HELPING CLIENTS RECOVER FAIR REIMBURSEMENT

ER and trauma surgeons do not have the luxury of planning. You treat patients at their worst moments, make fast decisions that save lives, and manage unpredictable cases that demand both skill and instinct. Every shift brings a new challenge and every case requires immediate action. Yet despite operating under some of the highest clinical pressures, ER and trauma surgeons continue to face the most aggressive reimbursement cuts in the industry.

The No Surprises Act was supposed to level the playing field. Instead, payers have used it as a tool to suppress reimbursement, delay payment, and challenge medical necessity even when the situation is clearly emergent. They assume ER and trauma surgeons will accept the reduced payment because fighting back takes time, resources, and specialized expertise. CHRMS exists to prove them wrong.

This specialty requires a partner that understands how emergency care actually works. Documentation is done under pressure. Procedures change midstream. The patient’s condition may shift rapidly. Payers use the fast pace of ER medicine to justify reductions that ignore the reality of trauma care. CHRMS pushes back by rebuilding the story of each case with clarity, precision, and the authority needed to demand fair compensation.

Our team interprets documentation with a deep understanding of trauma medicine. We correct coding inaccuracies, highlight the critical elements of each intervention, and prepare claims in a way that leaves no room for payer reinterpretation. When insurers attempt to reduce payment by citing flawed benchmarks, we challenge the determination immediately. CHRMS does not sit back and wait for payers to act. We take the first step. We move quickly. We lead the process.

And when a claim needs more than operational intervention, you gain the strength of Cohen Howard. Their legal team has built a national reputation for winning out-of-network disputes, especially in emergency and trauma cases where payers often violate both the intent and the letter of the NSA. With CHRMS and Cohen Howard working together, your practice carries a level of leverage most billing companies cannot provide.

ER and trauma surgeons deserve compensation that reflects the level of responsibility, risk, and skill required to perform in this environment. Independence is possible, but only when the financial side of the practice is defended with the same urgency you bring to patient care. CHRMS is built for that purpose. We are not a billing vendor. We are an operations and legal powerhouse designed to protect the revenue of highly skilled surgeons who refuse to accept payer-driven limitations.

Staying out of network is not a gamble when you have the right partner. It is a strategic decision that gives ER and trauma surgeons control over their work, their income, and their future. CHRMS ensures that control is never compromised. We defend every claim, challenge every underpayment, and take every opportunity to prove the true value of your expertise.

You save lives. We protect the financial structure that allows you to keep doing it on your terms. With CHRMS, independence is not an aspiration. It is a certainty backed by strategy, experience, and results.

Discuss Your ER Trauma Surgery Practice

General surgeons are the backbone of modern medicine. You stabilize emergencies, manage complex abdominal conditions, perform procedures that determine long-term patient outcomes, and support nearly every department inside the hospital. The work is demanding, unpredictable, and essential. Yet despite your central role, payers routinely undervalue the breadth and intensity of general surgery.

Independence becomes harder when reimbursement shrinks, denials rise, and payers apply the No Surprises Act in ways that distort or minimize your services. Many practices start to believe the only option is joining a larger system, accepting network restrictions, or compromising on autonomy. CHRMS exists to prove that general surgeons can remain independent without sacrificing financial stability.

Our approach begins with a clear understanding of your specialty. General surgery is diverse and wide-ranging. Every case requires clinical judgment and adaptive thinking. Payers, however, often apply simplistic formulas that ignore the actual work. They look at general surgery as a category instead of recognizing the complexity behind each intervention. CHRMS corrects that narrative by presenting claims with the level of detail and authority necessary to demand fair compensation.

When you work with CHRMS, you gain a partner that refuses to let payers define your value. We rebuild the clinical story behind each procedure with precision. We challenge inappropriate downcoding, reject flawed median rate comparisons, and attack unreasonable denials at their source. Our process is intentional and aggressive because general surgeons do not have time for slow, timid reimbursement support.

And when a claim needs more than operational advocacy, we bring in Cohen Howard, our legal affiliate that has reshaped out-of-network arbitration across the country. Their attorneys understand the realities of surgical practice and have the expertise to counter payer arguments at every level of dispute. With CHRMS and Cohen Howard together, general surgeons gain the strongest possible shield against underpayment.

Remaining out of network is not the risk payers claim it is. For general surgeons, it can be the most logical path to financial stability, especially when backed by a team that knows how to enforce fair reimbursement under the NSA. Independence gives you control over your schedule, your operations, and the standard of care you are committed to delivering. CHRMS protects that independence by defending the revenue that supports your practice.

General surgeons who partner with CHRMS consistently see the same result. Their reimbursements become predictable. Their underpayment rates fall. Their confidence in out-of-network operations grows. Most importantly, their freedom to practice medicine on their own terms strengthens.

