WHAT’S THE DEAL WITH LIPEDEMA BILLING? Covering “borderline” or “grey area” procedures is a constant struggle in plastic surgery billing. Certain insurance companies do certain things. Lines are blurred. Rules are changed. The landscape is ever-changing. Even if you can get something covered, who the heck knows what you’ll be paid…certainly not what you would […]

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 […]

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? […]

Should I Use A Collections Company / Agency As enticing as sending out “Bruno with the Bat” may sound…there’s a bit more thought to put into the uncollected patient balances you have for more reasons than one. So should you use a traditional/true collections agency? IMHO…you need one…but you shouldn’t be using them if you […]

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 […]

An optimized medical billing process has streamlined payments for all parties. Of course, even the most well-oiled machines quickly grind to a halt when denials occur.

When a provider receives payment over the amount payable for a service rendered, they have received an overpayment.

While overpayment happens in every practice, it creates problems when left unaddressed. Insurance companies typically issue the overpayment, but overpayment can sometimes come from the patient via excessive co-pay.

Big changes to Acellular Dermal Matrix (ADM) Medical Policies! As an aside – we are not affiliated with, making any recommendations regarding, or suggesting superiority of brands in any way. For a long time, Alloderm has been the only allowed ADM.  Other venders and brands have been considered “experimental.”  Dermacell, another prevalent brand in the marketplace, […]