Our orthopedic billing services in Maryland come from Medical Claim Management LLC, a remote orthopedic medical billing company based in Owings Mills. We help orthopedic surgeons, sports medicine physicians, hand and spine specialists, and foot and ankle practices get paid correctly for the work they already do — without adding staff to the front office. Maximizing Claims, Minimizing Complexity.
Orthopedic billing is one of the most detail-heavy specialties in medicine. A single surgery can involve multiple procedures, laterality, a global period, implants or DME, and a payer that is not a health plan at all. When any piece is missing, the claim stalls. Our job is to keep every piece in place.
Book your free orthopedic billing audit
Why Orthopedic Claims Get Denied
Orthopedic practices lose revenue in predictable places. These are the areas we focus on first:
- Modifiers 25, 59, LT and RT. An E/M visit on the same day as an injection or procedure needs modifier 25 with documentation that supports a separately identifiable service. Distinct procedures may need modifier 59 (or the more specific X modifiers). Missing or wrong laterality (LT/RT) on bilateral or single-side procedures is one of the most common avoidable denials.
- Global surgical periods. Post-op visits inside a 10- or 90-day global period are generally not separately payable — but unrelated problems, complications and staged procedures can be, with the right modifier (24, 58, 78, 79). We track global periods so billable visits are not left unbilled and non-billable ones are not sent as errors.
- DME and supplies. Braces, splints, walking boots and other durable medical equipment need the correct HCPCS codes, modifiers and documentation, and many payers have their own supplier rules.
- Prior authorizations. MRI, injections, arthroscopy and joint replacement frequently require authorization. Missing or expired auths lead to denials that are hard to overturn.
- Workers’ compensation claims. Work injuries require the right employer, carrier and claim number, state-specific forms and fee schedules, and follow-up with adjusters rather than a health plan.
- Auto accident and PIP claims. Motor vehicle injuries involve personal injury protection (PIP) and auto carriers, coordination with health insurance, and sometimes attorney liens. These claims need a different workflow than standard commercial billing.
Our Orthopedic Billing Services in Maryland
We handle the full revenue cycle or just the parts you need:
- Charge entry and coding review for office visits, injections, fracture care, arthroscopy, joint and spine procedures, with modifier and laterality checks before claims go out.
- Claim submission and scrubbing for Medicare, Maryland Medicaid managed care plans, and commercial payers.
- Prior authorization support — tracking which services need auths and confirming they are on file before the date of service.
- Workers’ comp and auto/PIP billing, including carrier follow-up and documentation requests.
- Denial management and appeals, with root-cause tracking so the same denial does not keep coming back.
- A/R follow-up on aging claims, underpayments and unapplied payments.
- Payment posting and reporting so you can see what was billed, paid, denied and still open.
- Credentialing and payer enrollment for new providers joining your practice.
Why Maryland Orthopedic Practices Choose Us
- Specialty-aware billing. We understand how orthopedic care is coded and documented — multiple procedures, laterality, global periods, DME and non-health-plan payers.
- Local knowledge. We are based in Owings Mills, MD and work with Maryland payers and Maryland practices.
- Remote and flexible. We work inside your existing practice management or EHR system, so there is no software change for your team.
- Clear communication. You get a direct contact and regular reporting, not a ticket queue.
- HIPAA-conscious processes. Patient data is handled with secure access and least-privilege practices.
- No-pressure start. We begin with a free audit so you can see exactly where revenue is slipping before you commit to anything.
Frequently Asked Questions
Do you bill for orthopedic surgery and sports medicine practices in Maryland?
Yes. We provide orthopedic billing services for Maryland orthopedic surgery, sports medicine, hand, spine and foot and ankle practices, working remotely from our Owings Mills office.
Can you handle workers’ compensation and auto/PIP claims?
Yes. We bill workers’ comp and auto accident (PIP) claims, including carrier and adjuster follow-up, alongside your Medicare, Medicaid and commercial claims.
How do you reduce modifier and global period denials?
We review modifiers 25, 59, LT/RT and the global-period modifiers before claims are submitted, and we track each patient’s global period so related post-op visits are not billed in error and unrelated, billable visits are not missed.
Do you help with prior authorizations and DME billing?
Yes. We help track authorization requirements for imaging, injections and surgery, and we bill braces, splints and other DME with the correct HCPCS codes and modifiers.
What does the free billing audit include?
We review a sample of your recent claims, denials and open A/R to identify coding, modifier and follow-up issues, then walk you through what we found on a 30-minute call. There is no cost and no obligation.
Get a Free Orthopedic Billing Audit
Find out where your practice is leaving money on the table. Book a free 30-minute audit call with Medical Claim Management LLC.
Prefer to call? Phone (336) 791-4110 · Fax (336) 347-3950