December 21, 2022
by John Gwin

CLIENT QUESTION: OPTING OUT OF MEDICARE – WHAT DO I NEED TO KNOW?

All Medicare beneficiaries, have the right to choose their own doctors and other healthcare providers. But if you are a physician who has opted out of the Medicare program, there are a few things you should know. First of all, what does it mean to opt out of Medicare? Essentially, it means that a physician has chosen […]

November 18, 2022
by John Gwin

CLIENT QUESTION – HOW TO PROTECT AGAINST POST OP PATIENT INSURANCE CLAIMS

THE QUESTION: THE PATIENT HAD TOLD ME THEY’RE OK MOVING FORWARD COSMETIC AND HAVE NOW BILLED THE INSURANCE COMPANY ON THE BACKEND, FORCING US INTO THE BILLING PROCESS. ANY WAY TO AVOID THIS IN FUTURE? We were asked a really good question about insulating against patients submitting self-pay cases to their insurance after the fact- […]

December 1, 2021
by John Gwin

How is Dermatology Billing & Coding Different?

What’s so special about dermatology billing anyways? Dermatology coding isn’t the most complicated thing in the world. The claims amounts aren’t that big per claim. They do a lot of the same stuff. Simple right? You can take the laissez faire route and lose some time, money, and potentially patience (probably also patients). 😱 Or […]

November 4, 2021
by John Gwin

How is Plastic Surgery Billing & Coding Different

The words “plastic surgery” often can conjure thoughts of celebrities attempting to preserve their youth. But plastic surgery isn’t all about “cosmetic” surgery. Not only can a number of traditionally “cosmetic procedures” be covered by insurance (i.e., breast reductions, rhinoplasties, blepharoplasties, panniculectomies, etc.), but many plastic surgeons serve patients seeking strictly medically necessary procedures such […]

October 29, 2021
by John Gwin

How to Handle Authorizations in the Medical Billing Process

Here’s a question for you: A doctor tells a patient they need to schedule a procedure. Whose responsibility is it to get that procedure pre-approved by insurance? Did you guess the MD?  You’re technically wrong, but in all actuality you are correct.  The patient is actually technically responsible for ensuring prior notification and approval are […]

October 6, 2021
by John Gwin

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

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 […]

September 13, 2021
by John Gwin

Why Outsource Medical Billing?

Don’t just outsource medical billing… Outsource is a dirty word! It sounds like you’re faxing your patient information to some foreign company with zero oversight or control and who cares. Find a partner. Find a company / a firm /a team who you trust to be a true custodian of your dollars. Everyone says they’re […]

August 26, 2021
by John Gwin

I Hate Medical Billing and Coding (there’s gotta be an app for that right?)

So…you’re an MD, a medical biller without coding experience, you work at a private practice and have had this terrifying task voluntold to you, or you’ve married into this conundrum and operate as forced labor… Bad news first…I can’t make you a coder…not even a good one…it takes experience (the certification is a +). Good […]

August 20, 2021
by John Gwin

What is Recoupment in Medical Billing? Here’s How to Prevent It

In an ideal world, your medical practice would 100%  accurate billing with no overpayments (valid or otherwise), refund requests, or automated recoupments. Even with 100% accurate billing…you’re still going to receive all of the above.  It is the unfortunate reality of medical billing today.     The good news is, with better understanding of recoupments and […]

July 22, 2021
by John Gwin

What Is The Medical Billing Process?

What’s A Medical Billing…AKA How Does Medical Billing Work? Medical billing isn’t sexy. In fact, it’s complicated and confusing…just like your ex. We wish we could just loan you John (seriously we need a few days away from him…volunteers?)…but hey, billing is a necessary evil in the medical industry today…and I guess job security? Either […]

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