rcm solutions General Surgery facilities

Medical Billing And Revenue Cycle Management Solutions For General Surgical Facilities

General surgeons encounter a varied set of billing challenges, from intricate procedural coding to navigating authorization requirements and payer-specific documentation rules. At StafGo Health, we provide specialized end-to-end medical billing and revenue cycle management (RCM) solutions tailored for general surgery practices. Our team has comprehensive knowledge of the complexities of surgical billing and tries to solve all the problems related to denials and optimize reimbursements.

Expert CPT Coding & Modifier Management With Stafgo Health

At StafGo Health, our team is an expert in handling the complexities of general surgery revenue cycle management, including the proper use of key CPT codes. Commonly used CPT codes in general surgery include 44950 (appendectomy), 49505 (inguinal hernia repair), 47562 (laparoscopic cholecystectomy), 44140 (colectomy), 43235 (upper gastrointestinal endoscopy), and 49082 (abdominal paracentesis). Our certified coders ensure the correct use of modifiers such as -51, -59, -78, and -22 to reflect multiple procedures, distinct services, repeat procedures, or increased procedural complexity.

Why Outsource Medical Billing And RCM To Stafgo Health For Your General Surgical Practice?

A medical billing and revenue cycle management partner can help your billing staff by performing periodic audit risk assessments, helping minimize compliance issues, and helping your practice bill more efficiently and effectively. Depending on your general surgery practice’s needs, your practice may also benefit from outsourcing all or part of your billing, coding, and revenue cycle processes. By partnering with StafGo Health, your practice benefits from improved cash flow, reduced claim rejections, and more time to focus on surgical care, not paperwork.

Common RCM Challenges Faced by General Surgery Practices

There are numerous billing and RCM challenges that General Surgery practices encounter that can impact efficiency and financial stability if not managed correctly.

Complex and High-Volume Coding Requirements - Misuse of CPT codes or modifiers that involve a wide range of procedures of general surgery can lead to denials or reduced reimbursements.
Pre-Authorization and Medical Necessity Issues - In General Surgery Practices, major surgeries require prior authorization and detailed or accurate documents of medical necessity. Delay in this process can lead to delayed payments.
Coordination with Multiple Providers and Facilities - In General Surgery Practices, surgeons provide services at various places like hospitals, ASCs, and clinics. Managing and coordinating billing across different locations is very challenging for them.
High Denial Rates and Rework Load - In General Surgery Practices, Surgeons usually experience higher denial rates because of complex and complicated documentation and coding demands due to which they have to rework on certain claims.

Insurance Plan Variability - Different insurance companies have different plans and navigating their different requirements, reimbursement rules, and fee schedules adds extra administrative burden on office staff, which increases the risk of errors.

Solving Your General Surgery Practice’s Challenges with StafGo Health

Expert Surgical Coding & Modifier Use - At StafGo Health, we have a team of certified coders who are well-versed in the application of complex codes and modifiers. They ensure the accuracy of claims and reduce the chances of claim denials due to coding errors.

Prior Authorization Support - Our team handles pre-authorizations on time by gathering all the essential documents, verifying medical necessity, and submitting the claims to the payer quickly.
Multi-Location Coordination - Our team of experts works collaboratively; whether you operate in hospitals, surgery centers, or clinics, we can streamline your billing process efficiently by ensuring claim submissions from all settings to maintain billing accuracy.
Denial Management & Appeals - Our team of experts proactively understands the reasons for denials, finds out the root cause, and works on quick resubmissions to recover the revenue and improve the claim acceptance ratio.
Insurance Verification & Fee Schedule Management - At StafGo Health, our team stays updated with the changes to the payer guidelines and policies, and they also make sure that claims are submitted based on accurate contract rates and reimbursement structures.