Orthopedics
Key pain points
- Workers' comp and auto claims
- Surgical prior authorizations
- Multi-procedure bundling
- Global surgical periods
Top denials resolved
- Medical necessity
- Prior authorization
- Modifier & bundling edits
Built for Orthopedics
We know the payors, denial patterns, and collections complexity that define your specialty.
Meridian HealthCedar GroveNorthwindSummit CareVantageBrightwellHarbor Health
Meridian HealthCedar GroveNorthwindSummit CareVantageBrightwellHarbor HealthMeridian HealthCedar GroveNorthwindSummit CareVantageBrightwellHarbor Health
Explore specialties
Denial patterns differ by specialty. See how Avicena Care handles the insurance recovery challenges your RCM team faces every day.
DME & HME
Key pain points
- CMN documentation and renewals
- Rental vs. purchase logic
- HCPCS coding specificity
- Payor coverage policies
Top denials resolved
- Expired or missing CMN
- Medical necessity
- Prior authorization
Cardiology
Key pain points
- High-cost device and procedure claims
- Prior auth for imaging and cath
- Bundled diagnostic codes
- Frequent policy changes
Top denials resolved
- Medical necessity
- Prior authorization
- Non-covered diagnostics
Behavioral Health
Key pain points
- Session limits and authorizations
- Parity and coverage disputes
- Telehealth billing rules
- Frequent eligibility changes
Top denials resolved
- Authorization limits
- Non-covered services
- Eligibility lapses
Ophthalmology
Key pain points
- Medical vs. vision plan routing
- Bilateral and staged procedures
- Premium lens and elective billing
- Testing frequency limits
Top denials resolved
- Frequency limits
- Medical necessity
- Coordination of benefits
Anesthesiology
Key pain points
- Time-unit and modifier accuracy
- Concurrent and directed cases
- Out-of-network disputes
- Surprise-billing compliance
Top denials resolved
- Time / unit discrepancies
- Medical direction rules
- Out-of-network reductions
Dermatology
Key pain points
- Cosmetic vs. medical determinations
- Pathology and biopsy bundling
- Mohs surgery documentation
- High claim volume
Top denials resolved
- Cosmetic exclusions
- Bundling edits
- Medical necessity
Urology
Key pain points
- In-office procedure billing
- Device and implant reimbursement
- Prior auth for imaging
- Multi-visit episode tracking
Top denials resolved
- Prior authorization
- Bundling edits
- Medical necessity
Dental
Key pain points
- Medical-dental crossover claims
- Pre-authorization requirements
- Frequency and age limits
- Attachment documentation
Top denials resolved
- Missing attachments
- Frequency limits
- Non-covered procedures
Oncology
Key pain points
- High-cost drug and infusion claims
- Prior auth for regimens
- NDC and units accuracy
- Payor pathway compliance
Top denials resolved
- Prior authorization
- NDC / unit errors
- Non-covered drugs