Orthopedic revenue cycles cover a lot of ground.
Office visits, X-rays, joint injections, bracing, surgery, fracture care, and post-op visits can all come out of the same clinic week. Each one has its own coding, modifier, authorization, and payer rules.
VeroRCM provides orthopedic medical billing and revenue cycle management for independent practices that want closer oversight without replacing the EHR their surgeons and staff already use.
A busy orthopedic practice does not send one kind of claim.
A new-patient visit does not bill like a knee injection. A knee injection does not bill like an arthroscopy. And the visit two weeks after that arthroscopy may or may not be separately payable.
Our job is to understand that claim mix and manage the billing around it.
Many orthopedic procedures have global periods that affect how post-op visits and related services are billed. Some follow-up care may be included, while unrelated problems, certain staged procedures, or returns to the OR may be separately payable depending on the circumstances.
We track the global period so separately payable work is billed appropriately and bundled services are not submitted unnecessarily.
Fracture care has its own rules. Whether the fracture was treated with or without manipulation, who provided the initial care, and who is following the patient all affect how the claims should be built.
Modifiers play a major role in orthopedic billing, including laterality, distinct procedures, staged or related returns to the OR, and significant visits performed on the same day as a procedure.
A missing or incorrect modifier can lead to denials, reduced reimbursement, or unnecessary follow-up.
Joint injections, viscosupplementation, and other drug-related services involve both the procedure and the drug, plus units, imaging guidance, documentation, and payer coverage rules.
Small errors in units, documentation, drug billing, or procedure coding can repeat across a large volume of claims.
In-office X-ray and other imaging can involve professional and technical components. The claim needs to reflect what your practice performed and owns.
MRIs, surgeries, and some injections often need payer authorization before the service.
We review whether the authorization matches the service, date, site, and payer before submission when that information is available.
Braces, splints, and other DME come with documentation and supplier requirements of their own.
We review the documentation and supplier requirements that can cause DME claims to delay or deny.
Not every revenue problem starts as an obvious denial.
Orthopedic denials often come from authorization, modifier, bundling, global-period, medical necessity, or documentation issues.
Vero works the denied claim, but we also look for the pattern. If the same denial keeps coming back, fixing each claim is only half the job.
The more important question is whether something upstream can be changed so the same denial does not keep returning.
Surgical claims are too valuable to sit in an aging report.
We prioritize outstanding orthopedic claims on more than age alone. Balance, payer status, denial history, filing deadlines, appeal windows, and the next action needed all matter.
An orthopedic claim can be paid and still be paid wrong.
Multiple-procedure reductions, drug reimbursement, modifiers, and contract terms can make orthopedic payments difficult to evaluate at a glance.
Where enough reimbursement information is available, we look for short-pays and allowed amounts that do not match what was expected.
Monthly collections tell you what was deposited.
They do not necessarily tell you:
Vero is built to give independent practices better visibility into the work that still needs attention.
You do not need to replace your EHR to improve your billing.
Vero works with major EHR and practice-management systems including ModMed, Athenahealth, eClinicalWorks, Tebra/Kareo, AdvancedMD, NextGen, DrChrono, Practice Fusion, and others.
Your surgeons keep their clinical workflows. Your staff keeps the system they already know.
We handle the billing around it.
Using ModMed? See orthopedic billing for ModMed practices.
Yes.
Changing billing companies does not require changing your clinical system. Vero works claims, payments, denials, and A/R inside your existing environment.
Yes. Your surgeons, PAs, and staff can keep using the clinical and front-office system they already know. Vero manages the billing operation around it, including claim review, denials, payments, A/R, and underpayment review.
Depending on the practice, that can include office E/M, in-office imaging, joint injections and drugs, DME and bracing, fracture care, surgical claims, global periods, modifiers, and prior authorizations.
The exact workflow is based on the services your practice actually provides.
Yes. We track each surgical global period so related visits are not billed in error, and unrelated or separately payable work is not missed.
Where enough reimbursement and payment information is available, yes. Multiple-procedure and drug claims are common places for short-pays to hide.
No.
Our Free Revenue Leak Audit reviews your existing claims and payments before you decide anything.
You do not have to replace them just to get another perspective.
Start with your existing data.
Vero's Free Revenue Leak Audit reviews your claims, payments, denials, underpayments, and aging A/R and shows you anything that deserves attention. If things look healthy, that is good to know too.