Orthopedic Medical Billing That Maximizes Every Claim
ClainetRCM delivers end-to-end revenue cycle management tailored for orthopedic solo providers, clinics, and hospitals. Stop leaving money on the table.
Certified coders review every chart, modifier, and implant line before the claim is submitted, not after it is denied
Why Orthopedic Billing Demands a Specialist
Orthopedic coding is among the most complex in medicine. Musculoskeletal procedures, implant billing, modifier nuances, and payer-specific rules require deep expertise.
Complex Procedure Codes
Arthroplasty, arthroscopy, fracture care, each demands precise ICD-10 and CPT coding to avoid denials and underpayments.
Implant and Device Billing
Separate line-item billing for orthopedic implants with pass-through cost documentation requires specialized experience.
High Denial Rates
Orthopedic claims are denied at above-average rates. Our proactive approach and rapid appeals protect your revenue.
Modifier Complexity
Multiple procedures, bilateral surgeries, and global period compliance require expert modifier application for full reimbursement.
Complete Orthopedic RCM Solutions
From charge capture to final payment posting, ClainetRCM handles every step of your orthopedic revenue cycle.
Orthopedic Medical Billing
End-to-end billing management designed for orthopedic practices, clinics, and hospitals.
- Charge entry and claim scrubbing
- Electronic and paper claim submission
- ERA/EOB posting and reconciliation
- Denial management and appeals
- Patient statement and collections
Orthopedic Medical Coding
Certified coders with orthopedic specialty expertise ensure every procedure is captured accurately.
- ICD-10-CM and CPT/HCPCS coding
- Arthroscopy and arthroplasty coding
- Implant cost reporting
- Modifier application (59, 51, RT/LT)
- Coding audits and compliance reviews
Healthcare Credentialing
Faster payer enrollment means faster payments. We manage your credentials from start to finish.
- Insurance enrollment and re-credentialing
- CAQH profile management
- Medicare and Medicaid enrollment
- Payer contracting and fee schedule review
- Ongoing status tracking and follow-up
Virtual Medical Assistant
Dedicated remote assistants free your front desk so your team can focus on patient care.
- Prior authorizations and referrals
- Appointment scheduling and reminders
- Insurance eligibility verification
- Patient follow-up calls
- EHR data entry and documentation
Accounts Receivable Management
Aggressive yet professional AR management to recover outstanding balances faster.
- Aging AR review and prioritization
- Payer follow-up and escalation
- Patient balance collections
- Write-off and adjustment analysis
- Monthly AR performance reports
Revenue Cycle Audit
Identify revenue leakage and compliance risks before they cost your practice more.
- Billing workflow assessment
- Coding accuracy audit
- Denial pattern analysis
- Payer contract review
- Custom improvement roadmap
Orthopedic Billing Challenges We Solve Every Day
We have seen it all and built proven workflows to fix it all.
High Claim Denial Rates
Medical necessity denials, authorization failures, and code errors. Our proactive review process prevents them before submission.
Slow Reimbursements
Long AR days drain cash flow. We submit clean claims within 48 hours and follow up aggressively until payment is received.
Complex Modifier Rules
Incorrect modifiers on orthopedic claims trigger automatic denials. Our coders apply the right modifiers every time.
Prior Auth Burdens
Orthopedic procedures require constant pre-authorizations. Our VAs manage the entire prior auth workflow end-to-end.
Implant Billing Errors
Improper implant invoicing and undocumented costs lead to lost revenue. We capture and bill every device correctly.
Undercoded Procedures
Undercoding costs practices thousands annually. Our certified coders ensure every service is captured at the highest appropriate level.
Credentialing Gaps
Expired credentials delay payer payments. We proactively manage re-credentialing timelines so you are never out of network.
Global Period Compliance
Post-operative billing within global periods triggers payer audits. Our billing team tracks and manages global periods meticulously.
Get Started in 5 Simple Steps
Onboarding with ClainetRCM is fast, seamless, and requires minimal effort from your team.
Free Consultation
We analyze your billing setup and identify revenue gaps at no cost.
Custom Onboarding
We integrate with your EHR and PM system and configure our workflows.
Team Assignment
A dedicated orthopedic billing team is assigned immediately.
Claims Submission
Clean claims submitted within 48 hours with real-time tracking.
Revenue Growth
Watch collections rise with monthly performance reports.
What We Commit To on Every Orthopedic Claim
These are the standards we control and hold ourselves to, written into every engagement.
From charge capture to claim submission, on every working day
Business days to onboard your orthopedic practice end to end
Between full accounts receivable reviews, every single cycle
Starting rate on monthly collections. No setup fee, no contract
Orthopedic Billing for Every Practice Size
Whether you are a solo orthopedic surgeon or a multi-location hospital system, ClainetRCM scales with your needs.
Solo Orthopedic Providers
Independent orthopedic surgeons and specialists who need professional billing support without in-house staff overhead.
Orthopedic Clinics and Groups
Multi-provider orthopedic practices and specialty clinics seeking to optimize RCM performance across all providers and locations.
Hospitals and Health Systems
Hospital-based orthopedic departments and large health systems requiring enterprise-level RCM solutions with detailed reporting.
Frequently Asked Questions
Onboarding takes 7 to 14 business days. We sign a BAA, integrate with your existing EHR and PM system, configure billing workflows, and assign your dedicated team with minimal disruption to daily operations.
ClainetRCM works with all major EHR and PM systems including Epic, Athenahealth, Kareo, eClinicalWorks, Modernizing Medicine, DrChrono, AdvancedMD, and more. We adapt to your existing technology stack.
Yes. We provide comprehensive billing services for Ambulatory Surgery Centers specializing in orthopedics, including facility fee billing, implant cost reporting, anesthesia billing coordination, and payer-specific ASC rate management.
Our dedicated Virtual Assistants manage the entire prior authorization process from submission through approval. We track timelines, follow up with payers, and ensure no procedure proceeds without proper authorization.
ClainetRCM pricing starts at 2.29% of monthly collections, so we only get paid when you get paid. There are no setup fees, no long-term contracts, and no hidden costs. Schedule a free consultation to receive a custom quote for your orthopedic practice.
ClainetRCM is fully HIPAA-compliant. All data is encrypted in transit and at rest, access is role-based and logged, and we conduct regular security audits. Your patients PHI is always protected according to federal regulations.
Ready to Boost Your Orthopedic Revenue?
Talk to an orthopedic billing specialist about your denial rate, your AR aging, and the codes you are leaving on the table.
Request Your Free Audit TodayLet's Grow Your Orthopedic Practice
No obligation. Our specialists will review your current billing setup and identify revenue opportunities.
Why Consult With ClainetRCM?
In a single free session, our orthopedic billing experts will uncover hidden revenue gaps and give you a clear roadmap to increase collections.
Free Revenue Audit
We review your billing performance and identify gaps at zero cost to you.
Dedicated Orthopedic Expert
You will speak directly with a specialist who understands orthopedic RCM deeply.
100% Confidential
All information shared is protected by HIPAA and never shared with third parties.
Fast Onboarding
Practices go live within 7 to 14 business days of signing on.
No Long-Term Contracts
Pricing starts at 2.29% of collections. No setup fee, no lock-in.