Where orthopedics revenue actually breaks
Specialty
Global periods, implants and multi-payer casework across office and facility.
Problem landscape
Where dermatology revenue actually breaks
These are the failure points we look for first, in this discipline specifically.
Global surgical periods
Post-operative visits inside a global period are non-billable, while genuinely unrelated care needs the right modifier. Both directions leak money: unbilled legitimate work, or denials and refund exposure.
High-dollar surgical claims and implants
Implant-heavy cases mix professional, facility and device components. Invoice documentation, carve-out language and payer-specific implant policies drive whether the case is paid near contract.
Workers compensation and personal injury
Where applicable, these claims run on entirely different rules: state fee schedules, adjuster communication, authorization letters, lien handling and much longer collection cycles than commercial AR.
Imaging and procedure authorization
Advanced imaging, injections and surgical procedures frequently need authorization, often through a benefit manager, and often re-authorised when the surgical plan changes.
Fracture care and injections
Fracture care can be billed globally or itemised, and injection claims need correct drug units, wastage documentation and site modifiers. Both are routinely coded inconsistently across providers.
Facility differences and therapy coordination
The same surgeon bills differently in an office, ASC or hospital setting, and in-house therapy adds its own authorization, visit-limit and documentation requirements.
Interactive model
The shape of orthopedics revenue
An interactive illustration of the dynamic that defines billing in this specialty.
Surgical case timeline & global period
Orthopedic revenue is organised around the case, not the visit. Step through the lifecycle.
Pre-op
Financial clearance
Authorization, benefits, implant expectations and patient estimate documented in one case record.
Day 0
Surgical case
Operative note, implant log and assistant detail reconciled into a single charge set with correct sequencing.
Day 1-10
Global period opens
Routine post-op visits suppressed; unrelated care flagged for the appropriate modifier instead of write-off.
Day 11-90
Global period active
Therapy authorization, imaging follow-up and injections tracked separately from the global package.
Day 90+
Global period active
Therapy authorization, imaging follow-up and injections tracked separately from the global package.
Pure Billing workflow
How we run orthopedics revenue cycle
The operating model is consistent; the controls inside it are specialty-specific.
01
Surgical case financial clearance
Before the case: authorization, benefit verification, implant and assistant-surgeon expectations, and estimated patient responsibility documented in one case record.
02
Global-period tracking
Each surgical case carries its global window, so post-op visits are suppressed correctly and unrelated care is billed with the right modifier instead of being written off.
03
Case-level charge assembly
Operative note, implant log and anaesthesia detail reconciled into one charge set, with multiple-procedure sequencing and bundling checked before submission.
04
Separate WC / PI track
Where applicable, work comp and personal injury claims are worked on their own queue with adjuster contact logs, state fee schedule expectations and longer follow-up cadence.
05
Contract variance review
Surgical payments compared against expected contract values so systematic underpayment on implants, assistants or bundled components is caught and appealed.
Interactive model
What we typically run for this specialty
Coding & Charge Posting
Coding and charge posting handled with specialty context, so documentation,
View →Prior Authorization
Authorization requests initiated, tracked and documented so procedures are not
View →How this specialty is staffed
Orthopedics accounts are run by a named team that works this discipline daily — charge entry and coding review, payer-specific scrubbing, denial root-cause follow-up and AR recovery, all inside your existing EHR and practice management system.
Get a Dermatology Revenue Health Check
A structured review of your dermatology denials, AR ageing and front-end workflow — with findings specific to this discipline.
