Cardiothoracic billing built around the operative episode.
Cardiothoracic surgery claims bring together a detailed operative record, several practitioners and care before and after surgery. We help surgical groups organize those elements into a supported professional claim and follow up when the payer bundles, reduces or requests more information about the service.
- ClaimsDocumentation review
- A/RPayer follow-up
- ReportsClear next actions
Three ways Cardiothoracic 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.
- Practitioner roles are unclear
Primary, assistant and co-surgeon roles need support in the record and must meet the applicable reporting requirements. We ask for clarification instead of selecting a modifier by habit.
- Procedure detail is lost in a short charge description
The operative note may describe work that a brief charge entry does not capture. We review the documented procedures and applicable coding relationships together.
- Postoperative care is reported without context
Visits during a surgical period need review against the procedure and reason for the encounter. We do not assume every follow-up is separately payable.
What we bill for cardiothoracic surgery teams
If something you do is not on this list, ask. We will tell you honestly whether we have the depth for it.
How Cardiothoracic Surgery accounts are actually run
The worklist connects each claim to its documentation, payer requirements and next follow-up date.
- Map the episode and practitioners
We confirm the surgeon group, facility relationships and records needed for each case.
- Read the operative report with the charges
Procedure details and practitioner roles are checked before claim submission.
- Review bundling and payer requests
We compare the response with the supported service and determine whether correction or appeal is appropriate.
- Close the episode with clear accounting
Payments and adjustments are reconciled, with unresolved professional balances kept on the worklist.
Included for cardiothoracic surgery teams
- Charge review against the clinical record
- Eligibility and benefit checks within the agreed scope
- Submission and rejection follow-up
- Payer denial review and supported appeals
- Payment posting and balance reconciliation
- Aged receivable review
- Specific documentation queries for your team
- Reporting on outstanding work and next actions
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.
Cardiothoracic Surgery billing across the country
These state guides explain local Medicaid programs and payer administration. They cover general billing requirements, rather than a separate Cardiothoracic 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 cardiothoracic surgery teams ask
Can you review co-surgeon claims?
Yes. We review the recorded roles, procedures and payer requirements. A shared operation does not automatically qualify for co-surgeon billing.
Do you also bill the hospital’s charges?
Not under this professional-billing scope. Hospital charges and the surgeon’s professional services are separate.
Can postoperative visits be billed separately?
It depends on the service, surgical period, documentation and payer rules. Each case needs a supported review.
Let’s review your cardiothoracic surgery billing
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.