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 […]

December 13, 2022
by John Gwin

Top 5 Things a Breast Reconstruction Patient Should Know/Do About Their Insurance  Coverage:

1. Women’s Health Rights and Cancer Act – you are protected folks.  This is a Federal Mandate.  So all the games insurance companies play hold even less water here.  You are protected for reconstruction (or not) at ALL STAGES including the contralateral breast.  The language of the mandate doesn’t answer every question or address every […]

April 16, 2022
by John Gwin

CLIENT QUESTION: IMPLANT EXCHANGE COVERAGE – WHEN CAN I BILL INSURANCE?

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 […]

April 8, 2022
by John Gwin

THE SLOW AND PAINFUL DEATH OF DIEP FLAP

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? […]

March 3, 2022
by John Gwin

SO THIS IS WEIRD…

So, I have a Google Alert setup for our company (thank you to our lovely marketing company GMG for the 🔥 tip)…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 […]

February 11, 2022
by John Gwin

CLIENT QUESTION: HOW DO I BILL FOR A MIDLEVEL PROVIDER LIKE AN NP OR PA?

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 […]

January 11, 2022
by John Gwin

What is Medical Billing and Coding? Your Questions Answered

Medical billing and coding are essential to running a practice. These systems impact patient safety and accounts receivable, as well as operations and efficiency. If not optimized, coding can directly affect your bottom line.

This blog explores common medical billing and coding challenges and provides suggestions for improvement.

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 26, 2021
by John Gwin

What You Need to Know About Medical Bookkeeping

Not sure what medical bookkeeping is?  Don’t sweat it, just reconcile the books against the bank account and 90% of docs won’t know the difference. Reports get generated.  Bills get paid, Taxes get filed.  People go home happy. 👍 That’s good enough, right? Medical bookkeeping isn’t just bookkeeping for the medical industry.  It isn’t just […]

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 […]

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