Orthopedic Medical Billing

One of the most important facets of the health care system is the billing department. From updating staff training to processing claims, medical billing is always changing due to medical regulations, insurance providers, and state or local laws. Those systemic factors can make medical billing complicated. However, it becomes even more complex when tackling specific services like orthopedic medicine.

If you’re looking for ways to optimize your orthopedic medical billing, then you should heavily consider outsourcing your orthopedic medical building.

While it may seem inconsequential, the right orthopedic medical billing service can help you serve your patients better. You will not only provide a better service but make sure that you are optimizing revenue.

Let’s break down the benefits of orthopedic medical billing and why you should invest today.

What is Orthopedic Medical Billing Responsible For?

  • Patient Signup and Enrollment
  • Insurance Authentication and Verification
  • Patients Appointments and Follow-up Reminders
  • ICD-9 and ICD-10 Coding, CPT Coding, HCPCS Coding
  • Updating Services for Regulation Changes
  • Claim Submittance, Claim Acceptance, Claim Denial
  • Account Collections and Reporting

How Can Outsourced Orthopedic Medical Billing Help Your Facilities?

Without the right team in place for your orthopedic medical billing, you could lose revenue. As regulations and the health care industry continues to evolve so should your billing. Staying up to date with this information though, even with a fully staffed department, is easier said than done.

Outsourcing your orthopedic medical billing can be crucial to improving your operations. Importantly, outsourced orthopedic medical billing takes the stress out of billing and payment processing. Most outsourced services can also work with different medical billing software integrations, so you can be up and running in no time. Consider services that will provide you with regular updates, account management, revenue reports as well as current laws changes. Here are some of the main benefits of orthopedic medical billing.

Navigate Complex Billing Issues Correctly

When it comes to orthopedic medical billing, insurance regulations, state laws, and federal laws all play a part in how a clinic files a claim. Navigating those instances can be tricky, doing so without properly informed staff can lead to claim denials and front-end mistakes. According to Medical Billing Wholesalers, over 35% of orthopedic surgery claims are incorrect. To negate this loss of revenue, an outsourced medical billing service will work with your team to make sure our front-end services are completed correctly and on time. This reduces the failure rate and increases the ROI when using an outsourcing service.

Stay HIPAA Compliant

One of the ways that outsourcing orthopedic medical billing helps your healthcare center is by staying HIPAA compliant throughout the entire process. Patient information stays secure with orthopedic medical billing companies, and many companies require workers to complete external HIPAA training and certification. Why is this important? 

HIPAA is an ongoing process. There have been many updates and changes since the law was first introduced, and there will continue to be changes due to privacy needs and technology transformation. Outsourcing your orthopedic medical billing provides you with security and keeps every part of the healthcare process HIPAA compliant.

Increase Your Revenue

Orthopedic medical billing services not only prevent denials but continue to improve revenue time and time again. Building services do this by instituting easy-to-use software, expert staffing, and optimized revenue cycles. Most billing services will tailor their software solutions and service to your needs, providing speed and accuracy. Furthermore, most orthopedic medical billing services will handle filing, collections, coding, billing, and account balance solutions. Many companies offer an all-in-one solution for your billing needs.

In-Depth Knowledge of Insurance Companies

Millions of people interact with health care facilities every single day. Due to the complex nature of billing, time is of the essence. Many insurance companies put restrictions on how quickly you can file a claim as well as how long you have to file a claim. Because medical billing companies are focused on one simple task, they often provide quick turnaround on claims and account management. These companies know how to navigate insurance providers.

Even then, insurance companies can throw curveballs when it comes to the claim process. Policies and regulations change, technology may make a technique obsolete, or medical coding can change. All these factors play a role when interacting with insurance companies. Instead of having to stay on top of these requirements by yourself, you can have a trusted guide to help navigate the space. Not only will your staff love this, but your patients will too! 

Quick Turnaround

When you work with an orthopedic medical billing service, you are investing in an expert partner that will keep up with rules and regulations regarding the billing process. Quick turnaround provides you with a better revenue cycle and better results for your money.  Quick turnaround also enables a more accurate view of healthcare costs and finances. Some hospitals and clinics find that the decreased time allows them to plan with more detailed and robust data.

Save Money and Time

Instead of hiring multiple staff members specifically for billing, outsourcing orthopedic medical billing negates that trouble. Hiring full or part-time staff precludes both upfront and ongoing costs and investment such as:

  • Salaries
  • Benefits
  • Training
  • Office Space
  • Extra Equipment
  • Certifications
  • And more!

Employees also may not always work out. Oftentimes, you can invest a lot of capital in someone and have them leave in a couple of years. Only then, you have to start the training and selection process all over again. That’s not all though, the training will also have to be updated every time to make sure each employee is up to speed on current practices.

Outsourcing your medical billing nullifies these problems and presents employees with a much easier process. Furthermore, a medical facility is free to spend more resources on patient and care-focused facilities improvements than administrative space.

Services Orthopedic Medical Billing Can Help Simplify

The services provided by orthopedic surgeons are complex, intensive, and growing. So is the billing of orthopedic services. Identifying which procedures fall under certain categories, applying correct coding to billing, and preventing penalties all complicate the work further. Without the right strategy in place, and without the right guidance, things can get out of hand quickly. Claims can become filed incorrectly, hospitals can lose funding, and staff or patients can feel misguided or confused.

The billing process doesn’t have to be this way though. In fact, it can even be empowering! Orthopedic medical billing can simplify the process and ensure better results. Some of the common tasks tackled by them are:


  • Hand
  • Arm
  • Elbow
  • Shoulder
  • Spine
  • Leg
  • Hip
  • Knee
  • Ankle
  • Foot
  • ACL
  • Joint Fusion

General Services:

  • Sports Medicine and Recovery
  • General Orthopedic Health and Wellness
  • Bone Trauma Treatment and Services


Where there are some free billing options for medical billing, they can never replace paying an outsource medical billing company. Most outsourcing companies will charge you around 4%-10% of collections depending upon the agency. This system creates a self-interest to process as many claims as possible.

Some companies prefer a flat fee system. They may charge you $3-$10 per billing claim. Again, this incentivizes processing as many claims as possible.

Both systems may require a setup fee that can cost anywhere from $150-$500 depending on the company and system requirements.

Ready for Orthopedic Medical Billing Services?

At 360Connect we can help you find high-quality orthopedic medical billing services. Fill out our form today and receive high-quality quotes from top vendors in medical billing services. Your solutions are at your fingertips!

Want to Learn More?

Check out our guides and other articles here:

OB/GYN Medical Billing

Family Practice Medical BillingHow Much Does Medical Billing Software Cost?

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