Orthopedic Surgery Medical Billing & Credentialing Services

Precision-Driven Revenue Cycle Management for Orthopedic Practices

Orthopedic surgery is one of the most complex and documentation-heavy specialties in healthcare, involving a wide array of surgical procedures, diagnostic imaging, therapy coordination, and durable medical equipment (DME) billing. At Oakview Medical Billing Solutions, we provide comprehensive orthopedic billing and credentialing support that simplifies the reimbursement process, accelerates cash flow, and ensures compliance with payer and regulatory guidelines.

Whether you're a solo orthopedic surgeon, a group practice, or a surgical center, our team of certified billers and credentialing experts are equipped to handle the unique financial and operational demands of your specialty.

Why Orthopedic Billing Requires Specialized Expertise

Orthopedic billing is not simply about submitting claims; it’s about mastering coding complexity, modifiers, medical necessity, and payer policies. Without dedicated expertise, practices are at high risk for denials, underpayments, and compliance audits.

Key orthopedic billing challenges we solve include:

• Multiple procedure billing and modifier use (e.g., -59, -RT, -LT, -51)

• Bundling and unbundling issues per NCCI edits

• Delayed DME reimbursement and documentation errors

• Pre-authorization and medical necessity documentation for surgeries

• Workers’ compensation and personal injury billing

• ASC (Ambulatory Surgery Center) billing for orthopedic cases

• High-value procedures subject to medical reviews

Our Orthopedic Surgery Billing Solutions

At Oakview, our billing team is trained specifically in musculoskeletal coding, surgical global periods, implant/DME billing, and payer-specific reimbursement rules. We manage the entire orthopedic revenue cycle — from pre-authorization to appeals — so you can focus on providing care.

Our RCM solutions include:

• Accurate surgical coding based on op reports and imaging

• Thorough charge capture for injections, joint procedures, and supplies

• Expert use of orthopedic modifiers (-58, -78, -79, etc.)

• Fast electronic claim submission with scrubbers

• Dedicated follow-ups on unpaid or underpaid claims

• Appeals for medical necessity and denied surgery claims

• Real-time reporting and analytics dashboards

• Dedicated account manager for transparency and support

Credentialing & Enrollment Services for Orthopedic Surgeons

Getting credentialed with insurance panels is the first step toward practice growth and revenue stability. Oakview streamlines the orthopedic credentialing process by preparing accurate, clean, and complete applications that meet both payer and regulatory requirements.

Credentialing services include:

• Provider and group enrollment with Medicare, Medicaid, and all major commercial payers

• CAQH profile management and attestation

• State medical board license verification

• Facility/ASC credentialing for surgical procedures

• Revalidation and re-credentialing support

• NPI registration and PECOS enrollment

• Workers’ comp and MVA plan credentialing

Commonly Used CPT Codes in Orthopedic Surgery Billing

Note: Proper modifier usage is critical for multiple procedures on the same day (e.g., -51, -59, -RT, -LT, -XU).

Why Orthopedic Practices Trust Oakview

Orthopedic surgery billing is not something you leave to generalists. With Oakview, you're backed by a team that understands procedure complexity, surgical dictations, implant billing, and RBRVS-based reimbursement models. Our goal is simple: help orthopedic surgeons increase revenue, reduce denials, and grow their practice without billing headaches.

With Oakview, you gain:

• 98% claim acceptance rate

• 3–5x faster DME and surgical reimbursements

• Expertise in Medicare, BCBS, Aetna, UHC, and Workers’ Comp

• Transparent reporting and real-time insights

• Full HIPAA-compliant data security and U.S.-based support

Ready to eliminate orthopedic billing errors and get paid faster?

📞 Book your free consultation today with Oakview Medical Billing Solutions — your orthopedic RCM and credentialing partner.