ORTHOPEDIC SURGERY
An EMR Built for Imaging, the Global Period, and the Office Procedure Between Surgeries
Your 9:40 AM knee comes in with a recent MRI, a baseline KOOS, and a question about an injection. Twenty minutes later the imaging is folded into your note, the 20610 carries the joint and supply as discrete data, the global-period tracker on the 6-week post-op patient next door has the right modifier teed up, and the DME packet for the brace is ready to ship. That is what your day looks like on GlaceEMR and GlaceRCM, billed at a percentage of collections with no base fees, backed by a billing team that hits 95%+ first-pass claim adjudication and 99%+ collection rate of payer-allowed amounts*.
*Of payer-allowed amounts.
WHAT WE HEAR FROM ORTHOPEDIC SURGEONS
The Problems Orthopedic Practices Tell Us About
Orthopedic surgery runs on a rhythm general EMRs do not understand: a clinic full of imaging-driven decisions, in-office injections and casting, and surgical patients moving through pre-op clearance, the procedure, and a global post-op period where billing rules change. Your record has to hold imaging alongside a region-specific exam, track the global period, and code the injection or splint correctly. Horizontal platforms leave you to build the orthopedic flow yourself. The list below is what we hear in the first thirty minutes of every discovery call with a busy orthopedic practice.
Imaging lives somewhere else. X-ray, MRI, CT, and ultrasound studies sit on a separate PACS viewer that needs a second login and a third password. The radiology report and the image rarely land in the chart in a usable form, and the surgeon ends up alt-tabbing through three windows to read a knee. By the time you have the films open next to the H&P, the patient is already talking, the MA is already gone, and the structured findings you need on the claim are stuck in a PDF you never re-typed.
The global period quietly eats your revenue. The 90-day global after a TKA or an arthroscopy collapses your post-op visits into a single bundled payment, which is the rule. Where practices lose money is the unrelated care that walks into the same room: the contralateral knee, the new shoulder, the staged procedure on the other side. Without a tracker prompting the -24, the -57, the -58, or the -79 at the right moment, those visits get coded as global follow-up and the work is given away. Across a busy ortho panel, five-figure revenue leakage per surgeon per year is the rule, not the exception.
Injection and casting documentation needs anatomical specificity. Joint, approach, agent, dose, lot number, viscosupplement choice, ultrasound guidance, supply: all six have to be captured or the claim and the next visit both suffer. Most generic templates capture three of those six and let the rest live in free text the biller cannot code from. The 20610 you do every Tuesday gets billed without the supply HCPCS, and the J-code for the viscosupplement that should have paid the patient’s annual visit several times over never makes it to the claim.
Surgical op notes are long and the structured data is missing. Implants with manufacturer, model, size, and lot number, approach, fluoroscopy time, tourniquet time, estimated blood loss, complications, intraoperative findings, and the post-op plan all have to live in the note for billing today and for the revision a decade from now. Most platforms do not capture the implant lot as a structured field, so when the recall notice arrives in 2031, your office is paging through ten years of PDFs to identify the affected patients instead of pulling a one-screen report.
PROMs, DME, and workers’ comp do not fit anywhere. KOOS, HOOS, DASH, QuickDASH, and VAS scores live on paper at the front desk or in a separate app the patient never opens. Brace, boot, sling, and walker ordering is yet another packet of paperwork that floats around outside the chart, and the medical-necessity letter is hand-typed every time. Workers’ comp adds a third channel of documentation, with the carrier’s intake forms, work-restriction letters, and IME requests that nobody on the team owns until somebody complains.
Your software bill keeps growing for things that should be one product. Separate vendor for PACS, separate vendor for PROMs, separate vendor for the brace catalog, separate vendor for surgical scheduling, separate vendor for the telehealth follow-up, separate vendor for the patient portal, separate vendor for HR and credentials. Each renews on its own schedule, each lifts its price every twelve months, and each integrates with the others only when one of them feels like it. Your office manager prints the SaaS list once a year, the total is bigger than payroll for two FTEs, and half the licenses are barely used.
