In plastic surgery billing, accounts receivable, often referred to as AR, rarely deteriorates overnight. More often, AR slowly drifts. Denials increase, aging stretches out, cash flow tightens, and leadership assumes it is a payer issue. AR is a slow burn… once you notice a fire is it often too late or at least you’ve lost […]

Medicare Prior Authorization for Ambulatory Surgical Centers: What You Need to Know (2025 Update) Oh, 2025. Just when you thought you’d finally made peace with paperwork, CMS pulls a rabbit out of its regulation hat—another prior authorization rule, this time for ambulatory surgical centers (ASCs) in ten of America’s biggest, boldest states. Spoiler alert: If […]

The Future of Medical Billing Technology Is Already Here Remember when “AI” sounded like something from a sci-fi movie? Yeah, same. Now it’s sitting in your billing software, quietly doing more in five seconds than a human could in five hours — without the caffeine dependency. Artificial Intelligence (AI) and Machine Learning (ML) are no […]

You know what’s more complicated than medical billing? Explaining it to someone who’s never seen an EOB (Explanation of Benefits). But buckle up, because the next generation of billing tech is about to make that complexity look like child’s play — or, better yet, make it disappear. The world of healthcare billing is evolving faster […]

Out-of-Network PPO Patients & The No Surprises Act: The Only Guide You Need Out-of-Network PPO Patients & The No Surprises Act Insurance billing is about as fun as dental work without anesthesia. Out-of-network (OON) PPO benefits? Even murkier. Luckily, federal law—the No Surprises Act (NSA)—finally tilts the scale in your favor (sometimes). This guide lays […]

CC Services QA: Your No-Nonsense Guide to Payer Contracting Where Do I Start? Let’s start with your strategy. We have to decide who you want to get in-network with and why! Should I Take Medicare? Medicare is a major government payer serving largely the 65+ age range. So, if you’re serving a population even partially […]

Stop Billing Like a 1099 in 1999: The Right Way to Set Up Insurance Contracts (EIN, GNPI, INPI & More) Let’s talk about a tale as old as time. A well-meaning provider launches a practice, gets credentialed under their Social Security Number (SSN) and individual NPI (INPI)… or, equally messy, their SSN with their group […]

What is Patient Liability: A Complete Guide For Patients, Providers, and Planners If you’ve ever looked at a medical bill and wondered why you still owe money, even after your insurance or Medicaid paid their part, you’re dealing with patient liability. This is a term that comes up a lot in healthcare, but it’s not […]

Dermatology Medical Billing and Coding: A Complete Guide Dermatology medical billing and coding can feel like a headache, especially with all the codes, modifiers, and insurance rules involved.  If you’re a dermatologist, practice manager, or biller, getting this process right is key to getting paid on time and avoiding claim rejections. At The Auctus Group, […]

Modifier 25 vs 59: What’s the Difference If you’ve ever been unsure about when to use Modifier 25 or Modifier 59 in your medical billing, you’re not alone.  These two CPT modifiers are often misunderstood, but getting them right is critical.  Using the wrong one can lead to denied claims, lost revenue, or even audit […]