orthopedic practitioner who wants to be compensated properly but are you stuck with an inefficient billing process? Your medical billing for the revenue cycle is one of the most critical functions in your orthopedic practice which means you will need to ensure your billing needs are completed accurately and promptly. Not just that, it’s essential to keep up with all the latest medical billing and coding updates so that you stay compliant. With a proper medical billing system, your practice can gain continuous revenue with minimal delays and lesser stress for cash flow issues. So that you can know how to bill correctly for your Orthopedic Practice.

When it comes to orthopedic billing, there are important processes and standards that are to be followed to ensure the billing is specific with minimized chance of claim denials.

Accurate Patient Information

We are aware of the practice of having accurate patient information but often we disregard the importance it holds and how it affects the billing service. It’s essential to thoroughly check the patient’s names and spellings, the date of birth, address details, and any other details that can be easily overlooked or misspelled. All of these errors can lead to claim rejection or delayed claim processes. You can ensure correct patient information and consistency by having your administrative team cross-check the forms that are filled out by your patients before you fill out your claim.

Proper Documentation

Other than patient information, the other aspect would be to have and create proper documentation of the patient’s medical history which can include past surgeries and consultations. Also, you will need correct coding to assign codes for assistants/consultation, surgeries, and medical necessity documentation. AAOS and AMA have stated that documentation must comprise of the medical necessity of an assistant and their part as recorded by the surgeon.

Verification of Insurance Coverage

Verifying insurance coverage will help make your orthopedic billing process efficient which will, in turn, save time and money by eliminating denials and coverage errors. In order to make your orthopedic billing methodical, efficacious, and profitable, you will need to verify all facets of your patient’s insurance. Inculcate the practice of prior-authorizing and pre-verifying coverage that is offered by the insurance carrier for the kind of medical services you will be providing. This will help identify patients with active coverage. You can also request patient reports from their insurance company so that you are in the position to verify if the policy covers specific medical care you will be rendering.

On-time File Claims

One of the most common billing mistakes that orthopedic practices can refrain from is filing their claims on time. To do so, a process can be created with common procedures and metrics that will contribute towards the ability to submit claims within a specific time period. Meeting the claim filing deadlines will determine the execution of a claim- whether it will be denied or paid. Be sure to keep a track of these deadlines and ensure timely filing is provided by the insurance carriers.


Many times orthopedic practices have seen denials based on information that was not specific enough. To avoid such scenarios, your administrative team will have to ensure they collect as much information as possible and justify the codes that are being selected against it. Along with this, you will also have to ensure the codes used for a specific procedure or service are accurate.

ICD-10 states that coding for such billing should be more specific to guarantee payment. This means our orthopedic billing and coding process should be compliant with the latest system and coding standards. To do so you will need to provide your team with the right technology and knowledge so that they are able to record and code claims efficiently while adhering to the highest level of specific coding by bill correctly for orthopedic practice.

Have you considered outsourcing your orthopedic billing?

Well, give it a try and see your billing system working as efficiently as possible. When you outsource your billing and revenue cycle management, it helps decrease costs and increases your revenue. This will allow staff to save time who otherwise is stuck with appealing or re-filing claims that were denied. Allow 24/7 Medical Billing Services to become your partner with the right expertise in medical billing, to manage your revenue cycle and orthopedic billing services so that you can focus on your practice. Witness your orthopedic practice receiving increased revenues, lowering overhead costs, and minimizing the risk of denials with 24/7 Medical Billing Services. Contact us to know more about our billing services for orthopedic practice.

Read more: How Orthopedic Billing Companies Can Increase Your Profits?

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