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.
Effective 08/13/22, Cigna is pulling sooooooome shiiiiiiiiiiiit as it pertains to Modifier 25. Every claim with Mod 25 will require medical records for review. EVERY. SINGLE. CLAIM. “How the heck can they feasibly review all those records in a timely fashion,” you say? I have created a short video to outline how I expect this […]
THE ANSWER: How many patients who come to you for a “septoplasty” have zero desire for a positive aesthetic outcome? Like they care 0% about how they look after surgery and are seeing you solely because their deviated septum has robbed them of their ability to breathe? None. They might say they don’t care, but […]
Rumored to be in existence, thought not to be…rare as the Tasmanian Tiger…the mythical Medicare Authorization does indeed exist. Worse yet, you need to know how to handle it, even though it technically is not a requirement for professional service providers (AKA Docs). So…what are we talking about here? As of 2020 Medicare started requiring […]
“The day you can fire me is one of the happiest days in our relationship” – Famous last words from John Gwin, CEO of The Auctus Group But seriously…why should you care? You’re a cosmetic / aesthetic surgeon. You’re making 2-3K+ per hour. Why would you ever lose money to deal with insurance? …Because you […]
THE ANSWER: Almost all payers, including Medicare/Medicaid DO cover/WILL cover REMOVAL of implants placed for any reason w/ Bakers III+ and/or Rupture. PAY ATTENTION HERE: they cover ONLY removal of implant/extracapsular material, perhaps capsulectomy/capsulotomy, and NOT revision/replacement UNLESS there’s a personal history of breast cancer or mastectomy for prophylaxis. So…tell that patient we can […]
Raise your hand if you want to go to school for 15 years and then stand for 8 hours turning a stomach into a breast and get paid $500 per hour for your expertise? Are you familiar with microvascular anastomosis? Yeah, you gotta do that stuff too. Do you skeletonize vessels in your free time? […]
SO THIS IS WEIRD…A BIT ABOUT US So, I have a Google Alert setup for our company, and in the past few weeks I’ve gotten some alerts that these random sites are writing about us… Looks to me like they are semi-bogus sites trying to push folks to buy these “market research” reports, which I’m […]
Search engines handle approximately 2.45 million searches for health-related topics, and over 100,000 searches for “plastic surgery” every month. Just think about what the right search engine optimization (SEO) strategy can do for your plastic surgery practice. SEO is using a set of practices to improve the positioning and appearance of your web pages. It […]
THE QUESTION: I’M THINKING ABOUT HIRING A NURSE PRACTITIONER OR PHYSICIAN ASSISTANT…HOW DOES THE BILLING WORK? THE ANSWER: Great question! Long answer…I’m going to make more questions than I answer here I think… Can the midlevel bill under the MD? In short, yes…but you have to be careful and adhere to the regulatory guidelines. This […]
So, I got an email from a client, with a great question and thought I would share our reply! The Question: What the average insurance pay-out is for a small in office cyst or lipoma removal. Wondering if we should be submitting or billing cosmetically? The Answer: Good question. They are medically necessary procedures typically […]
