Orthopedic Revenue Cycle Management Services

The seven common revenue cycle steps are patient scheduling and registration, insurance eligibility verification, authorization when required, charge capture and coding, claim submission, payment posting, and denial or accounts receivable follow-up. Each stage affects the next: inaccurate demographic, coverage, authorization, or coding information can delay payment. A strong RCM partner monitors the entire sequence rather than only submitting claims.

Orthopedic revenue cycle management coordinates the financial work required to move a patient encounter from scheduling through final payment. Services commonly include eligibility verification, authorization tracking, charge capture support, CPT, ICD-10, and HCPCS coding review, electronic claims submission, payment posting, denial management, appeals, A/R follow-up, and performance reporting. The objective is cleaner claims, fewer delays, and more predictable collections.

RCM helps reduce denials by identifying preventable issues before and after claim submission. This includes confirming active coverage, reviewing authorization requirements, checking documentation and coding details, applying appropriate modifiers, monitoring payer edits, and analyzing recurring denial reasons. When denials occur, the team corrects claims and pursues appeals where appropriate. Persistex reports a 98% clean claim rate across clients and a 72% appeals success rate.

Yes. Persistex integrates with major EHR and practice management systems, including AdvancedMD, Kareo, athenahealth, DrChrono, and TherapyNotes, among others. During onboarding, the team reviews your current systems and workflow to establish secure access, define handoffs, and preserve continuity for staff. The goal is to make billing support function as an extension of your practice rather than create a separate process.

Practices commonly see measurable improvements within 30 to 60 days of onboarding, depending on claim volume, existing A/R, payer mix, and the complexity of outstanding denials. Early work typically focuses on urgent revenue leakage, denial patterns, and clean-claim processes. Longer-standing A/R balances and appeals may require additional follow-up, but reporting keeps progress visible throughout the engagement.

Persistex offers flexible percentage-based or flat-rate pricing options based on a practice’s size and claim volume. The company does not require long-term contracts and states that there are no hidden fees. This approach lets practices select a structure that fits their operations while aligning billing support with collection performance. A free RCM audit can help identify priorities before selecting a service arrangement.

Persistex operates with HIPAA-compliant processes designed to protect patient and practice information throughout billing, coding, reporting, and communication workflows. Secure handling is embedded into its operations rather than treated as a final compliance step. During onboarding, access and workflow requirements can be reviewed to ensure the engagement supports your practice’s privacy responsibilities and internal procedures.

Submit a request for a free RCM audit, and an RCM specialist will respond within 24 hours during Monday through Friday business hours. The no-obligation review evaluates the current revenue cycle, denial patterns, and revenue leakage opportunities, then provides a custom optimization roadmap. It is available to practices of varying sizes and can also help teams evaluating a transition from another billing provider.