We are Orthopedic and Spine billing specialists...
Orthopedic and spine care professionals have unique coding and billing concerns. Reimbursement and coding is the number one concern of orthopedic and spine care professionals. Correct coding and billing, with submission of “clean claims” is the key to ensuring proper reimbursement. At A&E Billing Solutions, we have experience in handling the nuances of coding and billing in the orthopedic and spine specialty arenas. We know how to submit that “clean claim.” We are well versed in billing for co-surgery spine cases. We are familiar with payor specific reimbursement guidelines and we keep up to date on current coding and billing news specific to orthopedic and spine specialists, including billing for cutting-edge surgical techniques. Our surgery appeals are aggressive and effective in obtaining additional reimbursement that many surgeons lose.
Did you know?
Of the estimated 30% of all claims which are rejected, approximately 15% are never resubmitted. With over 15 billion claims being filed by providers (at approximately $100 per claim), a staggering $67.5 billion in revenue is lost each year.
Approximately 40% of all spine surgery claims are processed incorrectly by third-party payors.
The most common reasons for claim denials include:
- Patient registration errors
- Incorrect insurance information
- Lack of documentation to support the reported services
- Invalid diagnosis or procedure codes, including modifier misuse
- Medical necessity
About 15% of all claim denials are due to modifier misuse.