Your reporting is somebody else’s job. You need an injection-volume report by joint and by surgeon, a global-period exposure report so you know how many post-op patients are inside which window today, a PROM trajectory cut by procedure type, a denial-trend report by payer for the modifier-25 challenges that keep coming back. Every one of those is a support ticket, a consulting fee, or a week of waiting for somebody to write SQL. The practice runs on whatever the office-manager spreadsheet still holds, instead of running on real data, and the decisions get made on gut feel.
GLACEEMR FOR ORTHOPEDIC SURGERY
An EMR Designed Around Imaging, the Global Period, and the Office Procedure
GlaceEMR is ONC-certified and has been deployed in private orthopedic practices since 1999, with 30+ years of company history behind it. Every feature below is in the platform today, not a roadmap promise. 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 actually runs on.
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 captured as discrete data, not free text. The knee exam you write Tuesday is the knee exam your associate writes Thursday, and the structured fields are where the biller and the next-visit auditor will look for them.
Integrated PACS and DICOM viewer
X-ray, MRI, CT, and ultrasound studies open inside the chart through the integrated viewer, no second login and no add-on viewer license. The radiology report and the actual images sit alongside the exam you just wrote, the trend pulls up the prior films for comparison, and the structured findings you fold into your assessment carry forward into the procedure note and the claim.
Surgical global-period tracker
A live day-counter sits on every post-op patient’s chart. When a visit falls inside a 10-day or 90-day global 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 unrelated procedure on the contralateral side. The modifier that used to get missed gets teed up at the moment you sign the note.
In-office injection and aspiration 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. Anatomical-diagram annotation lets you mark the exact injection site for the chart and the next visit, and the supply data your billing team needs is captured the first time, not chased after the EOB arrives short.
Casting, splinting, and DME workflows
Cast and splint application codes carry the 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 all assembled before the patient leaves the room. Your DME revenue stops slipping past the front desk, and the medical-necessity language is consistent across every order you write.
Operative-note templates with implant lot capture
Arthroscopy, TKA, THA, ORIF, and rotator-cuff repair op-note templates carry the 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, your office pulls a one-screen report of every affected patient instead of paging through a decade of PDFs.
PROM capture with auto-scoring
KOOS, HOOS, DASH, QuickDASH, and VAS are native questionnaires the patient completes through the portal or the kiosk before the visit. Scores land in the chart as discrete data, trend over recovery, and surface inline with the encounter for the conversation about whether the patient is on track. The functional-status MIPS measure accrues as a byproduct, rather than as a separate reporting project at year end.
eRx with EPCS and PDMP
Electronic prescribing for analgesic, injection, and VTE-prophylaxis favorites with default dosing, plus EPCS with PDMP integration for the post-operative controlled analgesics where the monitoring obligation is real. The PDMP check happens inside the prescribing moment, not in a separate browser tab, so the legal step is part of the workflow and the audit trail lives in the chart.
Hospital and ASC coordination
15+ hospital interfaces and ASC partners deliver ADT, OR schedules, and discharge documents straight into the chart. Your TKA discharge summary lands the day of, not the week after. The pre-op clearance loop closes back from the hospitalist, the anesthesia note attaches to the encounter, and the seven-day post-op call gets prompted on the right day for the right patient.
Workers’ compensation documentation
Workers’ comp visits run with the right intake forms, carrier-specific authorization tracking, work-restriction letters generated from the chart, MMI determinations, impairment ratings, and IME response templates. The third documentation channel that nobody on the team used to own now lives where the clinical work lives, and the carrier callbacks shrink because the packet you send the first time is complete.
Clinical decision support, configurable
VTE-prophylaxis prompts on post-op patients, imaging-appropriateness nudges per AAOS guidance, compartment-syndrome and open-fracture emergency cards, surgical-global-period reminders, and post-op-follow-up-due alerts with the supporting citations. You decide which alerts fire and which stay quiet by role and provider, so the system supports your judgment instead of fighting it with thirty pop-ups before noon.
