Specialized Orthopedic Billing Services for New York Practices
With our orthopedic billing team in New York, your practice can:
- Handle NY Workers’ Compensation billing rules, including medical necessity documentation
- Manage prior authorizations for orthopedic procedures like MRIs and spinal surgeries
- Optimize billing for frequent orthopedic CPT codes, including 29881 (knee meniscectomy)
- Support DMEPOS billing for braces, splints, walkers, and orthopedic supports
- Submit accurate SPARCS data to avoid penalties from NY Medicare and Medicaid
- Benefit from AI RCM agents for orthopedic coding accuracy and real-time denial prediction
What Orthopedic Billing Challenges Do Practices Usually Face in New York?
Orthopedic practices in NY face medical billing challenges, including:
- Strict Workers’ Compensation Rules: Orthopedic billing for NY Medicaid and Workers’ Comp must follow exact fee schedules, MTG, and eMedNY formatting requirements to avoid denials.
- Frequent Payer Audits for Costly Procedures: Due to expensive surgeries like spinal fusions and fracture repair, NY orthopedic groups are regularly targeted for medical necessity audits.
- OON and Surprise-Billing Compliance: New York’s strict OON and Surprise Bill laws require orthopedic practices to follow proper disclosure and IDR processes for non-contracted services.
- DME and Implant Billing Challenges: Orthopedic practices must manage detailed coding and billing for implants and surgical hardware to avoid errors in HCPCS coding or units.
How Transcure Supports Practices With Their New York Orthopedic Billing Services?
Transcure delivers orthopedic billing services in New York to help practices stay compliant with state-specific regulations. Our NY orthopedic RCM solutions include
Real-Time Insurance Verification
With our ELIXA AI agent, we instantly check patient eligibility for orthopedic surgeries and arthroscopy procedures. Our orthopedic billing company uses AI to prevent coverage denials.
Faster Prior Authorization Approvals
Our PRIA AI agent accelerates approvals for orthopedic services, including spine surgery, total joint replacement, fracture repair, and advanced imaging, for uninterrupted patient care.
Compliance with NY Billing Requirements
All of our NY orthopedic billing services providers follow NY Medicaid rules, surprise-billing regulations, and eMedNY formatting standards to maintain full compliance.
DME and Implant Billing Support
We assist with accurate HCPCS coding, unit calculation, and documentation for DME items, surgical implants, and orthopedic hardware to minimize revenue leakage.
Orthopedic-Specific Coding Accuracy
Using CODIN AI and certified orthopedic coders, we accurately assign CPT, ICD-10, and HCPCS codes for procedures like 29881 (arthroscopy) and 27130 (hip replacement).
Denial Prevention and Smart Appeals
Transcure’s DEXA AI agent monitors denial patterns for orthopedic claims, such as bundling and medical necessity rejections, and automatically drafts appeals for faster recovery.
Our Success in Numbers
In Which New York Cities Does Transcure Offer Orthopedic Billing Services?
New York City
Buffalo
Rochester
View All Cities
Yonkers
Syracuse
Albany
New Rochelle
Mount Vernon
Schenectady
What Are the Potential Savings for Practices by Outsourcing NY Orthopedic Billing Services?
Glassdoor reports that a Medical Billing Specialist in New York earns an average of $62,000 per year. By choosing Transcure to handle your orthopedic billing, your practice pays only 5% of the revenue collected, eliminating the need for full-time salaries. For instance,
- For an orthopedic practice generating $500,000 annually, outsourcing billing would cost just around $25000.
- As a result, your practice could save around $37,000 per year, which can be reinvested into expanding services or upgrading equipment.
Which New York Counties Will Benefit from Transcure’s Orthopedic Billing Services?
Kings County (Brooklyn)
Queens County
New York County (Manhattan)
Suffolk County
Bronx County
Nassau County
Westchester County
Erie County
Monroe County
Which Procedures Does Transcure Handle with Their NY Orthopedic Billing Services?
Transcure provides specialized orthopedic billing support for high-volume procedures, including but not limited to:
Joint Replacement Billing
Our orthopedic billing company in New York handles billing for total hip, knee, and shoulder replacements. We perform accurate CPT/ICD-10 coding, correct modifier application, implant reporting, and documentation required for NY payers.
Orthopedic Trauma Billing
With our NY orthopedic billing team, Transcure manages internal fixation, external fixation, and open reduction procedures. We document all device usage, surgical approach, and NY-specific medical necessity requirements to maximize collections.
