Orthopedics Revenue Cycle

Global surgery periods are not supposed to mean free follow-up care.

Global period visits treated as unbillable when they should not be, implant cost pass-through that never reconciles, and DME that gets dispensed but never charged. Book a free 15-minute conversation and we will show you the three we see most often.

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15 minutes. Custom financial scorecard for your practice.

At a glance

Starts withFree 15-minute assessment
FormatEducational diagnostic, no cost
You getA scorecard of your top revenue leaks and where to focus
Next step/free-assessment

Is This Right for You?

This is for orthopedic practice owners who:

Global surgery periods are creating confusion. Your billers are not sure which follow-up services can be billed separately
Workers comp claims require employer-specific documentation that is inconsistently completed, leading to denials and payment delays
DME (braces, splints, crutches) is being dispensed but not consistently billed or documented properly
Injection coding (joint injections, trigger points) varies by provider and you suspect some are under-coding
Modifier complexity for bilateral procedures, co-surgery, and assistant surgeons is leading to payment errors

Want ongoing financial oversight? Our Fractional CFO service for orthopedic practices may be a better fit.

What We Analyze

Where Orthopedic Practices Lose Revenue

We trace every dollar from claim submission to bank deposit in your orthopedic practice.

01

Surgical Coding & Global Periods

  • Global surgery period compliance audit
  • Separately billable service identification during global periods
  • Multi-procedure surgical coding accuracy
  • Assistant surgeon and co-surgeon billing review
02

Injection & Procedure Coding

  • Joint injection coding standardization across providers
  • Image-guided procedure billing review
  • Fracture care coding and global period management
  • Cast/splint application charge capture
03

DME Billing

  • DME dispensing-to-billing reconciliation
  • Medical necessity documentation for DME
  • ABN documentation for non-covered items
  • DME payer-specific billing requirements
04

Workers Comp Process

  • Initial evaluation documentation compliance
  • Impairment rating and independent medical exam billing
  • Follow-up visit coding within workers comp guidelines
  • Employer notification and return-to-work documentation

Results

What Orthopedic Practices Recover

FindingTypical Outcome
Implant cost savings$186,000 annually through vendor renegotiation and standardization
DME revenue recovered$73,000 from billing process corrections
PT department improvement4% to 13% margin through productivity optimization, adding $108K annually

Case Study

Real results from a practice like yours

6-surgeon orthopedic group with ASC ownership, in-house PT, imaging center, and DME dispensing. Total revenue across all entities was $11.4M, but partner take-home had declined 15% over three years. The partners suspected declining reimbursements but the real problems were operational.

What we found:

  • Implant costs had increased 22% over three years without any vendor renegotiation. $186K in annual savings was available through competitive bidding and standardization
  • The PT department was operating at a 4% margin instead of the 12 to 15% benchmark because three of the six PTs were averaging only 8.5 visits per day against a target of 11
  • DME was dispensed on 35% of eligible visits but billed on only 22%. The 13% gap represented $73K in missed annual revenue
  • Global surgery period coding errors meant the practice was leaving $117K per year in separately billable post-surgical services uncollected

The results

$186,000 annually through vendor renegotiation and standardization

Implant cost savings

$73,000 from billing process corrections

DME revenue recovered

4% to 13% margin through productivity optimization, adding $108K annually

PT department improvement

We were blaming the insurance companies for our declining income. Turns out we had $350K sitting in our own operations that we were not collecting.

Managing Partner, South

Common Questions About Revenue Cycle Analysis for Orthopedic Practices

Find out where your orthopedic practice revenue goes.

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