ORTHOPEDIC SURGERY
An EMR Built for Imaging, the Global Period, and the Office Procedure Between Surgeries
Your 9:40 AM knee arrives with a recent MRI and a question about an injection. The imaging folds into the note, the 20610 carries the joint and supply as discrete data, the global-period tracker on the post-op patient next door has the right modifier teed up, and the brace DME packet is ready to ship. That is your day on GlaceEMR and GlaceRCM, at a percentage of collections with no base fees, backed by 95%+ first-pass claim adjudication and 99%+ collection of payer-allowed amounts*.
*Of payer-allowed amounts.
WHAT WE HEAR FROM ORTHOPEDIC SURGEONS
A Rhythm Horizontal EMRs Do Not Understand
Orthopedics runs on imaging-driven decisions, in-office injections and casting, and surgical patients moving through a global period where billing rules change. Horizontal platforms leave you to build the orthopedic flow yourself. Four pains come up in the first thirty minutes of almost every discovery call, and each one quietly costs you time, revenue, or both.
Imaging lives somewhere else
X-ray, MRI, CT, and ultrasound sit on a separate PACS that needs a second login. You alt-tab through three windows to read a knee, and the structured findings the claim needs are stuck in a PDF you never re-typed.
The global period eats revenue
The contralateral knee, the new shoulder, the staged procedure on the other side. Without a tracker prompting the -24, -57, -58, or -79 at the right moment, those visits get coded as global follow-up and the work is given away.
Injection data goes uncoded
Joint, approach, agent, dose, lot number, and supply all have to be captured. Most generic templates catch three of six and leave the rest in free text, so the 20610 goes out without the supply HCPCS and the viscosupplement J-code never reaches the claim.
PROMs, DME, and comp do not fit
KOOS and DASH live on paper, brace ordering floats around outside the chart, and workers’ comp adds a third documentation channel of carrier forms and IME requests that nobody on the team owns until somebody complains.
GLACEEMR FOR ORTHOPEDIC SURGERY
An EHR Designed Around Imaging, the Global Period, and the Procedure
GlaceEMR is ONC-certified and has run in private orthopedic practices since 1999, with 30+ years of company history behind it. The orthopedic configuration is wired in before training starts, so the chart your team opens on day one already knows the regions, the procedures, the implants, and the workflows your day runs on. Every capability below ships in the platform today, not as a roadmap promise.
Region-specific MSK exam templates
Spine, hip, knee, shoulder, hand and wrist, foot and ankle, sports and trauma each ship with their own structured exam: range of motion, special tests, strength grade, and neurovascular status as discrete data. The knee exam you write Tuesday is the knee exam your associate writes Thursday.
Integrated PACS and DICOM viewer
X-ray, MRI, CT, and ultrasound open inside the chart through the integrated viewer, no second login and no add-on license. The report and the images sit alongside the exam, the trend pulls up prior films for comparison, and the structured findings carry forward into the procedure note and the claim.
Surgical global-period tracker
A live day-counter sits on every post-op chart. When a visit falls inside a 10-day or 90-day window, the system prompts the -24 for unrelated care, the -57 for the decision-for-surgery visit, the -58 for the staged procedure, the -78 for a return to OR, and the -79 for the contralateral procedure. The modifier that used to get missed gets teed up at signing.
In-office injection documentation
The 20610, 20611, 20605, and 20600 templates capture joint, side, approach, agent, dose, lot number, supply HCPCS, and ultrasound guidance as discrete fields. The viscosupplement J-code drops on the claim with the injection, so the supply data your biller needs is captured the first time, not chased after the EOB arrives short.
Casting, splinting, and DME workflows
Cast and splint codes carry location, material, and laterality as structured fields. The DME order for the brace, boot, walker, or sling generates from the same chart, with the L-code, the medical-necessity letter, and the patient handout assembled before the patient leaves the room. Your DME revenue stops slipping past the front desk.
Op-note templates with implant lot capture
Arthroscopy, TKA, THA, ORIF, and rotator-cuff repair templates carry implant manufacturer, model, size, and lot as discrete fields, alongside approach, fluoroscopy time, tourniquet time, EBL, and complications. When a recall notice lands in 2031, you pull a one-screen report of affected patients instead of paging through a decade of PDFs.