200+ built-in reports plus a report builder
Injection volume by joint and surgeon, global-period exposure today by patient, PROM trajectory by procedure, denial trends on modifier-25, surgical case volume by ASC partner, no-show rate by clinic location, and a hundred more running off the same database your clinicians and billers already produce. Need a custom report for a payer audit tomorrow? Use the report builder UI yourself, no support ticket and no analyst hour.
MODULES INCLUDED WITH GLACEEMR
Things Other EMRs Charge Extra For. You Get Them.
When you price-out another EMR for an orthopedic practice, count what is included before you compare the headline number. PACS, native telehealth, kiosk, mobile apps, the practice-administration suite, all of them are upsells everywhere else. They ship with GlaceEMR. No tier games, no surprise line items at renewal, no third-party vendor management for the modules a real orthopedic practice depends on.
Native iOS and Android apps
Phone and tablet apps for surgeons and staff. Sign op notes, review post-op imaging, message patients, take an OR call from the ASC, see the next-day schedule, all from wherever you are. Native build, not a mobile-friendly browser view, so the experience holds up at the bedside, in the OR locker room, and on the drive home from a late case.
PACS, DICOM viewer, MSK ultrasound
Full PACS, DICOM viewer, and point-of-care MSK ultrasound capture, all integrated. No add-on viewer subscription, no separate vendor for the in-office ultrasound, no surprise renewal at the year mark. Read a knee, capture a guided injection clip, and have both attached to the same chart your billing team will code from.
Self-check-in kiosk with PROMs
Run check-in on an iPad, an Android tablet, or the patient’s own phone. Demographics, consents, copay, joint-specific questionnaires, KOOS or DASH, and insurance updates, all done before the rooming MA gets there. Bilingual English and Spanish so the Spanish-speaking patient does not need an interpreter to update an address or score a knee.
Native telehealth, no add-on
HD video built into the chart for post-op check-ins, conservative-management follow-ups, and pre-op discussions that do not require a hands-on exam. No third-party video link, no separate seat license. Your two-week post-op TKA with a question about activity restrictions runs in the same chart as the in-person work, with GlaceScribe capturing the note either way.
GlaceOffice administration suite
HR, timesheets, PTO, inventory, surgical-instrument tracking, documents, contracts, credentials, asset management, mail handling, expense tracking, and the KPI dashboard your practice manager actually checks. Free for every Glenwood client. Run the business side of the orthopedic practice without a fifth subscription and a fifth login the front desk has to remember.
Multi-location, multi-provider, role-based
Grow from a solo surgeon to a multi-surgeon group across clinic, ASC, and hospital outreach sites on one platform without renegotiating the contract or rebuilding the configuration. Role-based access controls and audit trails throughout. No per-location upcharge. Add a satellite clinic or a second ASC next quarter and the chart works the same way Monday morning.
GLACERCM FOR ORTHOPEDICS
A Billing Service That Knows Your Orthopedic Code Mix
GlaceRCM charges a percentage of collections with no base fees, no implementation charges, and no monthly minimums. The service is built for the orthopedic code mix: surgical claims, global-period modifier handling, injection and DME capture, ASC versus hospital outpatient coordination, and workers’-comp follow-through. Our numbers reflect that focus.
95%+
First-pass claim adjudication. Most claims pay on the first submission, with no rework, no resubmission, and no calendar lost to denial follow-up while the surgical AR ages.
99%+
Collection rate of payer-allowed amounts*. The dollars the payer contractually 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.
Claim scrubbing tuned to surgical and procedure codes
Payer-specific and service-specific rules check every claim before submission. 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 including ORIF, 99024 global visits, and the DME L-codes) is the bread and butter of our scrubber. Claims that need a fix get fixed before they go out, not after a denial comes back four weeks later.
Global-period and modifier intelligence
The -24, -25, -57, -58, -78, and -79 modifiers are applied by rule based on the encounter context, the patient’s open global windows, and the documentation in the note. The unrelated knee visit during the post-op global on the other side gets the -24 it deserves. The decision-for-surgery visit that should pay separately gets the -57. The staged revision gets the -58. The contralateral arthroscopy gets the -79. The revenue your generic biller used to give away to global comes back on the claim.
