Orthopedics

Orthopedic Billing Services & Practice Management

Global Health Management Services provides expert Orthopedic Medical Billing and Practice Management Services to help navigate the new Medicare and Medicaid bundled payment rules and regulations along with establishing the necessary hospital partnerships for maximum allowable reimbursement for your Orthopedic Practice.

In November 2015, CMS Medicare and Medicaid billing and reimbursement requirements for Orthopedic procedures changed dramatically, shifting many Orthopedic practices from a fee-for-service to a new bundled payment model for hip and knee replacement surgery in acute-care hospitals, as well as many other Orthopedic procedures. The CJR model’s goal is to give hospitals a financial incentive to work with physicians, home health agencies, skilled nursing facilities and other providers, promoting coordinated care.

While these new regulations may seem extremely overwhelming for many Orthopedic practices, with a careful planning and practice analysis, it is entirely possible to manage a very successful medical practice under the new bundled payments model.

Orthopedic Practice Analysis

Global Health Management Services provides a complimentary benchmark analysis that demonstrates the performance of your Orthopedic revenue in accordance with national and regional measures. Our courtesy evaluation provides a comprehensive assessment of each element of your Orthopedic revenue cycle which includes the accuracy of your coding, billing and reimbursement practices.

A Global Health Executive Partner oversees the implementation of each client’s distinctive increase revenue plan, helping to maximize potential reimbursement.  Our extensive healthcare experience in analytical problem solving strategies in defined areas of your Orthopedic practice includes managed care payer contracts, specialized Orthopedic billing, coding, claims appeals and AR management. Request an Orthopedic Benchmark Revenue Analysis.

GHMS also provides Orthopedic Practice Consulting services specializing in Orthopedic revenue analysis, billing, coding, AR management, credentialing, claims appeals, payer contracts and payer contract negotiations.

Orthopedic Practice Management

Global Health offers a wide variety of Orthopedic Medical Billing and Practice Management services. To better customize the menu of benefits for your practice, our Orthopedic Medical Practice Management Consultants conduct a complimentary comparison to demonstrate how your business compares with similar providers, practices and medical facilities. The analysis results provide the specifics for coordinating the most efficient and comprehensive strategy for increasing your revenue.

Clients are welcome to choose one or any combination of our Orthopedic Practice Management services.  Our informed recommendation, and the preference of the majority of our Orthopedic clients, supports the bundling of our Orthopedic practice management services to streamline the revenue cycle while reducing expenses.

Orthopedic Practice Management services:

  • AR Management
  • Claims Appeal Services
  • Orthopedic Practice Analytics
  • Medical Billing
  • Orthopedic Coding by Certified Medical Coders
  • Medical Collections Services
  • Orthopedic Provider Credentialing
  • Payer Contracting Services
  • Payer Contract Negotiations

Orthopedic Contract Negotiation

Payer contract negotiations, evaluation and renegotiations is very critical to every Orthopedic practice, yet many practices only set up their managed contracts one time and allow them to automatically renew without any negotiations. Most Orthopedic practitioners lose additional revenue of 10-30 percent because they do not have the time or the required expertise to renegotiate contracts with insurance payers.

Global Health Management Services are experts in managed care contract negotiations. We perform a contract analysis of your Orthopedics managed care negotiation process, evaluating each contract and devising a contract negotiation and renewal strategy for your Orthopedic practice by using leverage points to maximize normal contract terms, resulting in significant revenue increases for our Orthopedics clients.

Orthopedic Billing and Coding

Now more than ever, it has become crucial to have a professional medical billing company specializing in Orthopedic medical billing and coding that can navigate through the complexities of the Orthopedic coding requirements.

GHMS, a national Orthopedic billing company, provides professional certified medical coders and billers who specialize in Orthopedic distinct set of codes and modifiers. Working together, our certified medical coders and Orthopedic specialized billers will identify past billing problems and denied claims, evaluate underpayments, submit claims appeals with correct documentation and bill appropriately with the correct ICD, CPT and Modifier codes to insure maximum reimbursement.

