John Gwin, Author at The Auctus Group

Eloisa Ylanan – Operations Coordinator

Eloisa Ylanan – Operations Coordinator Dinner with Anyone, Ever? Albert Einstein. Eloisa isn’t trying to solve quantum physics, but she is solving daily chaos like a pro. She admires Einstein’s ability to question everything and think outside the box—two traits that come in handy when managing portal requests and tackling unexpected curveballs. She’d pick his […]

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 […]

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 […]

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 […]

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 […]

September 11, 2025

by John Gwin

Plastic & Reconstructive Surgery Billing Services

Plastic & Reconstructive Surgery Billing Services Billing for plastic and reconstructive surgery isn’t straightforward. Unlike other specialties, surgeons here deal with both cosmetic procedures and reconstructive cases. Insurance carriers demand strong proof of medical necessity, pre-authorizations are frequent, and coding mistakes can lead to costly denials. Practices that don’t specialize in this type of medical […]

August 29, 2025

by John Gwin

Stop Billing Like a 1099 in 1999: The Right Way to Set Up Insurance Contracts (EIN, GNPI, INPI & More)

Stop Billing Like a 1099 in 1999: The Right Way to Set Up Insurance Contracts (EIN, GNPI, INPI & More) Let’s talk about a tale as old as time. A well-meaning provider launches a practice, gets credentialed under their Social Security Number (SSN) and individual NPI (INPI)… or, equally messy, their SSN with their group […]

August 28, 2025

by John Gwin

Dermatology Coding Guidelines (2025 Edition)

Dermatology Coding Guidelines (2025 Edition) Accurate dermatology coding is the foundation of clean claims, faster payments, and fewer denials. With new 2025 updates, understanding the right CPT and ICD-10 codes matters more than ever. This guide explains the latest dermatology coding guidelines, common pitfalls, and practical tips for better medical billing. 2025 Dermatology Coding Updates […]

August 21, 2025

by John Gwin

Dermatology Billing Company: How to Choose the Right Partner for Your Practice

Dermatology Billing Company: How to Choose the Right Partner for Your Practice Running a dermatology practice isn’t just about seeing patients, it’s also about getting paid for the work you do. And that’s where choosing the right dermatology billing company makes all the difference. Dermatology billing is notoriously complex. Between lesion counts, biopsy codes, modifier […]