The Reason as to Why Orthopedic Medical Billing Requires Professional Excellence
Our orthopedic billing team at NexCure LLC is well trained about these challenges therefore having a precise, compliant and optimally paid claim.
Welcome to NexCure
Billing Professionalism
of Orthopedic Practice
Orthopedics is one of the most comprehensive fields in which different procedures are available, and codes are the most complex, and payers are a frequent crowd to alter and modify the policies on the regular basis. Orthopedic billing encompasses a wide range of CPT, ICD-10 and HCPCS codes as well as the appropriate use of modifiers to cover a vast area of treatment of fractures and sports injuries, joint replacements and spinal surgeries. Coding mistakes, failure to document can result in a denial of claims, delays or loss of revenue even when it is a small mistake.
NexCure LLC provides Medical Billing services that specializes in Orthopedics and gives you the best chance to maximize your reimbursements, stay in compliance and simplify your revenue cycle. The team of our AAPC-certified medical coders and billing specialists is well versed in the special needs of orthopedic billing and will strive to get rid of errors, increase payment cycles, and enhance your cash position.
In contrast with numerous other specialties
orthopedics deals both with surgical and non-surgical treatment and commonly includes
Multiple Procedures Within a Single Session
As an example, arthroscopy and meniscus repair together with debridement may involve proper application of many CPT codes and proper use of modifier to prevent bundling issues.
Differentiated Treatment Sites
Procedures can be to differing joints, bones or limbs and each must be coded as such (e.g. -RT, -LT).
Bundling & NCCI Rules
The National Correct Coding Initiative has been strict on bundling of what procedures can be charged at the same time. They can be denied in case they are not followed.
Implants & Devices
Common surgical implants and devices that should be tracked with billing or entered in the proper payer specific documentation would include, but not be limited to, plates and screws, prosthetic joints, etc.
Pre-Authorizations
All the highly priced surgeries require prior clearance (e.g. knee replacement, spinal fusion). Failure to do this is going to lead to rejection of the claim, despite medical necessity.
Rapid Policy Changes
CMS and private payers are continuously changing the orthopedic-related coverage and reimbursement policies, particularly those of bundled services and physical therapy caps.
Orthopedics Billing and Revenue Cycle Services – End-to-End Offerings
We handle your orthopedic practice’s revenue cycle from patient scheduling to the final posting of payment, allowing you to concentrate on the care and treatment of patients.
- Obtaining and protecting compliant and secure data on the billing that keep patient information safe.
- Maintaining the currents of the developments in payer policies and orthopedic coding conventions.
- Orthopedic CPT, ICD-10 and HCPCS-certified AAPC coders.
- Code experience in the area of fracture care, joint replacements, arthrocopic surgery and complex spine procedures.
- Modifier precision abbreviations (-RT, -LT, -59, -50, -51, etc.) to reduce the inaccuracy of payment and possible cases of bundling.
- Applying the latter the NCCI rules and payer specific coding rules.
- Confirming the coverage of the patient prior to the scheduling of orthopedic procedures with large expenses.
- Administration of the prior authorization process of, among others, hip replacement procedure, the procedure on the rotator cuff, and spinal fusion procedure.
- Eliminating lost revenue as a result of authorization denials.
- Charging of claims through utilization of a full and correct documentation.
- Faster processing, electronic claim submission and real-time rejection monitoring.
- The electronic paper, on which the process of claims paying is displayed.
- Insurance on patients/payment.
- Use of Electronic Remittance Advice (ERA) to compare it with billed charges to find out underpayments.
- Beate to inequality.
- Supervision of the trend of refusals with the aim of solving repetitive issues.
- Appeals letters are attractive to the documentation.
- Establishing remedial action measures in order to avoid future rejection.
- Sending direct clear readable patient messages.
- Flexible payment plan can be provided whereby there is the opportunity to do this.
- Particular billing support telephone where patient questions are resolved easily.
