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 […]

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 charge self-pay right? Enter lipedema, a […]

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 […]

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, 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 […]

You may have heard about the new legislation surrounding “Price Transparency” in 2022, effective January 1. I put that in quotes for a reason. I may be a bit of a skeptic, but this new law is nothing more than insurance carriers pushing reimbursement rates lower with “price transparency” and “helping patients” as a rather […]

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 […]

Anything and everything you’ve ever wanted to know about global human illnesses is explained and categorized in the new and improved International Classification of Diseases AKA ICD-X. The 11th edition, which was presented by the World Health Organization (WHO) in May 2019, will go into effect January 1, 2022. So why does this matter? It’s […]

Protect Your Medical Practice Do you know why healthcare regulatory attorneys exist..or malpractice attorneys to that end? Why do medical billing companies exist? Why do MACRA/MIPS consultants exist? Why healthcare has hundreds of industry-specific software programs exist just to run a medical practice? Why do thousands of plug-in programs exist? The list goes on. Healthcare […]

Hi Auctus Clients, The Auctus Group is committed to ensuring that you have the most up to date information about COVID-19. Here is some information you need to know regarding SBA loans and Telehealth. [WEBINAR TODAY]  How the Corona Virus will Impact Telehealth Insurance Reimbursements & Encounters: Plastic surgeons and other aesthetic doctors are searching for guidance […]