Orthopedic Complex Claims Experts

Increasing Revenue through Analysis and Relentless Problem Solving.

Why Your Current Billing Underperforms

Poor / No Transparency

You’re left in the dark, unable to see what’s being done – or not done – to collect your revenue. The lack of accountability raises questions about whether your billing has the expertise to truly optimize reimbursements.

Lack Technology and Insights

Without advanced workflow systems, reporting tools, and analytics, billing companies can’t identify or address systematic problems, much less track and improve performance.

Missing Key RCM Functions

Critical tasks like credentialing, payer enrollment, following up on missing documentation, and making necessary claim adjustments are often overlooked, leaving money on the table.

Low Hanging Fruit Only

Challenging claims like spine surgeries, out-of-network cases, workers’ compensation, and personal injury require significant effort. Many billing organizations focus only on easy-to-resolve claims, neglecting tougher claims, having lots of writeoffs or ballooning AR, and ignoring root causes that repeat over time, leaving systemic issues unaddressed.

Insufficient Orthopedic Expertise

Most billing companies bill for 3, 5, or even 10 or more specialties and lack a really deep specialized knowledge of orthopedic coding, payer rules, and provider documentation. This leads to inaccuracies, underpayment, and lost revenue opportunities.

SPS - Solving Complex Problems to Get You Paid

SPS demonstrates proven results increasing orthopedic practice collections and profitability.

Deepest knowledge of ortho

  • We only do orthopedic billing and ortho at ASC. No one has more expertise in orthopedic billing.
  • Specializing in complex claims like spine, challenging payer categories like WC and managed care, and out-of-network and NSA.

Technology / Insights

  • Sophisticated workflows and automation ensure no claim is left behind.
  • Analysis pinpoints root causes of denials and underpayments.

Relentless, complex claims

  • Proactive communication with your practice to resolve missing information.
  • Productivity, proactive, problem solving / analysis

Transparency

  • “Won’t tell you we’re doing a great job, we’ll show you”

Insights and Analytics

We won’t tell you we’re doing a great job – we’ll show you.

RCM Performance

You’re left in the dark, unable to see what’s being done – or not done – to collect your revenue. The lack of accountability raises questions about whether your billing has the expertise to truly optimize reimbursements.

Transparency

A comprehensive report tracks each claim’s progress, detailing what has been worked on, who handled it, and when it was completed. It ensures transparency and accountability for all tasks related to the claim. This process helps identify potential delays and improve overall efficiency.

Valuable Analysis

SPS – we slice and dice, do actual analysis…not just claim reporting is “analytics”. Get you answers, in timely manner. Huge flexibility and range of what can get you, even if “reporting” doesn’t do it we’ll pull the data and crunch it with things like pivot tables

Increase Practice Profitability

Consulting using data – help you make data-driven decisions like should you be in network our OoN with a particular payer, fee schedule analysis, contract negotiation support, changing/adding/removing procedures, how to be more profitable, etc.

Services

Fully accountable for all related billing functions to ensure reimbursement is maximized.
  • Including the Most Complex-Spine
  • Coding Feedback
  • Patient Retention
  • Prevention
  • Resolution
  • Data-Driven Consulting
  • Demos, charge entry, payment posting
  • Internal dispute resolution (IDR) process

How SPS Has Helped Other Orthopedic Practices Increase Profitability

Boosting Orthopedic Practice Bottom Lines

SPS is a national orthopedic-only medical billing company specializing in the most challenging aspects of orthopedic billing, including complex coding (e.g., spine), clinical documentation review, provider training, credentialing, and handling difficult payers like workers’ comp, Medicare Advantage, and Medicaid MCOs. We serve clients nationwide.
We combine tireless claims pursuit with data-driven insights and analysis to maximize your revenue, understand payer trends, improve profitability, and negotiate better contracts.

The Leading Orthopedic RCM Executive Team In the US

Kristin Callaway-Kelly
Chief Executive Officer

Kristin is a nationally recognized expert in orthopedic billing and complex claims management for orthopedic practices. With over two decades of leadership in revenue cycle management, she has consistently delivered measurable results in practice profitability and efficiency. Her expertise spans orthopedic practice consulting, ASC operations, advanced analytics, staffing strategies, and training programs designed to optimize workflows and maximize revenue.
As the CEO of Strategic Practice Solutions (SPS), Kristin heads the leading orthopedic billing service in the United States. SPS is dedicated to transforming revenue cycle management through innovative workflow solutions, cutting-edge technology, and in-depth analytics. The company’s relentless focus on problem-solving and strategic insights empowers orthopedic practices to achieve unparalleled financial performance. https://www.linkedin.com/in/kristin-callaway-kelly-78705b7/

Brian Rota
Vice President of Operations

Brian brings over 15 years of leadership in revenue cycle management, medical practice consulting, and strategic marketing to his role as Vice President of Operations at Strategic Practice Solutions (SPS). A cornerstone of SPS since its inception, Brian has played a pivotal role in shaping the company’s operational excellence and reputation for innovation.
Fanatical about developing and optimizing internal processes, ensuring compliance, and delivering impactful training programs, Brian is also a leader in software configuration and integration, leveraging technology to streamline operations and maximize revenue for SPS’s orthopedic clients. His deep technical knowledge of carrier reimbursement strategies and data-driven approaches has been instrumental in improving financial outcomes for orthopedic practices. In addition to his operational acumen, Brian excels in fostering effective provider communication, ensuring that SPS remains a trusted partner in overcoming the complexities of orthopedic billing and practice management. His commitment to excellence and innovation continues to drive SPS’s mission to empower orthopedic practices through advanced workflow solutions and cutting-edge technology. https://www.linkedin.com/in/brian-rota-4b7024b/

Ready to stop living with the pain…of bad billing?

Let us analyze your practice issues and provide detailed feedback on performance and solutions.