Orthopedic Medical Billing Company in New Mexico | EZE Medical Billing
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Orthopedic Medical Billing Company : Billing That Keeps Pace With Your Practice
Orthopedic practices deal with some of the most procedure-heavy documentation-intensive billing in all of healthcare. Between surgical modifiers implant coding, pre-authorization headaches and workers compensation cases orthopedic billing can go wrong in a dozen ways before a claim even reaches the payer.
EZE Medical Billing Services is an orthopedic medical billing company built to handle exactly that complexity. We work with orthopedic surgeons sports medicine physicians and musculoskeletal specialists across New Mexico we taking the billing burden off your team so you can focus on patients not on paperwork.
If you are dealing with high denial rates and slow reimbursements or a billing team that struggles to keep up with orthopedic coding changes so we should talk.
Why Orthopedic Billing Is Harder Than Most Specialties
A lot of billing companies say they handle orthopedics. What that usually means is they handle general surgery billing and assume orthopedics is close enough. It isn’t. Here’s what makes orthopedic billing genuinely difficult:
Complex Surgical Modifiers
Orthopedic surgery claims routinely require modifiers bilateral procedures (Modifier 50), multiple procedures on the same day (Modifier 51), assistant surgeon billing (Modifier 80/82), staged procedures (Modifier 58) more.
Implant and Hardware Billing
When a patient gets a knee replacement, hip replacement or spinal fusion with hardware the implant has to be billed separately from the surgical procedure. Each payer handles implant reimbursement differently some pay invoice cost some pay a flat rate some require itemized documentation.
Pre-Authorization on Almost Everything
Elective orthopedic procedures : joint replacements, arthroscopic surgeries, spine procedures almost always require pre-authorization.
Workers’ Compensation and Auto Injury Cases
Orthopedic practices treat a significant volume of workers’ comp and auto injury patients. These cases don’t go through standard health insurance they go through state workers’ comp programs and auto liability carriers, each with their own fee schedules or forms, reporting requirements.
Global Surgery Periods
When an orthopedic surgeon performs a procedure Medicare and most private payers apply a global surgery period it is typically 90 days for major procedures. During this window routine follow-up visits are bundled into the surgical fee and cannot be billed separately.
Our Orthopedic Billing Services
Insurance Eligibility and Benefits Verification
Before every scheduled procedure or appointment, we verify the patient's insurance coverage including active enrollment, deductibles, co-insurance, out-of-pocket limits and whether pre-authorization is required for the planned procedure.
Orthopedic CPT Coding
Accurate orthopedic coding is the foundation of a clean claim. Our coders are trained in the full range of orthopedic CPT codes from E&M office visits to complex spinal surgery we including proper use of surgical modifiers add-on codes and bilateral procedure coding rules.
Pre-Authorization Management
We handle pre-authorization requests for all scheduled procedures submitting the request with proper clinical documentation, tracking approval status, following up with payers when responses are delayed and flagging any cases where authorization may expire before the procedure is completed.
Accounts Receivable Cleanup
If your practice has an aging AR backlog claims that have been sitting unpaid at 60, 90, or 120+ days we take that on as part of onboarding. We work systematically through outstanding claims, resubmit corrected claims, and file appeals for anything recoverable.
Implant and Hardware Billing
We document and bill implants correctly whether that means invoice-based billing, percentage-of-cost reimbursement. We work with your supply team to capture the right implant codes (HCPCS Level II where applicable) and supporting documentation so this revenue is not missed.
Claims Submission and Real-Time Tracking
All claims are submitted electronically within 48 hours of receiving complete encounter and documentation. Every claim is tracked through the payer's system we identify stalled claims follow up on aging receivables and never let a claim fall through the cracks at 30, 60, or 90 days.
Workers' Compensation and Auto Injury Billing
We handle clear, easy-to-understand patient statements and can assist with payment plan setup. This reduces patient confusion, improves collections, and keeps your accounts receivable low.
Monthly Performance Reporting
Every month you receive a clear report covering collections by payer, clean claim rate, denial rate by reason code, AR aging breakdown and month-over-month trends. If something is going wrong in your revenue cycle, you'll see it before it becomes a serious problem.
CPT Codes We Handle : Orthopedic Procedures
Types of Orthopedic Practices We Work With
We work with a wide range of orthopedic providers across New Mexico, including practices of all sizes and subspecialties:
- General orthopedic surgery practices
- Sports medicine and athletic injury clinics
- Spine and neurosurgery centers
- Joint replacement and arthroplasty programs
- Hand and upper extremity surgery practices
- Foot and ankle surgery practices
- Pediatric orthopedic specialists
- Trauma surgery centers
- Orthopedic urgent care and fracture clinics
- Multi-physician orthopedic group practices
- Hospital-based orthopedic departments
We serve orthopedic providers in Albuquerque, Santa Fe, Rio Rancho, Las Cruces, Roswell, Farmington and surrounding areas throughout New Mexico.
Common Orthopedic Billing Errors We Catch
Orthopedic practices often lose revenue due to small billing mistakes. Our team identifies and fixes these issues before they lead to claim denials or underpayments. Common errors include incorrect billing for bilateral procedures, missing pre-authorization for surgeries, and not using required modifiers during global surgery periods. We also catch missed add-on codes, incorrect place-of-service codes, unbilled implant hardware, and assistant surgeon fees. Additionally, we prevent claim rejections caused by workers’ compensation mix-ups, missed filing deadlines, and incorrect E&M coding—helping practices protect revenue and stay compliant.
What We Deliver for Orthopedic Practices
Clean Claim Rate
Client Saticifaction
Denial Recovery Rate
Why Orthopedic Practices in New Mexico Choose EZE
Workers’ Comp Is Part of Our Process
New Mexico has a significant volume of workers’ comp orthopedic cases. We handle NMSIF private workers‘ comp carriers and auto injury billing as standard.
Pre-Auth Never Falls Through the Cracks
We track every scheduled procedure against its authorization status. If an auth is expiring we inform before the case gets booked, not after the claim gets rejected.
HIPAA Compliant From Day One
All data handling is fully HIPAA compliant. We sign a Business Associate Agreement (BAA) with every client. Patient records are encrypted in transit and at rest.
Real Reporting Not Just Summaries
Monthly reports break down performance by payer procedure type, denial reason and AR aging. You get actual data to manage your practice’s financial health.
No Long-Term Contracts
We do not lock clients into multi year agreements. We earn the relationship month by month. If you’re not satisfied you are free to leave
Frequently Asked Questions
Do you handle both in-office and surgical orthopedic billing?
Can you manage workers' compensation orthopedic billing in New Mexico?
How do you handle implant and hardware billing?
What happens when a pre-authorization gets denied?
What EHR systems do you work with for orthopedic practices?
How much does orthopedic billing outsourcing cost?
Can you help if we have a large backlog of unpaid claims?
Talk to an Orthopedic Billing Specialist Today
Orthopedic billing is too complex and too high value to leave to a general billing team. Whether you’re losing revenue to denied surgical claims, struggling with workers’ comp billing or simply want a billing partner who actually knows orthopedic coding EZE Medical Billing Services is ready to help.
Call Us:
+1 505-903-2759
E-mail Us:
info@ezemedbills.com
Visit Us:
11100, Apache Avenue NE, Albuquerque, NM, 87112, USA