Included with GlaceEMR vs usually an add-on
When you price out another EMR for an orthopedic practice, count what is included before you compare the headline number. The rows below are upsells or separate vendors almost everywhere else, each with its own renewal date and price increase. They ship with GlaceEMR, with no tier games and no surprise line items.
| Capability | Most EMRs | GlaceEMR |
|---|---|---|
| PACS, DICOM viewer, MSK ultrasound capture | Add-on license | Included |
| Hospital and ASC ADT, OR schedules, discharge docs | Interface fee | Included (15+ hospitals) |
| PROM capture (KOOS, HOOS, DASH, VAS) with auto-scoring | Separate app | Included |
| Self-check-in kiosk with PROMs, English and Spanish | Third-party vendor | Included |
| GlaceOffice administration suite (HR, PTO, instruments) | Separate subscription | Included, free for clients |
| Native iOS and Android apps for surgeons and staff | Mobile-web only | Included |
A solo surgeon can grow to a multi-surgeon group across clinic, ASC, and hospital outreach sites on the same platform, with no per-location upcharge and no contract to renegotiate when you add a satellite clinic or a second ASC.
THE GLOBAL PERIOD, TRACKED
The Modifier Teed Up at the Right Moment
Every post-op patient carries a live day-counter. When a visit falls inside the window, GlaceIQ checks the encounter context and the documentation and surfaces the right modifier for your review, the scrubber confirms it against payer rules, and your named billing specialist works the queue to resolution. The same chart and the same team carry the dollar from the OR to the deposit, so the unrelated knee no longer gets given away to global between four different vendors.
GLACERCM FOR ORTHOPEDICS
A Billing Service That Knows Your Orthopedic Code Mix
GlaceRCM bills your claims in your EMR or ours, at a percentage of collections with no base fees and no monthly minimums. We would rather run it on our platform, where the scrubber sees the full chart, but if you are staying on your EMR our team works your claims there. The service is built for surgical claims, global-period modifier handling, injection and DME capture, ASC coordination, and workers’-comp follow-through.
95%+
First-pass claim adjudication. Most claims pay on the first submission, with no rework and no calendar lost to denial follow-up while the surgical AR ages.
99%+
Collection rate of payer-allowed amounts*. The dollars the payer owes you on the TKA and the arthroscopy actually arrive, because we work the queue to resolution instead of writing it off at 90 days.
$0
Implementation fee, setup charge, and monthly minimum. We get paid when you get paid, so our interests and yours line up from the day the contract is signed.
*Of payer-allowed amounts.
Scrubbing tuned to surgical codes
Payer-specific rules check the mix orthopedics bills: office E&M with the right MDM, 20610-family injections with supply and J-codes, 29881 and arthroscopy variants, 27447 and 27130 joint replacements, fracture care and ORIF, 99024 global visits, and the DME L-codes. Claims that need a fix get fixed before they go out.
Global-period and modifier intelligence
The -24, -25, -57, -58, -78, and -79 modifiers are applied by rule based on the encounter context, the open global windows, and the documentation. The unrelated knee gets its -24, the decision-for-surgery visit gets its -57, the staged revision gets its -58, and the revenue your generic biller used to give away to global comes back on the claim.
Workers’-comp and DME billing
Workers’-comp billing, carrier-specific authorization workflows, IME response packaging, and DME claim submission with L-codes and medical-necessity documentation are all included. The brace and boot that used to be a separate billing relationship now run through the same team that works your surgical AR, on the same dashboard.
A named billing specialist
A dedicated account manager who knows orthopedic payer mix in your state, your surgical case mix, your ASC partners, and your top denials. Not a ticket queue, not an offshore call center. The peer-to-peer that needs to happen Friday afternoon does not get lost in a queue over the weekend.
Percentage of collections, no base fees. Provider credentialing, payer enrollment, prior auth for imaging and surgery, daily patient statements, and a US-based billing call center are part of the service, not separate line items. Denials are worked to resolution through appeals, second-level reviews, and peer-to-peer when the necessity for the arthroscopy or joint replacement is in dispute, and the write-off only happens when you sign off. The new associate who finished fellowship in June is billing on day one of clinic instead of waiting six months for an enrollment letter.
