Medivanced’s Surgery Medical Billing Services are specifically designed to meet the complex billing needs of surgical practices across various specialties, including General Surgery, Orthopedic Surgery, Cardiothoracic Surgery, Neuro-Surgery, Vascular Surgery, and Trauma Surgery. We deeply understand the intricacies of surgical documentation, the Global Surgical Package rules, and the high-value nature of these claims. Our expert team ensures that your surgical practice receives accurate and timely reimbursement for all preoperative, intraoperative, and postoperative services. We manage the entire billing cycle, allowing your surgeons and support staff to focus entirely on optimal patient outcomes and surgical excellence while we handle the demanding financial aspects.
Medivanced manages the complete credentialing and enrollment process for surgeons and surgical groups. From the initial preparation of applications to diligent follow-ups and facility privileges confirmation, we ensure your surgeons are successfully credentialed and authorized to bill all major commercial, Medicare, and Medicaid payers. We stay current with all payer-specific regulations and compliance standards related to surgical payment. Once your surgeons are approved, we seamlessly integrate their credentials with our billing operations, ensuring efficient claims submission for both facility-based and office-based procedures and uninterrupted revenue flow.
Our certified coders are specialists in surgical coding, proficiently applying the most current ICD-10 (for diagnoses of conditions requiring surgery), CPT (for surgical procedures), and HCPCS codes. Whether it involves complex coding for robotic surgery, billing for assistant surgeons (modifier -80), correctly applying the multiple procedure discount rule (modifier -51), or navigating the intricacies of the Global Surgical Package, we ensure every detail of the surgery and associated care is accurately captured and billed. By strictly adhering to modifier rules, operative report documentation requirements, and medical necessity standards, we significantly reduce claim denials and maximize appropriate reimbursement for every surgical encounter.
Medivanced provides end-to-end Revenue Cycle Management (RCM) for surgical practices, overseeing every step from pre-authorization for procedures to managing the post-operative period and final payment posting. Our proactive RCM approach actively identifies potential revenue leaks, improves the accuracy of charge capture (especially for facility charges and supplies), and meticulously tracks critical Key Performance Indicators (KPIs) such as initial denial rates, days in accounts receivable (AR), and collection efficiency. We are dedicated to stabilizing your practice’s cash flow and ensuring its robust financial health while your focus remains on surgical care.
Our specialized denial management team works tirelessly to recover revenue from denied or underpaid claims common in high-value surgical billing. We continuously monitor all rejected claims, accurately identify the fundamental root causes of denials (e.g., lack of proper pre-authorization, inadequate documentation of medical necessity in the operative report, or unbundling errors), and implement rapid corrective measures. We promptly resolve issues related to incorrect coding, missing clinical or operative documentation, or complex payer-specific guidelines to quickly recover lost revenue. We also provide comprehensive denial analysis reports, offering valuable insights into common denial patterns to help your surgical team refine documentation and reduce future denials.
Outsourcing allows your surgical team to dedicate their energy entirely to clinical activities, operating room efficiency, and patient recovery.
Outsourcing allows your surgical team to dedicate their energy entirely to clinical activities, operating room efficiency, and patient recovery.
Eliminate the substantial overhead costs associated with hiring, training, and retaining an in-house billing team with advanced surgical coding expertise.
We expertly handle the complexity of coordinating surgical claims, managing the global package, and dealing with facility billing interfaces.
Our certified coders ensure precise use of surgical CPT codes and modifiers, which is critical for reimbursement and minimizing audit risk.
Medivanced strictly adheres to all HIPAA, OIG, and specific payer regulations, especially those governing the global surgical period and assistant surgeon billing.
We possess deep, current knowledge of the nuanced coding and documentation rules required for high-reimbursement surgical procedures.
Our services can easily scale to support a solo surgeon's practice or a large multi-specialty surgical group spanning several hospitals.
We utilize cutting-edge billing software and ensure seamless integration with most major EHR (Electronic Health Record) and EPR (Electronic Patient Record) systems used in surgical settings.
Transparent, accurate billing practices lead to fewer post-op financial surprises, enhancing the overall patient experience.
Our fully compliant systems ensure that all protected health information (PHI) is managed with the highest level of security.
Through rigorous quality assurance and specialized surgical auditing, we maintain a high first-pass clean claim rate.
Our expert RCM strategies help optimize reimbursement rates for complex surgical cases, significantly boosting profitability.
Medivanced integrates effortlessly with all prominent EHR/EMR and practice management systems used by surgeons, automating eligibility checks, claim submissions, and payment postings. Our Accounts Receivable (AR) team is proficient in managing the surgical payment lifecycle, diligently monitoring aging reports, aggressively following up on outstanding claims, and ensuring timely reconciliation of payments. We provide transparent AR reports that highlight critical payer trends, underpayment issues, and specific opportunities to optimize the revenue cycle management for your surgical practice.
Medivanced provides real-time, customizable dashboards and detailed financial reports specific to surgical practices. Key performance indicators (KPIs) tracked include average reimbursement per surgical case, denial rates by surgeon/procedure, and total collections vs. target. These data-driven insights empower your practice leadership to make informed decisions that enhance operational efficiency and profitability.
Our Surgery Medical Billing Services are precisely tailored to the specific needs of various surgical groups, covering:
We guarantee strict compliance with complex operative report and medical necessity documentation requirements to maximize reimbursement for all surgical services.
We offer responsive, round-the-clock support for any urgent billing questions, sudden claim issues, or critical payer inquiries. Available via phone, email, or our secure client portal, our team is committed to supporting your practice’s financial operations whenever needed.
Medivanced offers continuous education and training for your administrative and clinical teams on the latest updates in operative note documentation, CPT code changes for new surgical techniques, proper use of modifiers during the global period, and overall billing compliance standards. This training is crucial for minimizing errors and ensuring maximum compliant reimbursement.
Each surgical practice receives a dedicated Account Manager who serves as a primary point of contact, tracks performance against financial targets, and ensures effective communication between your administrative team and our billing specialists. Your account manager will proactively collaborate with you to identify areas for improvement and streamline the entire surgical claims and collection process.
Surgery Medical Billing Services manage the complex revenue cycle for surgical procedures, focusing on correct coding, application of the Global Surgical Package rules, pre-authorization, and claim submission for high-value surgical cases.
We can typically begin within 2–4 weeks, depending on the time it takes for credentialing and EHR integration.
No, Medivanced integrates seamlessly with all major EHR and EMR platforms without requiring any changes to your current system.
Our certified team conducts multi-level audits, compliance reviews, and uses automated quality assurance processes to ensure 99% accuracy in billing.
We offer flexible pricing options—either percentage-based or flat-rate per claim—tailored to your podiatry practice’s structure and size