Denial management worked to resolution
We do not drop a denial after 90 days. Every surgical claim is tracked to complete resolution: appeals, second-level reviews, payer follow-ups, peer-to-peer when the medical necessity for the arthroscopy or the joint replacement is in dispute. The modifier-25 fight on the same-day injection plus E&M visit gets the documentation packet and the appeal letter the carrier actually responds to. The write-off only happens when you sign off on it.
A named billing specialist for your panel
You get a dedicated account manager who knows orthopedic payer mix in your state, your surgical case mix, your top denials, and your ASC partners. Not a ticket queue. Not an offshore call center. They pick up the phone when you call, and they know your practice by name within a month of go-live. The peer-to-peer that needs to happen Friday afternoon does not get lost in a queue over the weekend.
Workers’-comp and DME billing included
Workers’-comp billing, carrier-specific authorization workflows, IME response packaging, and DME claim submission with the L-codes and medical-necessity documentation, all included. The brace, boot, sling, and walker that used to be a separate billing relationship now runs through the same team that works your surgical AR, so the DME revenue and the surgical revenue land on the same dashboard your office manager reviews on Monday.
Percentage of collections, no base fees
No setup fees, no implementation charges, no monthly minimums. We get paid when you get paid. That is the contract, in writing, on every invoice. Your interests and ours are aligned from day one, and our incentive is to collect every dollar you earned on the OR case and the office injection, not to bill you for activity that did not produce collections.
Prior auth for imaging and surgery
Advanced imaging (MRI, CT) and elective surgery (TKA, THA, arthroscopy) carry heavy authorization burden. GlaceIQ assembles the documentation packet from the chart, and the billing team finishes, validates, and submits. The 45-minute manual auth project shrinks to a five-minute review, and the patient who needs the surgery actually gets on the schedule before their pain forces an ER visit.
Credentialing and payer enrollment included
Provider credentialing and payer enrollment are part of GlaceRCM onboarding, not a separate engagement and not a referral to a third-party credentialing company. New surgeons, new locations, ASC privileges, and Medicare-Medicaid revalidations are handled by the same team that runs your billing. The new associate who finished fellowship in June is billing on day one of clinic instead of waiting six months for an enrollment letter.
GLACESCRIBE FOR ORTHOPEDICS
Ambient SOAP Notes, Tuned to Orthopedic Vocabulary
GlaceScribe listens in the room and generates a complete SOAP note structured the way orthopedics writes: injury or chief-complaint HPI, region-specific exam with range of motion, special tests, and neurovascular status, imaging findings folded into the assessment, and a plan organized by problem with the procedure, the DME, the activity restriction, and the follow-up. It is built on HIPAA-compliant AI infrastructure from Amazon, Google, Anthropic, Deepgram, ElevenLabs, and other enterprise AI providers. Multi-vendor architecture preserves operational redundancy and continuous improvement, so the scribe gets better over time without ever depending on a single upstream vendor.
It learns your voice, your abbreviation patterns, and your preferred phrasing over time. The first month it sounds like a careful orthopedic resident trying to write the way you write. By month three it sounds like you. ICD-10 and CPT suggestions surface alongside the draft note, including the right injection code, the right modifier, and the right side. All suggestions are reviewed by you before signing. Nothing reaches the chart until you approve it, and the codes never touch the claim until you sign the note. The AI is a careful resident who hands you the note for review; the coding judgment and the surgical-billing decision stay with you.
Up to four simultaneous speakers are captured cleanly, so a spouse, an adult child, an interpreter, or a workers’-comp case manager in the room is documented alongside the patient without scrambling the assessment. The scribe runs in person and in telehealth, and the same chart receives the note either way. Patient-facing language is supported in English and Spanish, so a Spanish-speaking patient gets the same encounter experience while the clinical documentation lands in English for your billing and reporting.