AI AND PATIENT ENGAGEMENT
The Documentation, the Coding, and the Phones
Every AI capability is a suggestion you review and select. Notes wait for your signature and codes wait for your approval before either reaches a claim, so the coding judgment and the clinical decision stay with you. The AI is built on HIPAA-compliant infrastructure from Amazon, Google, Anthropic, Deepgram, ElevenLabs, and other enterprise AI providers, with multi-vendor architecture that preserves operational redundancy.
GlaceScribe
Ambient notes structured the way orthopedics writes, with the region-specific exam pulled into the assessment and the procedure note finished for the injection or casting that happened. Up to four speakers, in person or telehealth, English and Spanish patient-facing. The op-note dictation that used to wait is done before the patient leaves the room.
GlaceIQ
30+ AI features tuned to your day: pre-charting with an imaging summary, global-period modifier suggestions, undercoding detection on complex visits, the Drug Cost Comparator for injectables, denial prediction before submission, and per-code reimbursement at charge entry. You review and select each one.
GlacePhoneSmart
An AI phone agent answers as your practice in English or Spanish, books into real scheduler slots, runs post-op and follow-up recall campaigns, fills the cancellations that open up on a packed surgical clinic, and surfaces voicemail summaries so the front desk stops drowning.
A practice-branded portal, mobile app, kiosk, SMS, and email round out the stack, with English and Spanish on every patient-facing surface and PROM capture through the portal or kiosk before the visit. The patient who fills out a KOOS at home and the patient who scores a DASH on the waiting-room iPad both walk into a room where the rooming MA spends her time on vitals instead of typing. Replies route back into the chart as structured tasks, so post-op follow-ups and overdue surveillance visits get worked on the cadence the recovery calls for.
SWITCHING IS EASIER THAN YOU THINK
Coming From Another EMR
Most orthopedic practices we onboard are leaving a horizontal platform that never fit the surgical and imaging load. The transition is the part you dread most, and it is the part we have done hundreds of times. Implementation is $0, data migration is included, and your account manager runs the move and stays your account manager after go-live.
DAY 1
A chart that already looks like yours
You log in to migrated history, active problem lists, current meds, recent imaging, and outstanding orders, with your MSK templates, op-note libraries, injection templates, and code favorites wired in. EMR go-live happens in under one week. The first few cases run slower; by the end of the day, your hands start to remember where everything lives.
DAY 30
Charting faster, claims flowing
You are charting faster than on the old system because the templates match how you document, and GlaceScribe carries your op notes. Your first month of submissions is on the dashboard, the injection supply and J-codes are landing, and you have walked the denial queue with your account manager. The global-period tracker is live and the recall workflows are filling tomorrow from the recall list.
DAY 90
The switch starts paying for itself
Your first quarter’s dashboard shows cleaner surgical claims, faster posting, fewer denials parked in the 60-to-90 bucket, and the global-period modifiers landing instead of being given away. The viscosupplement J-codes and DME L-codes are real revenue lines again, GlacePhoneSmart has cut front-desk call volume, and the conversation turns from migration triage to using the platform harder next quarter.
Data migration covers historical records, documents, imaging, problem lists, medications, allergies, and outstanding orders, handled by Glenwood from your prior vendor’s data export so your staff does not have to clean charts. The RCM transition runs 4 to 8 weeks with payer enrollment in parallel, and we recommend a 30-to-90-day overlap with your previous vendor so the surgical pipeline keeps operating normally. Provider training is delivered in pieces around your real schedule, and every role gets unlimited online training during onboarding with continued access for new hires. Glenwood has been independent and privately held since 1994, when our founder helped his physician wife acquire a private practice in Connecticut: 30+ years in market, no outside investors. Support runs 7:00 AM to 8:00 PM Eastern on weekdays, with 24×7 on-call coverage for urgent issues.
