Procedure authorizations
Approved services, levels, laterality and date ranges need to be connected to scheduling and claim preparation.
Orthopedic & Pain Management Billing
Procedure-focused billing support for orthopedics and pain management, including authorizations, global periods, modifiers, denials and A/R.
Specialty revenue-cycle support
Build the billing workflow around the care you deliver.
Orthopedic and pain-management revenue cycles involve office visits, imaging, injections, procedures, surgery, durable medical equipment and postoperative care. Each service may carry its own authorization, documentation, modifier and global-period considerations.
CMT supports independent orthopedic groups, pain-management practices, musculoskeletal clinics and procedure-driven specialty practices.
CMT specialty workflow
Orthopedics & Pain Management
- Front-end clarity
- Documented ownership
- Denial prevention
- Visible follow-through
Where revenue can stall
Four pressure points to control.
The goal is to resolve individual accounts while improving the workflow that created the problem.
Global-period context
Related postoperative visits and procedures require review before billing decisions are finalized.
Modifier dependencies
Claim details may need to communicate distinct, staged, bilateral or unrelated services under payer-specific rules.
High-value aging A/R
Complex denials and underpayments require timely documentation, escalation and appeal ownership.
What CMT can support
Defined work queues across the revenue cycle.
CMT can support the complete workflow or a focused part of it. Scope, access, responsibilities and escalation rules are documented before launch.
- Eligibility, authorization and referral-status support
- Procedure and surgery claim-preparation workflows
- Diagnostic, injection and DME billing support
- Global-period and modifier exception routing
- Denial correction, appeal coordination and payer follow-up
- High-value A/R prioritization and reporting
Workflow focus
Controls designed for orthopedics & pain management.
Connect scheduled procedures to the exact approved service and date range.
Route missing operative, imaging or medical-necessity records before deadlines.
Review global-period and modifier context using practice-approved coding procedures.
Prioritize A/R by value, age, filing deadline and recoverability.
Coverage, authorization and reimbursement depend on payer rules, contracts, documentation, coding and the patient’s circumstances. CMT supports the administrative workflow and does not guarantee payer approval or payment.
Frequently asked questions
Questions practices ask before getting started.
We define the exact scope after reviewing your current workflow and systems.
Can CMT support procedure prior authorizations?
Yes. CMT can verify requirements, prepare administrative submissions, track payer requests and document determinations. Clinical decisions and attestations remain with the provider.
Do you review global periods and modifiers?
CMT can apply practice-approved billing rules and identify accounts needing coding or clinical review. Final coding responsibility remains with the practice and qualified professionals.
Can you focus only on old orthopedic A/R?
Yes. A focused recovery project can be scoped by payer, age, balance, denial category or service line without replacing the entire billing operation.
Do you guarantee authorization or reimbursement?
No. Payer decisions depend on coverage, medical necessity, documentation, contracts and policy. CMT supports a disciplined process but does not control the payer's decision.
Start with a focused review
Request a consultation
See where work is slowing down.
Tell us about your specialty, payer mix and current pressure points. We will determine whether a focused queue or broader RCM engagement makes sense.