You hold the surgical foundation of patient care. CHRMS ensures you are compensated in a way that reflects your skill, judgment, and impact. Independence is not just possible. With the right team behind you, it becomes the strongest version of your practice.

Discuss Your General Surgery Practice

Maxillofacial surgeons occupy a uniquely complex space in healthcare. You move between medicine and dentistry, trauma and reconstruction, optional care and life-altering intervention. You operate on some of the most delicate anatomical regions with a level of precision that few specialties match. Yet despite this expertise, payers routinely undervalue maxillofacial procedures as if they require less skill, less risk, or less surgical judgment.

The result is a specialty that faces constant reimbursement friction, especially when operating out of network. The No Surprises Act has magnified these challenges. Payers frequently misclassify maxillofacial procedures, attach flawed median rates, and dismiss legitimate reconstructive cases as cosmetic. These decisions are not based on reality. They are based on a lack of understanding. CHRMS is here to correct that.

Maxillofacial surgeons deserve a partner who understands the true complexity of the work. Our team digs into the medical necessity, the clinical narrative, and the rehabilitative impact of your procedures. We examine operative notes with a level of scrutiny that payers often ignore. We highlight the surgical intensity and defend your coding with evidence that is impossible to overlook.

CHRMS approaches maxillofacial claims with the same precision you bring to the OR. We are clear, detailed, and unyielding. When payers attempt to recategorize your work or undervalue it based on dental assumptions, we respond immediately. We challenge reductions, escalate disputes, and prepare cases for arbitration when necessary.

Cohen Howard strengthens this process by providing maxillofacial surgeons with legal representation that understands both the medical and procedural complexities behind your cases. Their attorneys have seen every payer tactic and know how to dismantle them. This partnership gives your practice an unparalleled advantage in a system designed to undervalue specialized services.

Remaining independent is not about resisting change. It is about protecting your professional identity. Maxillofacial surgery requires autonomy and the freedom to determine what is medically appropriate for your patients. CHRMS supports that autonomy by ensuring you are paid fairly for the work you perform.

You trained for years to gain mastery in this field. You deserve a financial structure that reflects that mastery. With CHRMS, your independence remains secure, your claims receive the attention they deserve, and your revenue reflects your expertise.

Discuss Your Maxillofacial Surgery Practice

Neurosurgeons operate at the highest level of surgical intensity. Every procedure carries serious risk. Every case demands exceptional judgment. Every decision has life-altering consequences. Yet despite the profound responsibility you carry, insurers often apply reimbursement logic that fails to recognize the complexity of neurosurgical care.

The out-of-network environment is especially brutal for neurosurgeons. High-value procedures become targets for reductions. Implant costs get questioned. Bundling errors appear without explanation. And under the NSA, payers frequently impose median in-network rates that ignore both regional data and procedural difficulty. Neurosurgeons deserve better than algorithm-driven reductions.

CHRMS provides neurosurgeons with a powerfully structured approach designed to defend the full value of your work. We understand spine involvement, cranial interventions, multi-level procedures, device considerations, and the documentation required to justify the intensity of neurosurgical cases. We do not accept superficial payer interpretations. We counter them with evidence that stands up to scrutiny.

Our team reviews neurosurgical claims line by line. We identify inaccuracies, reconstruct the clinical narrative, and prepare submissions that clearly demonstrate the necessity and complexity of each intervention. When payers downcode or underpay, we challenge them immediately. CHRMS does not wait for claims to settle. We take the offensive from day one.

When disputes escalate, neurosurgeons gain the additional power of Cohen Howard. Their attorneys are nationally recognized for their success in complex, high-dollar out-of-network surgical cases. This legal advantage creates leverage that neurosurgeons rarely receive from traditional billing or RCM vendors.

Remaining independent as a neurosurgeon requires a partner capable of protecting your financial foundation. CHRMS is built for that responsibility. Our approach reduces uncertainty, strengthens reimbursement consistency, and ensures that your revenue reflects your skill and training.

Your specialty is defined by precision and strength. You deserve a revenue partner that operates with the same level of discipline. CHRMS provides the defense, strategy, and authority required to keep neurosurgeons independent in a system designed to push you toward conformity.

Discuss Your Neurological Surgery Practice

Orthopedic surgery demands precision, strength, and unwavering confidence. You repair the structures that allow patients to move, work, and live their lives. Every procedure, from joint replacement to fracture repair, carries both clinical complexity and the responsibility of restoring function. Yet despite the value you provide, orthopedic surgeons face some of the most aggressive reimbursement suppression in the industry.

Payers know orthopedic cases often involve implants, device costs, multi-line coding, and significant RVUs. That combination makes your specialty a prime target for reductions. The No Surprises Act has only amplified these pressures by giving insurers new tools to justify payment cuts under the banner of median in-network rates. These numbers do not reflect the true cost of orthopedic surgery. They are engineered to favor the payer.

