From surgical global periods and implant/DME billing to modifier accuracy and denial management — SCALE delivers revenue cycle intelligence purpose-built for orthopedic groups, ASCs, and MSOs.
Staged procedures and modifiers 58/78/79
Implant logs, invoices & payer carve-outs
In-office DME dispensing, KX & RT/LT modifiers
Joint replacement, spine & advanced imaging
Live dashboards via SCALE's analytics platform
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High-complexity care comes with high-complexity billing — and most generalist RCM vendors aren’t equipped to handle it. SCALE is.
Orthopedic surgery relies on global-period and staged-procedure modifiers (58/78/79) that drive denials when misapplied.
Implant invoices, hardware carve-outs, and in-office DME dispensing are frequently under-captured.
Joint replacement, spine procedures, and advanced imaging carry intensive prior-auth requirements that stall revenue.
Core Service
We manage joint, spine, and advanced-imaging authorizations end to end — including peer-to-peer review.
AI-Powered
Automated review flags global-period, modifier, and implant under-capture across surgical claims.
Denial Recovery
Payer-specific appeal templates for global-period, modifier, and medical-necessity denials.
Specialty Coding
Accurate implant, hardware, and in-office DME capture with KX/RT/LT modifiers.
Automation handles volume and velocity. Our experts handle exceptions, edge cases, and strategic optimization — creating a closed-loop system that continuously improves performance over time.
We analyze 90 days of claims data to identify coding gaps, denial patterns, and authorization bottlenecks specific to your practice.
Seamless connection to your EHR and practice-management system — no new software for your team to learn or manage.
SCALE’s dedicated team takes over day-to-day RCM operations with transparent reporting from day one.
Monthly performance reviews, payer-policy monitoring, and AI-driven recommendations keep revenue growing over time.
Representative results across SCALE Healthcare clients. Individual outcomes vary by organization size, payer mix, and baseline RCM maturity
Reduction in average days to pay across SCALE-managed client portfolios
Reduction in cost-to-collect through AI automation and workflow optimization
Reduction in A/R aging beyond 90 days through proactive denial management
Reduction in overall denial rates powered by DenialShield predictive scoring
Book a free 30-minute strategy call with a SCALE Orthopedic specialist. We’ll review your current denial rates, authorization backlog, and coding performance — at no cost.
