Blog

Running plastic surgery billing in-house isn’t one hire — it’s a full revenue-cycle system. Here’s the whole machine, end to end.

In-house or outsourced plastic surgery billing — the real trade isn’t cost. It’s who owns your AR, your follow-up, and your denials.

Outsourced or in-house billing for your dermatology practice? The real cost, where revenue leaks, and five questions to answer before you switch.

On January 1, 2026, Medicare cut skin substitute pay ~90% to a flat $127.14/cm². What survives for plastic surgery and dermatology — and what doesn’t.

The Core Problem: One Code, Many Techniques The technique changes depending on the patient. The CPT code doesn’t. For top surgery — augmentation, reduction, mastectomy with nipple reconstruction — reimbursement is tied to the standard diagnosis for that procedure type. A reduction for macromasty and a reduction for masculinization carry the same code, same reimbursement, […]

What Is a Good Clean Claim Rate? Ninety-five percent. That’s the floor. The reciprocal is a 5% denial rate — which sounds manageable until you see how many follow-up hours that 5% generates downstream. Most practices below 95% aren’t losing to payer behavior. They’re losing to their own intake process. Three variables move this number […]

In plastic surgery billing, accounts receivable, often referred to as AR, rarely deteriorates overnight. More often, AR slowly drifts. Denials increase, aging stretches out, cash flow tightens, and leadership assumes it is a payer issue. AR is a slow burn… once you notice a fire is it often too late or at least you’ve lost […]

Medicare Prior Authorization for Ambulatory Surgical Centers: What You Need to Know (2025 Update) Oh, 2025. Just when you thought you’d finally made peace with paperwork, CMS pulls a rabbit out of its regulation hat—another prior authorization rule, this time for ambulatory surgical centers (ASCs) in ten of America’s biggest, boldest states. Spoiler alert: If […]

The Future of Medical Billing Technology Is Already Here Remember when “AI” sounded like something from a sci-fi movie? Yeah, same. Now it’s sitting in your billing software, quietly doing more in five seconds than a human could in five hours — without the caffeine dependency. Artificial Intelligence (AI) and Machine Learning (ML) are no […]

Senjie Tayactac – Authorization Team Lead Ever met someone who can juggle patient authorizations, wrangle clinical notes, troubleshoot queues, and still be a devoted mum of three? Meet Senjie Tayactac — our powerhouse Authorization Team Lead who’s redefining the word multitasker. Dinner Date with a Side of Heart If Senjie could share a meal with […]