A surgical claim is one chance to get four things right.
The global period, the assistant, the multiple procedure reduction and the modifier all land on the same claim. Any one of them wrong and the episode underpays without ever being denied.
- 97%Coding accuracy on audit
- 50+Specialties covered
- 4.9/5Average client rating
Three ways General Surgery claims quietly lose value
Review these issues against the documentation, remittance and policy that applied on the date of service. They can appear as denials or underpayments.
- Global periods misapplied
Major procedures carry ninety day globals. Related visits inside them are bundled and unrelated ones are payable, and telling the two apart is a documentation job.
- Assistant at surgery not billed
When an assistant is documented and allowed by the payer, that is a real claim. Most practices never submit it.
- Multiple procedure reductions accepted without checking
Secondary procedures are reduced by rule, but payers also reduce things they should not. Nobody catches it unless somebody checks the allowed amount.
What we bill for General Surgery practices
If something you do is not on this list, ask. We will tell you honestly whether we have the depth for it.
How General Surgery accounts are actually run
The worklist connects each claim to its documentation, payer requirements and next follow-up date.
- A general surgery coder, not a general one
The coder assigned to your account works general surgery every day. They already know which of your payers do what, and they are watching global periods, multiple procedure rules and assistant modifiers.
- Charges checked against the note
Before anything goes out, the charge is read against the documentation. A code the note does not support is a recoupment waiting to happen, and in general surgery it is usually the highest value code on the claim.
- Eligibility and authorization ahead of the visit
Coverage is confirmed and any approval is in place before the service, not discovered afterwards when the work has already been done.
- Denials worked to cause, not just refiled
Every denial is tagged by payer and reason code. When a pattern shows up in your general surgery claims we change the upstream step so it stops recurring.
- Reporting you can act on
Monthly numbers by procedure family and payer, with the one decision they imply, rather than an export nobody opens.
Included for General Surgery practices
- Coders who work general surgery daily
- Charge review against documentation
- Eligibility and benefit verification
- Prior authorization management
- Denial management by payer and reason code
- Aged A/R worked oldest first
- Patient statements and balance follow up
- Monthly reporting by procedure family
These describe how we run the service. They are commitments about our process, not a guaranteed outcome on any individual claim.
We work inside the system you already use
We agree user permissions, claim queues, reporting access and escalation contacts in your current system before work begins.
General Surgery billing across the country
These state guides explain local Medicaid programs and payer administration. They cover general billing requirements, rather than a separate General Surgery service in each state.
Arizona payer guideAHCCCS and 7+ plans
Washington payer guideApple Health and 7+ plans
Texas payer guideTexas Medicaid and 8+ plans
New York payer guideNY Medicaid and 8+ plans
California payer guideMedi-Cal and 8+ plans
Ohio payer guideOhio Medicaid and 8+ plans
Florida payer guideFlorida Medicaid and 8+ plansWhat General Surgery practices ask
Do you check what the payer actually allowed?
Yes. Underpayment is a bigger number than denial in surgical billing and it is invisible unless someone reconciles it.
Can you bill for the assistant?
Yes, where the documentation and the payer policy support it.
How do you track global periods?
Per episode, per patient, so a visit inside a global is flagged before it is billed.
Do you handle emergency consults?
Yes, including the place of service and the consult rules that vary by payer.
Have a general surgery coder read your last ninety days
Tell us your specialty and the billing issue you want reviewed. We will agree the scope and arrange a secure way to share any records needed.