Orthopedic Procedures That We Usually Bill
Our group has worked with billing on a large variety of orthopedic services including:
Fracture Care
Closed and open treatment.
Joint Replacement Surgeries
Hip, knee, shoulder.
Arthroscopy Surgery
Repair meniscus, reconstruction ligament and restoration cartilage.
Orthopedic Procedures
Fusion, laminectomy, discectomy surgeries of the back.
Sports Injuries Treatment
ACL reconstruction / rotator cuff repair.
Orthopedic Oncology Surgical Procedures
Removal of bone tumors.
Casting and Splinting
Putting, taking off and putting on again.
Physical Therapy & Rehabilitation
Therapy billing after treatment following surgeries and injuries.
Bumbling Therapies
Injections steroid, PRP and viscosupplementation species.
The Way NexCure LLC Can Enhance Orthopedic Practice Revenue
- Specialty Knowledge – We cater only to specialty practices, such as orthopedics, so that your billing is done by specialists who are familiar with your precise needs.
- Faster Payments – Our clean claim payment process that improves rejections and hastens reimbursements.
- More Money – Eliminating denials, proper coding, and seeking denial offset ensures you are getting a full amount of money you have earned.
- Admin Reductions – Take the burdensome paperwork of billing off the hands of your staff – so they can work on other aspects of patient treatment.
- Transparent Reporting – Real-time tracking of your claims, payments and revenue cycles performance available anytime.
A proactive approach to billing that consists of the following solves these issues:
- Pre-Claim Review – All the claims are checked out on accuracy before they are launched.
- Daily Claim Tracking – Identification of problems early and their resolution.
- Root Cause Analysis – Analysis of denials to avoid future instances.
- Provider Education – Teaching your clinical staff to practice best practices documentation.
Many orthopedic practices lose significant revenue due to factors such as incorrect coding for complex surgeries, failing to bill for all chargeable services, incomplete documentation, and inefficient back-office claims collection. These issues can be effectively addressed through a proactive billing approach that tackles each of these challenges head-on.
Client Testimonials
What Healthcare Providers Say About Us
"Working with NexCure LLC has been a relief for my clinic. They took care of my credentialing process from start to finish, no delays, no confusion. I also like how they keep up with CMS quality programs and explain things clearly. Honestly, they’ve made my life much easier."
Dr. Ayesha Rahman, MBBS
"Before NexCure LLC, our billing was a nightmare — denials, delays, you name it. Their team stepped in and fixed our revenue cycle quickly. What I appreciate most is their guidance on MIPS reporting; they walked my staff through the requirements and we’ve already seen the results. Dependable and professional."
Dr. James Whitman, MD
"The attention to detail at NexCure LLC is impressive. They helped us get credentialed with several payers and made sure everything stayed compliant. Their support with HEDIS reporting boosted our scores, which directly benefited our contracts. I’m grateful for their hard work."
Dr. Maria Gonzalez, MD
"I’ve been very satisfied with the services from NexCure LLC. They keep me updated on payer rules and compliance, which is something many billing companies overlook. My billing cycle is smoother now, and their assistance with MIPS reporting has been a real plus. It feels like they are part of my team."
Dr. Omar Al-Farouq, MD
"Our practice needed someone who really understood billing and coding. NexCure LLC improved our collections and made the whole process less stressful. They’re straightforward, easy to reach, and they actually deliver on what they promise. I recommend them without hesitation."
Dr. Alejandro Ramirez, DO
12+
Years of Expertise in Medical Billing & Revenue Cycle Management
85+
Providers Across Multiple Specialties Trust NexCure LLC Consultancy
97%
Clean Claims Rate Achieved on First Submission of Project Delivery
15K+
Claims Accurately Processed Every Month
Book Consultation
(929) 587-3833
Email address:
Info@nexcurellc.com
1500 N Grant ST #5001, DENVER, CO, 80203
United States
WhatsApp:
(929) 587-3833