Blog posts by John Gwin

We stay up to date on the ever-changing insurance market's impacts on your specialty for you...because it's basically a full time job in and of itself.

October 3, 2025
by John Gwin

Denials in Medical Billing: Causes, Codes, and How to Fix Them

Denials in Medical Billing: Causes, Codes, and How to Fix Them Every denied medical claim costs time, money, and resources.  Denials in medical billing can disrupt cash flow, increase administrative work, and leave patients frustrated when services aren’t covered as expected. Recent studies show that nearly 12% of medical claims are initially denied, and hospitals […]

September 25, 2025
by John Gwin

CPT 15830: Complete Guide to Billing

CPT 15830: Complete Guide to Billing CPT 15830 is the code for the removal of excessive abdominal skin and fat below the belly button, known as an infraumbilical panniculectomy.  This procedure is often performed after significant weight loss or when an abdominal pannus causes medical issues such as infections, rashes, or difficulty with mobility. Insurers […]

September 23, 2025
by John Gwin

Out-of-Network PPO Patients & The No Surprises Act: The Only Guide You Need

Out-of-Network PPO Patients & The No Surprises Act: The Only Guide You Need Out-of-Network PPO Patients & The No Surprises Act Insurance billing is about as fun as dental work without anesthesia. Out-of-network (OON) PPO benefits? Even murkier. Luckily, federal law—the No Surprises Act (NSA)—finally tilts the scale in your favor (sometimes). This guide lays […]

September 19, 2025
by John Gwin

CC Services QA: Your No-Nonsense Guide to Payer Contracting

CC Services QA: Your No-Nonsense Guide to Payer Contracting Where Do I Start? Let’s start with your strategy. We have to decide who you want to get in-network with and why! Should I Take Medicare? Medicare is a major government payer serving largely the 65+ age range. So, if you’re serving a population even partially […]

September 17, 2025
by John Gwin

CPT 15839: What You Need to Know

CPT 15839: What You Need to Know If you work in medical billing or run a practice that offers plastic or reconstructive surgery, you’ve probably come across CPT 15839.  And like most CPT codes, it’s more than just numbers, getting it right can mean the difference between reimbursement and denial.  Here’s a complete breakdown of […]

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