WE KNOW YOUR CODES
We Have Billed Your Mix Before
You already know your codes. We have built the workflows, the scrubber rules, the documentation prompts, and the denial templates around them, so the reimbursement you earned is the reimbursement you collect. The list below is the short version of what runs every day inside the platform for an orthopedic practice:
- 99213, 99214, 99215: office E&M, established patient (often with modifier 25 alongside a same-day procedure)
- 20610, 20611, 20605, 20600: major and minor joint injections with supply HCPCS and viscosupplement J-codes
- 29881, 29826, 29827: knee, shoulder, and rotator-cuff arthroscopy
- 27447, 27130: TKA and THA, with the global-period tracker and the implant lot capture
- S82.- and fracture care codes: ORIF, closed reduction, casting and splinting with location and laterality
- 99024: post-op visits inside the global period, tracked for the MIPS work and the global accounting
- Modifiers 24, 25, 57, 58, 78, 79: applied by rule with the context the documentation supports
- DME L-codes: braces, boots, slings, walkers, with medical-necessity letters from the chart
QUESTIONS WE HEAR EVERY WEEK
Orthopedic Practice FAQ
Short answers below; the longer conversation happens on the demo. Tap any question to expand the answer.
Does GlaceEMR handle the surgical global period and stacked modifiers?
Yes. Every post-op patient carries a live day-counter for their 10-day or 90-day global window. When you write a visit during a global, the system checks the context and prompts the right modifier: the -24 for unrelated care, the -25 for the same-day E&M alongside an injection, the -57 for the decision-for-surgery visit, the -58 for the staged procedure, the -78 for the return to OR, and the -79 for the unrelated procedure on the other side. You review and select. The revenue your generic biller used to give away to global comes back on the claim. The 99024 post-op visits inside the global are tracked separately for the MIPS work and the practice’s global accounting, and the system shows you on demand which patients are inside which window today.
How does GlaceEMR handle imaging, and do I need a separate PACS vendor?
No separate PACS vendor. X-ray, MRI, CT, and ultrasound studies open inside the chart through the integrated viewer, with the radiology report attached and the actual images sitting alongside the exam you just wrote. MSK ultrasound capture for guided injections is supported in the same chart, with the clip stored as part of the procedure documentation. The lab and imaging interfaces are HL7 and DICOM standard. If you have an outside imaging partner today, we work with the major modalities and reference imaging centers; the interface is part of the included integration work, not a separate engagement. Trend studies pull up prior films for side-by-side comparison, which matters most on the second knee and the contralateral shoulder where the story develops over months.
Is GlaceScribe HIPAA-compliant, and where does the AI run?
Yes, fully HIPAA-compliant. GlaceScribe runs on HIPAA-compliant AI infrastructure from Amazon, Google, Anthropic, Deepgram, ElevenLabs, and other enterprise AI providers, all under business associate agreements. The multi-vendor architecture preserves operational redundancy, so a single upstream incident does not stop your visits. Up to four simultaneous speakers are supported, English and Spanish patient-facing, and all coding and order suggestions surface for your review before any signing. Nothing reaches the chart until you approve it, and nothing carries your signature until you sign it. Audio is processed in transit, the resulting note is stored in your single-tenant chart database, and the data never trains a shared model that mixes your patients with anybody else’s. Encryption at rest runs under LUKS full-disk encryption in production today.
What does GlaceRCM pricing look like, and can we keep our EMR?
You pay a percentage of what we collect, with no base fees, no implementation charges, and no monthly minimums. The exact percentage depends on your code mix, payer panel, surgical volume, and DME exposure, and you will have it after a 20-minute discovery call. We would rather run the full bundle, where the billing quality depends on a tight integration with the chart, and about 98% of Glenwood clients choose that path. But we are flexible: if you want to keep your current EMR, our billing team will work your claims in your EMR or ours. You will not see surprise line items for credentialing, denial follow-up, prior auth, statements, or the call center your patients use. The 95%+ first-pass adjudication and 99%+ collection rate of payer-allowed amounts are how we operate across our active client base.
How does GlaceEMR handle DME, workers’ comp, and ASC coordination?
All three live in the chart. DME orders for braces, boots, slings, and walkers generate from the visit with the L-code, the medical-necessity letter, and the patient handout assembled in one packet. Workers’ comp runs with carrier-specific intake forms, authorization tracking, work-restriction letters from the chart, MMI determinations, impairment ratings, and IME response templates, so the third documentation channel that nobody used to own now lives where the clinical work lives. ASC coordination runs over standard interfaces: OR schedules pull in, the pre-op clearance loop closes back from the hospitalist, the anesthesia note attaches to the encounter, and the discharge documents land the day of the case. The hospital outpatient and ASC sides run on one chart, billable from one system.
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