For the in-office procedure, the scribe carries the joint, the side, the approach, the agent, the dose, the lot, and the supply into a procedure-note draft as you describe what you are doing. The 20610 with viscosupplement that used to require ten minutes of after-clinic typing now finishes when the patient stands up. For the operative note, the dictated approach, the implants you name out loud, the fluoroscopy time, the EBL, and the closure all flow into the structured op-note template with the implant lot fields ready for your verification.
The outcome is documentation that finishes when the visit finishes. No charting at 9 PM. No weekend catch-up. No pajama time eating into the hours that should belong to your family. You read, edit, sign, and move to the next patient, and the note that gets billed is the note that reflects the work you actually did. The op note that used to take twenty minutes after a long OR day now needs three minutes of review while you change out of scrubs.
You will feel it most in the visits where the typing was always the bottleneck. The new sports injury walking in with a question and a phone full of X-rays. The post-op TKA at six weeks where the conversation goes long because the patient is anxious about the contralateral knee. The fracture follow-up where you and the patient are looking at three time points of films together. The note that used to eat twenty-five minutes after clinic now needs three minutes of review while the MA is rooming your next patient, and the HPI captures what your patient actually said, not the abbreviated version you would have typed from memory at the end of the day.
POWERED BY GLACEIQ
30+ AI Features, Tuned to the Surgeon’s Day
Every AI capability is a suggestion. You review and select. Codes wait for your approval before they touch a claim, and notes wait for your signature before they leave the chart. Compliance-first, surgeon-in-the-loop, every time. The list below is what runs in the background of your day on GlaceIQ, working on the cognitive load you carry today by hand between the clinic, the ASC, and the imaging review.
Pre-charting with imaging summary
Before the visit, GlaceIQ assembles a pre-chart summarizing the active injury, the most recent imaging with its read, prior conservative care, prior injections with date and response, current medications, and last-visit plan items still open. Your MA reviews it before you walk in, so the first thirty seconds of the encounter are spent on the patient and the films, not on chart archaeology.
Global-period modifier suggestions
As you sign a post-op visit, GlaceIQ checks the patient’s open global windows and prompts the right modifier. The unrelated visit during a global gets the -24, the staged revision gets the -58, the contralateral arthroscopy gets the -79, the same-day decision-for-surgery gets the -57. You review and select. The revenue your generic biller used to give away stops slipping through.
Undercoding detection on complex visits
The Undercoding Detector flags 99213 visits that the documentation supports as 99214, and 99214 visits that read as 99215 once the imaging review and the MDM around the surgical decision are counted. You review the suggested level with the supporting MDM next to it, and the visit you used to undercode by reflex now bills at the level the work actually justifies.
Drug Cost Comparator for injectables
For viscosupplementation, corticosteroid choice, and the post-op injectable analgesic, GlaceIQ surfaces the patient’s plan formulary, the typical out-of-pocket, and the alternative agent that would have the same clinical fit at a lower patient cost. You make the call. The patient walks out with the agent that fits their wallet as well as their joint, instead of finding out at the pharmacy two days later.
Denial prediction before submission
GlaceBillSmart scores each claim for denial probability based on payer history and code combinations: the modifier-25 fight, the medical-necessity question on the MRI, the global-period edit on the post-op injection. The billing team fixes problems before submission instead of working denials after the EOB arrives. The claim that would have failed gets the documentation it needed, while you can still adjust the note.
Per-code performance at charge entry
During charge entry, GlaceIQ shows expected reimbursement, denial probability, and payment timeline per code by payer. You see the dollar implications of a coding decision while you can still adjust documentation. The 27447 with the supporting MDM and the implant lot capture goes out as a 27447. The 29881 with the additional procedure documented properly bills with the secondary code that pays.
Care-gap surveillance across the panel
Care Gap and Population Registry views surface the post-op patients due for follow-up, the fractures due for healing checks, the joint-injection patients due for re-evaluation, and the surgical patients overdue for their final global visit. Orthopedic follow-up becomes a managed program rather than a stack of reminder cards at the front desk, with recall logic driving the outreach through SMS, email, or phone.
