Orthopedic-Specific Coding
Modifiers, laterality, global periods, multi-procedure surgical cases. Coded by specialists who live in orthopedic CPT codes every day.
About Cosentus
Cosentus is a healthcare revenue cycle management company combining specialty-trained experts with AI-native technology. With 25+ years of experience, we manage the full revenue cycle for orthopedic practices in San Diego and across California. From coding to collections, every step is connected through Zeus AI, which runs 23 modules, and managed by people who stay in orthopedics.
98%
Net Collection Rate
48hrs
Charge Lag
99%
Clean Claim Rate
<15%
AR Over 90 Days
Local Expertise
San Diego’s active lifestyle and large military population create strong demand for orthopedic services. Scripps Health, Sharp HealthCare, and UC San Diego Health anchor a market where sports medicine, joint replacement, and spine surgery volumes are consistently high. The region’s significant TRICARE population adds a payer type that requires specific billing knowledge many orthopedic billing companies lack.
Cosentus provides full-cycle orthopedic billing and revenue cycle management built for the San Diego market. Our team manages TRICARE, commercial, Medicare, Medi-Cal, and workers compensation billing with equal precision. Every surgical case is coded by orthopedic specialists who understand modifier requirements, implant documentation, and global period rules across every payer in the region.
What We Manage for Orthopedics Practices in San Diego
- Orthopedic-specific coding: surgical modifiers, implants, global periods
- Workers compensation billing and follow-up
- Eligibility verification and prior authorization
- Claim scrubbing and same-day submission to 1,400+ payers
- Denial management with root cause review
- Appeals with clinical evidence and payer escalation
- AR follow-up and aging management
- Live analytics by provider, procedure, payer, and facility
Complete Orthopedic Revenue Cycle
Implant & Supply Billing
Accurate documentation, pass-through billing, and cost reconciliation for implants, hardware, and surgical supplies.
Workers’ Comp & Personal Injury
Different payer rules, different timelines, different documentation. Our team manages WC and PI cases separately with specialty knowledge.
Prior Authorization
Authorizations for scheduled surgeries, MRIs, and procedures tracked and cleared before the date of service.
Denial Management & Appeals
Ortho denials are high-dollar. We appeal with clinical evidence, operative notes, and strategies built for each payer. Root cause analysis on every one.
AR Follow-Up & Collections
Chris calls payers for claim status, surgical case follow-ups, and escalations. Your staff stays focused on patients, not phone queues.
Ai AGENT: CHRISPatient Billing & Support
Cindy handles patient balances, co-pay follow-ups, and payment plans in over 50 languages. Clear statements, not confusing bills.
Ai AGENT: CINDYAnalytics & Visibility
See collections by surgeon, procedure type, payer, and denial category. Know where your revenue is going as it happens.
Why Local Knowledge Matters
We Know California Payers
San Diego practices work with a unique payer mix that includes TRICARE, commercial carriers, Medicare, Medi-Cal, and workers compensation. Our team understands the surgical authorization requirements, implant billing rules, and documentation standards for each payer type active in San Diego, including TRICARE’s specific orthopedic billing requirements.
Dedicated to Orthopedics
Our orthopedic billing team understands the nuances that define this specialty: surgical modifier stacking, implant pass-through billing, global period tracking, and the documentation required to support high-value surgical claims. Every coder on your account works in orthopedics, not across multiple specialties.
National Reach. Local Focus.
We manage orthopedic revenue cycles nationwide, but your team knows San Diego. They understand the military healthcare network, the local hospital systems, and the active-lifestyle demographics that drive surgical volume in this market.
Frequently Asked Questions
Know Exactly Where Your Revenue Is Going.
Wherever your revenue cycle needs to go, we can help.
- STEP 1
Connect
Tell us about your organization, your specialty and where revenue is getting stuck.
- STEP 2
Diagnose
We run a No-Cost Financial MRI on your revenue cycle and show you exactly what it finds.
- STEP 3
Recover
Together we fix the causes, and the revenue you were missing starts arriving.