Spine Surgery Billing
We manage billing for laminectomy, discectomy, spinal fusion, and minimally invasive spine procedures. Our orthopedic coders and billers in New York handle CPT, ICD-10, and HCPCS coding in accordance with NY payer rules.
Pain Management Billing
Transcure handles epidural steroid injections, facet joint injections, nerve blocks, and spinal cord stimulator procedures. Our New York orthopedic billing services use correct modifiers and documentation for NY Medicaid and commercial claims.
Hand and Foot Surgery Billing
We provide billing support for high-volume procedures, including tendon repairs, fracture fixation, and reconstructive hand and foot surgeries. While doing so, our orthopedic billing team ensures full compliance with NY payer guidelines.
Sports Medicine Procedure Billing
Transcure supports billing for common sports medicine procedures, including ligament repair, tendon transfers, and platelet-rich plasma injections. Our orthopedic billing company in New York performs precise documentation and coding.
Why Outsource New York Orthopedic Billing Services to Transcure?
With so many orthopedic billing companies in New York, practices still choose Transcure for specialized expertise and state-based compliance support:
Dedicated NY Orthopedic Billing Manager
Your practice is assigned a billing manager experienced in NY Medicaid rules, no-fault claims, and orthopedic-specific documentation requirements.
Orthopedic-Focused Coding Accuracy
Our certified orthopedic coders handle CPT, HCPCS, and modifier selection for joint injections, fracture care, arthroscopy, and orthopedic surgeries..
SPARCS Reporting for Orthopedic Procedures
We manage SPARCS submissions for surgical, post-operative, imaging, and procedural visits to ensure error-free state reporting.
Transparent Performance Reporting
Orthopedic practices receive monthly reports, including AR aging and payer performance metrics, along with procedure-level revenue insights.
Simplify Your Orthopedic Billing Tasks with Transcure’s AI RCM Agents
Tired of revenue leakage due to your in-house orthopedic billing team? Transform your New York orthopedic practice with Transcure’s AI-powered billing services. Our intelligent automation handles your entire RCM.
- ELIXA instantly checks patient coverage
- PRIA speeds up prior authorizations
- CODIN ensures accurate CPT and ICD-10 coding
- CLAIR intelligently builds and scrubs claims to reduce errors
- DEXA identifies denials and helps recover lost revenue.
With Transcure handling these critical steps, your team can focus on patient care instead of paperwork.
What EHR Systems Do Transcure’s Orthopedic Billing Specialists in New York Use?
We understand that switching EHR systems is stressful. That’s why our NY orthopedic billing company operates within your preferred EHR platform with precision.
Why Do New York Orthopedic Practices Trust Transcure for Their Billing Needs?
Explore real experiences from practices that turned complex billing challenges into consistent revenue gains with our support.
Jackie Judd
Practice Manager
Wilson Creek Internal Medicine
As a practice manager, I was looking to streamline the medical billing process. I tried other companies, but they were all complicated and took too much of my time. Fortunately, I found Transcure. They excel in tailoring solutions to fit my requirements.
Amber Vaughan
Office Manager
Idaho Kidney & Hypertension Institute
We are a large practice with 15 providers. Transcure has been working with us for the last 5 years. This billing company has been a great asset to us. I work with Transcure and they provide everything I ask for. The team is friendly and very pleasant to work with.
Ashlee Rose
Practice Manager
Harding Memorial Healthcare
We’ve been working with Transcure for 8 years now and I just wanted to say how happy we are with their services. They always get back to us quickly and are very easy to work with. They get my bills paid in record time and help us to generate millions in revenue.
Frequently Asked Questions (FAQs)
Which company is best for orthopedic billing services in New York?
Transcure stands out as the leading medical billing company in New York. With more than 12 years of expertise, the company has processed over $500 million in claims and totaled 2.7 million individual encounters.
What experience does Transcure have with orthopedic billing?
We bring specialized experience in orthopedic medical billing in New York. Our team has managed a wide range of orthopedic cases, including joint replacements, spine procedures, and postoperative rehab services. On top of that, we consistently stay aligned with the latest orthopedic coding updates and payer guidelines.
How do NY State laws protect patients from surprise medical bills?
New York offers strong protection to prevent unexpected medical charges. If you receive care from an out-of-network provider at an in-network facility (or the opposite), the state ensures you are protected from extra costs.
What are the most commonly used CPT codes in orthopedic billing?
Here are some of the most commonly used CPT codes in orthopedic billing.
25605 – Closed treatment of distal radius fracture
26600 – Closed treatment of metacarpal fracture
27786 – Closed treatment of ankle fracture
20610 – Major joint injection (shoulder, hip, knee)
20605 – Intermediate joint or bursa injection