AI prior authorization for imaging and surgery
For MRI, CT, advanced injectables, and elective arthroplasty, GlaceIQ assembles the documentation packet from the chart. The conservative-care history, the failed PT, the response to injection, the imaging findings, and the medical-necessity language are pulled into one packet your billing team finishes and submits. The 45-minute auth project shrinks to a five-minute surgeon review.
AI schedule maximization
When the clinic schedule has an opening, GlaceIQ identifies recall, waitlist, and post-op-overdue candidates and books them through GlacePhoneSmart or portal outreach. Your panel capacity stops leaking quietly. The 2:30 PM no-show turns into a 2:45 PM six-week post-op for the TKA patient who has been putting off the visit for ten days.
PATIENT ENGAGEMENT FOR ORTHOPEDICS
Reach Your Surgical Panel Where They Already Are
Your patient engagement stack runs on portal, mobile app, kiosk, SMS, email, and phone, with English and Spanish on every patient-facing surface. The seventy-year-old TKA candidate who only opens email and the twenty-eight-year-old sports-injury patient who only opens text both end up on the schedule, both fill out the joint-specific intake and the PROM before they walk in, and both make their balance payment without anybody at the front desk lifting a finger.
Practice-branded portal and mobile app
Imaging, secure messaging, scheduling, bill pay, joint-specific intake, PROM questionnaires, and telemedicine, all under your practice name, your logo, and your colors. Patients install one app, recognize the brand on their phone, and stay there. Adoption beats the generic vendor-branded portal every time, because the patient trusts the practice they already know from the OR consultation.
GlacePhoneSmart 24/7 line
AI phone agent answers as your practice in English or Spanish, books into real-time scheduler slots, runs post-op recall and reminder campaigns, fills cancellations on a surgeon’s clinic day, and surfaces voicemail summaries to your staff. The front desk stops drowning in calls during post-op season. The patient with a 9 PM question about activity restrictions reaches the practice and still gets an appointment for next Tuesday.
SMS and email recall campaigns
Post-op recalls, six-week and three-month follow-ups, fracture-healing checks, viscosupplement-series reminders, PROM prompts, and DME-fit follow-ups, all in patient-preferred language and channel, on the cadence the care plan calls for. Replies route back into the chart as structured tasks, not into an inbox somebody has to read on Monday morning between OR cases.
Bilingual kiosk, intake, and PROM capture
Self-check-in on iPad, Android tablet, or the patient’s own phone, in English or Spanish. AI-driven electronic intake via phone, SMS, or portal before the visit. KOOS for the knee patient, DASH for the shoulder, VAS for everyone. The patient walks into the room ready and scored, and the rooming MA spends her time on vitals and history instead of typing demographics off a clipboard.
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. The list below is the short version of what runs every day inside the platform for an orthopedic surgery 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
SWITCHING IS EASIER THAN YOU THINK
Coming From Another EMR
Most orthopedic practices we onboard are leaving a legacy EMR platform, a horizontal billing-first product, or a specialty-flat ambulatory suite that never quite fit the imaging and global-period load. We have migrated all of them. The transition is the part you dread most, and it is the part we have done hundreds of times.
$0 implementation fee. Data migration is included in the contract: historical patient records, surgical history, imaging records, active problem lists, current medications, allergies, outstanding orders, and the implant log. EMR go-live in under one week of focused workflow training. RCM transition over 4 to 8 weeks with payer enrollment running in parallel, so the cashflow gap is the smallest possible. We recommend a 30 to 90 day overlap with your previous vendor while the new chart proves itself, and we plan the transition around that overlap rather than against it.
Surgeon training is delivered in pieces around your real clinic and OR schedule, not as a multi-day disruption that forces you to cancel patients or move cases. Your account manager runs the migration and stays your account manager after go-live, so the person who answers your call in month six is the person who set up your workflows in week one. Glenwood has been physician-founded and privately held since Christmas Eve, 1994, when our founder helped his physician wife acquire a private practice in Connecticut. 30+ years in market, no outside investors, no roadmap roulette.
