I don't currently have any ortho providers but when I did they never met the guidelines for a comprehensive exam. I am assuming you are talking about the new and consults.
It was always very frustrating to them and me since many of those elements of exam are not medically necessary in a lot of ortho exams. On the other hand, they weren't the best documenters either.
Do any of your providers spend a lot of time with the patients? That would be one way they may qualify for a 4, if they document time properly.
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