CHRMS exists to stop that.

Orthopedic surgeons who choose to remain out of network need a partner with the power, expertise, and intensity to match the demands of the specialty. We understand implant billing, modifier use, device-driven coding, and the clinical details that define orthopedic complexity. Our team examines every claim as if the practice depends on it, because in many cases, it does.

We fight reductions early. We confront underpayments directly. We rebuild documentation to expose payer inaccuracies. When an insurer attempts to undervalue an orthopedic procedure, we do not respond with compromise. We respond with facts, clinical detail, and the authority needed to challenge flawed payer logic.
And when the dispute moves beyond operations, orthopedic surgeons gain the advantage of Cohen Howard. Their legal team is one of the most formidable forces in out of network arbitration. They understand how to defend device-heavy claims. They know how to dismantle poor payer reasoning. They have the experience required to ensure orthopedic surgeons receive the reimbursement they earned.

Independence is not just a business choice for orthopedic surgeons. It is a quality of life decision. It gives you control over your schedule, your approach, your standards, and your professional future. CHRMS protects that independence by ensuring that every out of network claim is defended with strength and precision.

With CHRMS, orthopedic surgeons never have to settle for inaccurate payments, unreliable benchmarks, or weak representation. You trained for mastery. You deserve a revenue partner that operates with the same level of commitment. Independence remains within your control. We make sure it stays that way.

Discuss Your Orthopedic Surgery Practice

Plastic and reconstructive surgeons deliver outcomes that transform lives. You rebuild form and function after trauma, cancer, congenital conditions, and complex soft tissue injuries. Your work requires artistic precision, surgical excellence, and technical judgment. Yet despite this expertise, payers attempt to trivialize your procedures by categorizing medically necessary surgeries as cosmetic or elective.

These reductions have only intensified under the No Surprises Act, where insurers often try to simplify the complexity of reconstructive surgery into categories that do not reflect the reality of your work. CHRMS is the partner built to stop that narrative.

Plastic and reconstructive surgeons need a team that understands the difference between true cosmetic services and legitimate medical necessity. We review every claim through a clinical lens, analyzing operative notes, history, soft tissue involvement, trauma factors, reconstructive goals, and risk. Our team presents claims so clearly that payers cannot hide behind vague language or inaccurate assumptions.

When insurers misclassify reconstructive procedures, reduce payment based on flawed logic, or ignore legitimate clinical detail, we respond with strength. CHRMS challenges these determinations immediately. We escalate aggressively when required. We do not accept half measures or partial explanations.

And when the situation demands legal reinforcement, Cohen Howard steps in. Their attorneys are recognized across the country for defending reconstructive surgeons in high-stakes disputes. They understand the procedural and legal frameworks needed to counter payer arguments and secure proper compensation.

Remaining independent as a plastic and reconstructive surgeon is not just about financial stability. It is about protecting the integrity of your work. Your specialty requires autonomy. You determine the best reconstructive approach, not a payer using superficial criteria.

CHRMS ensures your revenue reflects the skill and expertise needed for high-level reconstructive care. We eliminate payer interference, reinforce your independence, and strengthen the financial foundation required to keep your practice thriving.

Plastic and reconstructive surgery deserves respect. CHRMS ensures you get it.

Discuss Your Plastic & Reconstructive Surgery Practice

Spine surgery is one of the most challenging and scrutinized specialties in medicine. Your work involves complex anatomy, significant risk, device management, multi-level procedures, and high-value interventions that determine long-term patient outcomes. Yet these same characteristics make spine surgeons a top target for payer reductions.

Under the No Surprises Act, insurers use median in-network rates as justification to underpay high-level spine procedures. They routinely overlook multi-level involvement. They downcode multi-line claims. They ignore device costs. They challenge medical necessity for cases that clearly require surgical intervention. Payers push these reductions because they assume spine surgeons will accept them. CHRMS exists to prove them wrong.

Our team approaches spine claims with precision and authority. We understand decompressions, fusions, ACDFs, disc arthroplasty, minimally invasive techniques, and the full spectrum of spine procedures. We examine documentation with the detail necessary to protect your work and expose payer inaccuracies. We correct coding errors before they become a problem and defend every line item with strategic clarity.

CHRMS makes the first move. We do not wait for payers to dictate the outcome. We challenge reductions, escalate denials, and prepare disputes with the expectation of winning. When the case requires legal intervention, Cohen Howard provides unmatched representation for spine surgeons who refuse to accept artificial limits on reimbursement.

Independence gives spine surgeons the ability to set their own pace, maintain their standards, and control their environment. Out of network operations make sense when supported by a partner built to defend high-value procedures. CHRMS provides that support with a level of intensity that matches the demands of spine surgery.

