Who Cares If You Specialize In Plastic Surgery / Dermatology Billing?

October 6, 2021
by Admin

Really? Who cares if you’re a plastic surgeon or a dermatologist? You all just cut stuff right?

No, no I’m totally cool with a proctologist working on my rhinoplasty, because it’s basically the same. Yeah, I’d love a podiatrist to Coolsculpt my pannus with a toenail clipper…no big deal if my gut looks like a toe.

We specialize because it makes us better at what we do. Isn’t that why you do what you do the way you do it? I’m not knocking generalists, but when we focus, we can excel.

OK, fine. What do you do better with plastic surgery billing?I

In a word – coding. Everyone thinks coding is reading an op report and deciding what code to bill. And everyone is wrong. Coding is a skill every biller needs to possess, whether they are generating charges, reviewing payments, or working unpaid claims.

Charges – you gotta code it right to get paid right.

Payments – you gotta know if it’s coded right to know you’re paid right.

Nonpay – you gotta know it’s coded appropriately to argue to get it paid appropriately.

Outside of that, you expect plastics/aesthetic practices to have a fair amount of cash-pay/retail data in their systems, which means credits, dummy codes, quotes, sales, and everything that comes with the sales end of medicine (that’s what we are like it or not). We see it and we get it.

Also – plastics is scrutinized for “medical necessity” in a way no other specialty is. Additionally, what a plastic surgeon does is inherently concentric to aesthetic. The line between functionally/medically necessary and aesthetically desired is grey. Does your biller know when capsular contracture is severe enough for insurance to pay for a capsulectomy/explant? Does your biller know how to maximize your reimbursement for use of a tissue perfusion device on a micro case? Do they know how to help you document the difference between a myo/fascio flap and an adjacent tissue transfer? Hey, it’s your money, but if they don’t, you should probably care more.

What if I’m a dermatologist or medspa owner?

The above applies to a MUCH simpler extent from a coding context. With all due respect, derm coding is like a vicious pint-sized dog that lost its teeth…it’s just kinda cute, but you still have to pay attention or it will nip you. The coding matters as does the familiarity with cash-pay/retail revenue transactions/structures.

However, the key with derm billing is really clean claims. Scrutiny is lower on most charges, and volume is through the roof so it is all about getting your money in the door accurately on the first pass. We know this because we do it. So why not use a standard billing company if it is so easy? Easy. They won’t know your software. They won’t know dual revenue structures. They won’t know your practice. See if your rep knows what “blue light therapy” is. They probably think Levulan is a brand of escalator or a character from Star Trek.

OK, so you’re a plastic surgery / dermatology billing specialist? Prove it.

No problem. We’ll get an NDA/BAA signed and do a 100% commitment-free scope of your system delivering numbers, visuals, and a synopsis of what we can actually do based on your situation. Actually, we’ll offer this at no charge to any MD as a way to give back to the community.

Not good enough? We’ve developed an AAPC certified plastics coding program we put our team through because they shut down the certification. Also, Karen Zupko thinks we’re pretty cool so top that!

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