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Episode 1: Inside Global Surgery’s Medical Billing Challenge
A conversation about the hidden mechanics of medical billing, how a routine surgery can create a 90-day billing window, and the coding, scheduling and payer issues that can affect reimbursement. Hosted by Sarah Mitchell and Michael Carter.
MZ Medical Billing Podcast Season 1, Episode 1
Inside Global Surgery’s Medical Billing Challenge
with Sarah Mitchell & Michael Carter
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What this episode is about
In this episode, Sarah and Michael break down a general surgery billing case involving laparoscopic gallbladder removal and the financial problems that can develop after the procedure is performed. They explain how the 90-day global surgery period affects preoperative visits, medical coding and postoperative care, and how billing workflows can cause practices to miss legitimate reimbursement or create compliance problems.
The conversation covers Modifier 57 for the decision to perform surgery, Modifier 22 when a procedure requires substantially more work than expected, coding differences between 47562, 47563 and 47564, and Modifier 24 for unrelated visits during the global period. They also discuss how scheduling workflows, EHR defaults and payer-specific rules can affect claim submission, including the different requirements that may apply to Washington workers’ compensation claims.
Sarah and Michael then walk through how MZ Medical Billing identified these issues, changed the medical billing workflow and recovered revenue that had been missed or incorrectly handled.
When administrative friction is accepted as a natural law of the universe, you stop looking for the leaks.
Who's talking
Sarah Mitchell
Sarah spends her days inside coding architecture and payer rulebooks, translating them into workflows a front desk can actually run.
Michael Carter
Michael asks the questions a practice administrator would, always pressure-testing an idea against a real, busy clinic day.
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