Orthopedic Medical Billing & Coding Services
Precision coding for a high-volume, high-complexity specialty. Orthopedic Medical Billing & Coding
Why Orthopedic Billing Demands Expertise
Orthopedic practices operate at a scale and complexity that few other specialties match. A single patient encounter may involve multiple procedures, multiple modifiers, and intricate bundling rules – all of which must be coded perfectly to avoid leaving revenue on the table.
From fracture repairs and joint replacements to arthroscopic surgeries and injection therapies, orthopedic billing requires a deep understanding of:
- Global surgical periods and package bundling rules
- Modifier 59 (distinct procedural service) usage and payer-specific restrictions
- Multiple procedure reduction rules (modifiers 51, 50, 62)
- E&M coding alongside surgical procedures
- Medicare National and Local Coverage Determination policies
Orthopedic-Focused Billing That Delivers Results
We know the Florida payer environment inside and out: Medicare First Coast MAC policies, Florida-specific Medicaid rules, and the requirements of major commercial carriers like Florida Blue, Cigna, and Aetna.
Certified Coder
CPC-certified coders with dedicated orthopedic training and experience
Acceptance Rate
98% first-pass claim acceptance rate across all orthopedic procedures
Denial Management
Proactive denial management and appeal process within 48 hours
Seamless Timing
Real-time transparency - your practice data available any time
How Our Orthopedic Billing Process Works
Assurance Health Care Financial Services brings two decades of orthopedic billing experience to Florida practices. Our Certified Professional Coders understand orthopedic-specific documentation requirements – from the nuances of fracture coding to the intricacies of spinal surgery billing.
Claim Preparation
Our CPC-certified coders review each encounter, apply the correct orthopedic-specific CPT and ICD-10 codes, and attach appropriate modifiers based on the procedures performed.
Electronic Submission
Claims are filed within 24-48 hours through our clearinghouse, which performs automated edits and error checks before transmission.
Denial Prevention
We identify potential issues before claims are submitted. Claims that are denied are corrected, appealed, and resubmitted promptly - often within 48 hours.
Payment Posting
Insurance payments are deposited directly into your practice account. We post payments, adjust for contractual allowances, and reconcile accounts daily.
Transparent Reporting
Monthly reports show your practice-specific metrics: claim volumes, aging AR, collection rates, denial analysis, and revenue trends. Your dedicated account manager reviews them with you.
Why Florida Practices Choose Assurance Health Care
We are a Florida-based medical billing company, not a faceless national corporation. When you partner with us, you get a dedicated team that treats your practice’s revenue like our own.
Our clients stay with us year after year because we deliver results and personalized service. Our Certified Professional Coders work alongside your office staff to ensure seamless communication and maximum reimbursement.
- Headquartered in Panama City, Florida - we know the local market
- Over 20 years serving Florida orthopedic and multi-specialty practices
- Dedicated account manager who knows your practice by name
- Flexible pricing: flat-rate or percentage-based, whichever you prefer
- Tested and proven: 98% acceptance rate, 22% revenue increase average
Frequently Asked Questions
How do you handle the global surgical period for orthopedic procedures?
At this time, we do not provide provider credentialing services. Our expertise is focused exclusively on delivering accurate, efficient, and customized medical billing and revenue cycle management solutions. By maintaining this specialized focus, we ensure the highest level of service and support for our clients’ billing operations.
Can your team handle high-volume orthopedic practices?
Absolutely. Orthopedic practices often generate 500-1,000+ claims per provider per month. Our team is scaled to handle high-volume claim processing without sacrificing accuracy. We use automated claim scrubbing and clearinghouse edits to maintain our 98% first-pass acceptance rate regardless of volume.
What orthopedic-specific certifications do your coders hold?
Our team includes Certified Professional Coders (CPCs) with extensive experience in orthopedic coding. Many have completed additional training in orthopedic-specific coding guidelines, including fracture management, arthroscopy, joint replacement, and spine surgery coding.