Is Your Orthopedic Revenue Cycle Built for 2027?

Download the free Orthopedic Revenue Integrity Checklist and find out in 10 minutes.

The Metrics That Will Protect Ortho Revenue in 2027

Q1 2026 is closing. The practices that protect surgical revenue into 2027 will not be the ones doing more procedures. They will be the ones with tighter billing operations.

This checklist covers the 10 revenue cycle KPIs every orthopedic practice should be measuring monthly. First-pass clean claim rate. Denial triggers. Prior authorization predictability. Patient collections. All of it on one page.

Nearly 99%

First-pass clean claim rate

30%

A/R reduction in 90 days*

49 Years

Zero acquisitions. Same ownership.

Laboratory-Billing-Solutions-Reviews

The checklist covers 10 sections:

First-pass clean claim rate: target, audit triggers, and automation checkpoints
Initial denial rate: root cause categorization and weekly review cadence
Days in A/R: aging bucket ownership and surgical claim prioritization
A/R over 90 days: escalation workflow and appeal timeline standards
Prior authorization predictability: electronic PA workflow and site-of-service verification
Surgical readiness gate: the four things that must be confirmed before scheduling
Coding and documentation integrity: 2026 CPT update audit and CDI cadence
Remote monitoring capture: enrollment, time thresholds, and code accuracy
Automation penetration: which workflows should already be automated in 2026
Patient collections: upfront collection targets and financial communication standards

Get the Checklist

The checklist covers 10 sections:

First-pass clean claim rate: target, audit triggers, and automation checkpoints
Initial denial rate: root cause categorization and weekly review cadence
Days in A/R: aging bucket ownership and surgical claim prioritization
A/R over 90 days: escalation workflow and appeal timeline standards
Prior authorization predictability: electronic PA workflow and site-of-service verification
Surgical readiness gate: the four things that must be confirmed before scheduling
Coding and documentation integrity: 2026 CPT update audit and CDI cadence
Remote monitoring capture: enrollment, time thresholds, and code accuracy
Automation penetration: which workflows should already be automated in 2026
Patient collections: upfront collection targets and financial communication standards

"Our A/R dramatically reduced by 30% after the first 90 days. Denials have been reduced by 10% to 15%."

Gladys Serrano, CEO | Hempstead, NY

Talk With an Orthopedic Revenue Specialist

If you would like help interpreting the checklist or prioritizing improvements, schedule time with one of our specialists.