Practice Management: Monitor Claims to Max Out Your General Surgeons' Pay

Why This Topic Matters

Claims leakage, denials, and delayed follow-up can reduce collections even when coding and billing systems are otherwise current. The article helps practice leaders and billing staff understand which operational checks are commonly used to detect payment problems and support steadier reimbursement.

Article Sections

1. Ensure You’re Getting Contracted Amounts

   Discusses reviewing payer contracts and comparing payments to contracted fee schedules as part of routine claims monitoring.

2. Pre-Check Eligibility

   Covers verifying patient insurance information in advance and being aware of authorization-related administrative requirements.

3. Ensure Timely Patient Communication

   Addresses collecting patient cost-sharing amounts, explaining expected balances, and billing patients promptly after payer payment is received.

4. Monitor and Manage Claims Denials

   Focuses on tracking denied claims, using reports to identify unpaid claims, and separating delayed items from the normal claims workflow.

5. Perform A/R Aging Reports

   Describes using accounts receivable aging reports and month-end closeout routines to monitor unresolved balances and payer response patterns.