tci Medicare Compliance & Reimbursement - 2010 Issue 18
Reader Questions: Catch Up on Incomplete Claims
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Article Overview
This article explains how a surgical practice should respond when claims contain missing or incorrect information. It focuses on general billing workflow, claim suspension or holding, follow-up with records or clinicians, and the need for internal procedures to manage unresolved claims. The piece is aimed at billing staff, coders, and practice managers who handle claim preparation and clean-claim processes.
Why This Topic Matters
Incomplete claims can delay reimbursement and create avoidable denials. The article helps readers understand the operational importance of identifying problems early and having a consistent follow-up process.
What You Will Learn
- Why incomplete claims are typically not ready for submission
- Common reasons a claim may need to be held or suspended
- How billing teams may follow up on missing information
- Why practices benefit from written procedures for suspended claims
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Surgical practice administrators
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