Payers underestimate the value of your work. CHRMS corrects that. We protect the financial foundation of your practice so you can focus on delivering the exceptional care your specialty requires.

Discuss Your Spinal Surgery Practice

Thoracic surgeons operate in one of the most demanding fields in modern medicine. Every procedure carries serious risk. Every decision has long-term consequences. Whether you are performing a lung resection, repairing trauma, managing esophageal disease, or operating in the mediastinum, the margin for error is nonexistent. The skill required is rare. The responsibility is enormous. Yet payers consistently undervalue the complexity and intensity of thoracic surgery.

The No Surprises Act has only increased the pressure. Insurers frequently apply median in-network rates that do not reflect the true cost or risk of thoracic procedures. They challenge medical necessity even when the need for intervention is obvious. They attempt to simplify complex cases into low-value payment categories. These decisions undermine both the specialty and the independence of thoracic surgeons.

CHRMS exists to stop that erosion of value.

Our team approaches thoracic claims with a deep understanding of the anatomy, pathology, and technical challenges behind each intervention. We know the difference between a straightforward operation and one that requires advanced judgment and intraoperative adaptability. We examine every claim through a clinical lens, ensuring payers understand the specific details that justify full reimbursement.

Thoracic surgeons deserve a revenue partner with the strength, skill, and resolve to fight back against payer reductions. CHRMS is that partner. We do not accept artificially low payments. We do not wait for payers to dictate terms. We challenge inaccurate determinations immediately and position each claim for the strongest possible outcome. Our team works with urgency because your specialty demands it.

And when a case requires legal escalation, thoracic surgeons gain the advantage of Cohen Howard. Their attorneys are nationally recognized for their success in out of network disputes involving complex surgeries. They understand the legal and procedural framework needed to dismantle payer arguments and secure fair compensation under the NSA.

Independence matters in thoracic surgery. Your specialty benefits from an environment where clinical decision-making is guided by what is best for the patient, not what a payer believes is convenient. Out of network status gives thoracic surgeons the freedom to practice medicine at the standard they believe is right. CHRMS protects that freedom by defending your financial foundation with force and precision.

Thoracic surgery requires strength, clarity, and skill. Your reimbursement strategy should reflect those same qualities. With CHRMS, your independence remains intact, your revenue remains defensible, and your practice gains the stability needed to operate on your terms. Payers underestimate the complexity of thoracic surgery. We correct that. We protect your value, your autonomy, and your future.

Discuss Your Thoracic Surgery Practice

Vascular surgeons stand at the intersection of open surgical mastery and advanced endovascular intervention. You manage life-threatening pathology, operate under immense time pressure, and perform procedures that require absolute precision. Your specialty demands technical excellence and rapid decision-making. Yet despite the intensity of your work, payers consistently reduce vascular surgery reimbursement, especially when operating out of network.

The No Surprises Act has intensified these reductions. Insurers often ignore device costs, downplay multi-step interventions, and apply flawed median in-network benchmarks that fail to recognize the complexity of vascular care. These reductions threaten not only revenue, but the independence of vascular surgeons who rely on fair compensation to sustain their practices.

CHRMS is built to counter this entire system.

Our team understands the full spectrum of vascular surgery. We know the complexity behind aneurysm repairs, arterial bypass, stent placement, thrombectomy, venous reconstruction, trauma management, and emergent limb salvage. We know how easily payers misinterpret documentation or oversimplify multi-stage interventions. We rebuild each claim with clinical clarity and strategic detail, ensuring that insurers cannot minimize the work you performed.

Vascular surgeons deserve a partner that operates with the same precision and intensity they bring to the OR. CHRMS challenges reductions immediately. We refuse to accept incomplete explanations or inaccurate comparisons. We take the offensive, not the defensive. We make payers justify their decisions, not the other way around.
And when payer pushback escalates, you gain the legal force of Cohen Howard. Their attorneys have decades of experience defending high-value surgical claims and have established a national reputation for winning complex out of network disputes. Their involvement gives vascular surgeons the advantage needed to secure correct payment under both state and federal NSA frameworks.

Independence is essential for vascular surgeons. Your specialty requires flexibility, adaptability, and control over your surgical approach. Out of network operations provide that control, but only when supported by a revenue strategy capable of matching the intensity of your work. CHRMS delivers that strategy with precision.
With CHRMS, vascular surgeons do not just survive. They strengthen their independence, protect their income, and maintain control over the direction of their practice. The healthcare landscape may push toward consolidation, but vascular surgeons who partner with CHRMS have the leverage, advocacy, and financial support required to remain autonomous.

Your work saves limbs and lives. CHRMS protects the financial foundation that makes that work possible. Independence is not out of reach. With the right partner, it becomes your strongest strategic advantage.

Discuss Your Vascular Surgery Practice