Orthopedics Billing Cash Flow
Prior authorization adds weeks before surgery, and large surgical claim balances then sit 30 to 90 days in payer review while OR time, implants, and staff are already paid.
Where your cash goes after surgery, and how Copay closes the gap.
Prior authorization clears and surgery is scheduled
Authorization on surgery, imaging, or injections comes through, and your team books the OR block.
Prior authorization
Under reviewSurgery scheduled
OR block confirmed
You perform and bill the procedure
Your team submits the surgical claim through your existing software, exactly as you do today.
Claim 27447
UnitedHealthcare · $1,480.00
Payers review the surgical claim for weeks
Large surgical balances sit 30 to 90 days in payer review while OR time, implants, and staff are already paid.
Copay pays the next business day
Copay purchases the eligible claim and deposits the capital the next business day, by ACH.
Deposit from Copay
ACH · Next business day
The orthopedic codes Copay purchases.
Copay prices each claim individually at the service line, using how that specific code performs with your payer, rather than a blended portfolio average.
Every eligible orthopedic code, from joint injections to total knee arthroplasty, is funded the next business day.
Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
PurchasedArthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage, same or separate compartment(s), when performed
PurchasedArthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance
PurchasedArthroscopy, shoulder, surgical; with rotator cuff repair
PurchasedCapital that fits authorization-heavy orthopedic billing.
During authorization
Cover overhead while authorizations clear.
Prior authorization on surgery, imaging, and injections adds weeks before the work. Copay covers the eligible claims behind your OR time, implants, and staff so overhead stays funded.
Large balances
Big surgical balances, funded at once.
Total knee arthroplasty and rotator cuff repair carry large per-claim balances. Copay purchases the eligible surgical claim and deposits the full amount the next business day.
Non-recourse
A denied claim is our risk, not yours.
Non-recourse means a denied eligible claim is Copay's loss. If a purchased orthopedic claim is denied after the fact, your capital is not clawed back.
Orthopedic billing, answered.
No. Copay is not a loan, not factoring, and not a merchant cash advance. Copay purchases your eligible orthopedic claims outright and deposits funds the next business day, with no debt and no repayment schedule.
Prior authorization on surgery, imaging, and injections adds weeks before the work begins, and large surgical balances then sit 30 to 90 days in payer review. Copay purchases your eligible claims and pays the next business day, so you are not waiting on each surgical balance to clear while overhead is already paid.
Orthopedic revenue runs heavily through commercial payers such as UnitedHealthcare, Anthem, Aetna, Cigna, Humana, and BlueCross. Copay purchases eligible claims billed to those payers, so the next-business-day deposit covers the bulk of your practice's volume.
Yes. Total knee arthroplasty, rotator cuff repair, and other surgical procedures carry large per-claim balances. Copay purchases the eligible surgical claim and deposits the full amount the next business day, so OR time, implants, and staff are covered while the payer reviews.
Non-recourse means a denied eligible claim is Copay's loss, not yours. If an eligible purchased orthopedic claim is denied or downcoded after the fact, Copay absorbs the loss with no clawbacks against your practice.
From submitted claim to funded account.
While insurance takes 30 to 90 days, Copay moves in one.
Step 01 · Submit
You submit your claims as normal
Nothing changes about how your billing team works.
Claim #18473
DOS 02/04/24
Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
Step 02 · Verify & Price
We verify and price in real time
Copay checks payor history and prices the claim at the CPT level.
Underwriting in progress
Step 03 · Approved
Advance approved
Capital is approved and scheduled for next business day deposit.
Advance Approved
$9,000
Net advance
Step 04 · Funded
Capital in your account
While the payor takes 30 to 90 days, you already have your capital.
Your account
$0
Available balance
Copay reconciles automatically when the payor pays. You do nothing.
Get paid on your orthopedic claims the next business day.
Copay purchases your eligible orthopedic claims. No loans, no personal guarantee, no workflow change.