Global Health Management Services’ Orthopedic Billing and Coding specialists provide the knowledge and expertise your practice needs in order to ensure maximum reimbursement.

Orthopedic Billing Services

GHMS’s Orthopedic Medical Billing specialists can manage all aspects of your Orthopedic practice’s billing and revenue cycle and will work in conjunction with your Orthopedic practice to ensure you receive the appropriate reimbursement for services performed. We focus on maximizing every bill to each payer by also ensuring compliancy and sending each bill out in a prompt and timely manner resulting in the fastest revenue response from the payer directly to your Orthopedic practice.

Our Orthopedic Billing Specialists will

  • analyze, recognize and advise you of the advantages of reimbursement fee trending
  • keep current with insurance specifications and regulations and ensure the fees are kept at the maximum allowable reimbursement
  • focus on accurate procedure and diagnosis codes so claims are not suspended or rejected
  • carefully analyze insurance payments and Explanation of Benefits to ensure accurate payment and take appropriate action if necessary
  • process Secondary Insurance claims immediately upon receipt of the primary carrier Explanation Of Benefits

Our team of Orthopedic billing specialists will work closely with your practice and provide the necessary and continuing education on the best documentation and billing practices for procedures performed, including keeping your Orthopedics practice up to date with the latest CMS Medicare, Medicaid billing and documentation requirements, certifications and regulations.

At Global Health Management Services we make sure that you receive the maximum amount covered by the insurance companies while minimizing out of pocket expenses for your patients.

Orthopedic Certified Coding

Global Health Management Services understands the challenges faced by Orthopedic practitioners accustomed to CPT, ICD-9 and ICD-10 coding. Our certified Orthopedic coders remotely and seamlessly integrate with your staff, quickly familiarizing themselves with your practice. Identifying trends, past billing problems and denied claims, we custom design a menu of actions for your business that will result in accelerated revenue cycles and improved compliance. Our accredited coding specialists;

  • Evaluate and Manage Orthopedic Billing and Coding Functionalities
  • Provide Professional Coding Services for Orthopedic practices
  • Capture and Improve Orthopedic Revenue
  • Provide and Establish an Increased Efficiency
  • Reduce Compliance Risk

In order to maximize your revenue, it’s important to have Orthopedic billers and coders who specialize in Orthopedic practices and who understand the requirements needed to successfully bill Medicare, Medicaid and insurance companies for payment in order to receive the maximum allowable reimbursements. At GHMS, we are Orthopedic Billing and Coding experts with proven results for our Orthopedic clients.

Orthopedic AR Management

Global Health Managements Services’ innovative Orthopedic A/R Management coupled with our collection services have been providing Orthopedic practices improved collections over the past two decades. We are able to improve collections within a short period of time.

Our success comes from accurate, timely and professional Orthopedic billing followed by serious A/R follow up and collection activity by dedicated professionals who use technology to process and accomplish the task of collecting more, faster.

  • Each claim is meticulously tracked and followed up by our trained and experienced medical billing staff until the payment is received.
  • We have dedicated Orthopedic A/R managers to follow up with payers and patients.
  • Internal processes are clearly laid out to expedite collections and ensure follow through for each claim.

Global Health Management Services performs complete revenue cycle outsourcing for Orthopedic practices. Our practice management consultants are highly trained and specialized to maximize Orthopedic revenues.

For more information on how Global Health Management Services can increase your Orthopedic Practice revenue, contact our Orthopedic Billing and Practice Management consultants.


“Our orthopedic practice, which is one of the largest practices in the state of New Jersey, hired Global at a critical time with very little advanced notice.  They did a terrific job at turning around our billing operation by maximizing collections. 

Global helped us establish sound billing policies to ensure compliance with our insurance companies and Medicare.”

Board Certified Orthopedic Surgeon / Managing Partner of Ambulatory Surgery Center