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 Surgical Care Program 


Finding payers quality surgical care fast, at a predictable price.

Rising's Surgical Care Program (SCP) provides top-level medical treatment from vetted specialists nearby to individuals who have incurred a work-related injury.

If you're facing today's surgical care landscape, then you'll be up against many pressing questions, like:

  • Who is the best surgeon for this injury?
  • Is surgery really necessary?
  • How much should I reserve for the surgical cost?
  • Am I being billed appropriately and at a fair rate?

Rising’s SCP brings speed, simplicity and savings to your medical management strategy by resolving all these questions in one simple step. We add predictability to the surgery process by: partnering with top surgeons in Rising’s Orthopedic Surgeon Affiliation, ensuring evidence-based medical treatment, collaborating with Ambulatory Surgery Centers (ASCs), and negotiating flat, all-inclusive rates that take the mystery and sticker shock out of surgical care.

We fast-track your patient’s surgical intervention and achieve better outcomes at a fair, upfront price. With Rising’s SCP, one call connects a patient, provider and surgical facility.                              

The top surgeries performed in ASCs are 45 – 61% less expensive than in a traditional hospital outpatient setting.

 Ways You’ll Benefit:

  1. Save Time: Your patient is immediately scheduled with a high-quality, credentialed orthopedic surgeon.
  2. Predictable Reserving:  If surgery is needed, get a guaranteed, pre-determined rate which covers chief cost drivers for the surgical episode of care to 90-days postoperative.
  3. Lower Costs: Our pre-negotiated rate and model are typically much less costly.
  4. Convenience & Speed: ASCs offer shorter wait times, simpler scheduling and more locations.
  5. Better Outcomes: Patients encounter less infectious diseases and lower complication rates, leading to greater patient outcomes and satisfaction.
  6. Easier Payments: Rising pays provider quickly and directly. You see one clear bill.

How We Do It:

  • Pre-negotiate rates for the most common surgical procedures (we will also negotiate any procedure on a one-off basis)
  • Eliminate sticker shock and reduce infection rates by moving  surgical cases from a costly hospital setting to a free standing ASC outpatient setting
  • Deploy clinical care coordination to determine medical necessity and provide scheduling
  • Implement an all inclusive case rate by bundling services:
                    - ASC Facility           
                    - Surgeon (primary, co-surgeon, assistant surgeon)
                    - Implants              
                   - Anesthesia

90 – 95% of implant costs are not being discounted to fee schedule.
Rising’s SCP pre-negotiates case rates to make sure you get the fairest price.


Matching Patients with Quality Providers Across Insurance Lines

Have surgical claims outside Work Comp? Get more info:

> Auto
> Liability
> Group Health





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