Modifiers decide whether the claim pays
Bilateral procedures, multiple-procedure reductions, assistant surgeons, and staged surgeries all depend on modifiers applied correctly. A missing modifier can reduce payment or trigger a denial that reads like a coding error but is really a claim form issue.
We review surgical claims before submission against the operative note, then track outcomes by surgeon and procedure so patterns are visible.
- Multiple-procedure and bilateral modifier application
- Global-period rules and post-operative visit handling
- Implant and supply billing with invoice support
- Prior authorization for surgical and advanced imaging services
Workers' compensation and personal injury
Orthopedic practices often treat injuries that are not standard commercial claims. Those payers have their own forms, timelines, and reporting expectations.
Keeping them in separate queues protects the commercial A/R from being distorted by balances that are waiting on a settlement or a claims adjuster.