Support runs 7:00 AM to 8:00 PM Eastern Time on weekdays, with 24×7 on-call coverage for urgent or critical issues, so the practice that has a problem at 6:30 AM Pacific or 10:00 PM Eastern still reaches a person. You also get unlimited online training through onboarding, included online training for new staff who join later, and a self-help library of workflow documents and videos for the moments when somebody just needs to remember how something works.
What changes on day 1, day 30, and day 90
Day 1. You log in to a chart that already holds your migrated patient history, surgical log, imaging records, active problem lists, current medication lists, and the recent results from your previous system. The orthopedic configuration is already wired in: region-specific exams, injection and procedure templates, op-note templates with implant fields, smart phrases for the knee and the shoulder, code favorites, PROM questionnaires, and the surgical global-period tracker. You see a chart that looks like a real orthopedic chart, not a blank install asking you to build one. Your first few visits run slower because the workflow is new. By the end of the first day, your hands start to remember where everything lives.
Day 30. You are charting faster than you did on the old system because the templates match the way you actually document. You are using GlaceScribe on most visits and your HPIs no longer slow you down. Your first month of injection and DME revenue has cleared at the right level, and your first month of submissions is already on the dashboard. You and your account manager have done the first formal walk-through of the denial queue together. The post-op recall and PROM-capture workflows are live, and your front desk is starting to fill tomorrow’s schedule from the recall list rather than from whoever calls in.
Day 90. Your first quarter’s RCM dashboard shows the new shape: cleaner claims, faster posting, fewer denials parked in the 60-90 bucket, and the global-period modifier capture you used to give away. Your DME and injection revenue lines are now visible. PROMs are trending across recovery on every surgical patient. GlacePhoneSmart has visibly cut your front-desk call volume, and your recall campaigns have closed post-op follow-up gaps on hundreds of patients you would not have reached otherwise. The switch starts paying for itself, and the conversation with your account manager turns from migration triage to optimization, the parts of the platform you are ready to use harder next quarter.
QUESTIONS WE HEAR EVERY WEEK
Orthopedic Practice FAQ
The questions below come up in almost every discovery call with an orthopedic practice. 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 the major 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, and it keeps the platform able to adopt the next generation of voice and language models as they ship. 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 the GlaceRCM pricing actually look like in practice?
You pay a percentage of what we collect. No base fees, no implementation charges, no setup fees, no monthly minimums. The exact percentage depends on your code mix, your payer panel, your surgical volume, and your DME exposure, and you will have it in your hand after a 20-minute discovery call. The contract is straightforward: we get paid when you get paid. You will not see a surprise line item for credentialing, for denial follow-up, for prior auth, for patient statements, or for the call center your patients use to ask about their bills, because all of that is part of the service. The 95%+ first-pass adjudication and 99%+ collection rate of payer-allowed amounts are how we operate across our active client base. If your current biller is running below those numbers on the surgical and global side, what we charge tends to pay for itself out of the dollars you start collecting that you were quietly writing off before.
Do we have to switch EHRs to use GlaceRCM?
Yes. GlaceRCM is a bundled service that includes GlaceEMR clinical software, the practice management software that runs scheduling and charge capture, and the medical billing team that works your claims to resolution. The billing service runs inside our platform because the quality of the billing depends on the quality of the integration: real-time eligibility, claim scrubbing tuned to the actual chart documentation, denial root-cause analysis that closes the loop back to the encounter and the op note. We do not run our billing service on third-party EHRs, because we have spent thirty years learning that hybrid setups produce hybrid results, particularly on surgical and global-period work. The good news is that the switch is well-rehearsed: EHR go-live is under one week, data migration runs 2 to 4 business days and is handled by Glenwood, implementation is $0, and the 30-to-90-day overlap with your prior vendor protects continuity. If you want our software without our billing service, GlaceEMR is available standalone for the small minority of practices that prefer to keep their existing billing team. About 98% of Glenwood clients choose the bundled GlaceRCM path.
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 of your practice run on one chart, with one log of cases, billable from one system, so the surgical revenue and the office revenue land on the same dashboard your office manager opens on Monday morning.
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If you carry adjacent panels, see how GlaceEMR runs pain management, podiatry, rheumatology, and physical medicine and rehabilitation.
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