May 6, 2024
by John Gwin

10 Revenue Cycle Management Best Practices

10 Revenue Cycle Management Best Practices Revenue cycle management (RCM) is a key aspect of running any successful practice.  It encompasses everything from scheduling and appointment booking to billing and payment processing – pretty important things if you want your practice to thrive! Effective RCM not only ensures the financial health of a clinic, but […]

April 22, 2024
by John Gwin

New Patient CPT Codes: A Guide for 2024

New Patient CPT Codes: A Guide for 2024 It’s no secret that medical billing and coding are an alway-changing landscape, making it essential to keep up-to-date with the latest changes for the health of your practice. The CPT (Current Procedural Terminology) codes related to new patients undergo updates once in a while, and these codes […]

April 9, 2024
by John Gwin

ICD-9 vs. ICD-10: Why The Change?

ICD-9 vs. ICD-10: Why The Change? ICD-9 was replaced in the USA with its much more capable younger brother, ICD-10, back in 2015. But why the change? How does it affect your coding? And why is it important to know the differences? Let’s dive into why ICD-10 is the current norm, why ICD-9 doesn’t cut […]

December 21, 2022
by Admin

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 […]

September 9, 2022
by Admin

WHICH PLASTIC SURGERY PROCEDURES ACTUALLY PAY (THROUGH INSURANCE)?

WHICH PLASTIC SURGERY PROCEDURES ACTUALLY PAY (THROUGH INSURANCE)? As a plastic surgeon, it’s likely that you got into this field because you like to help people.  But, realistically, you can’t help every person that walks through your doors and still keep the lights on. To run a successful practice, you have to keep an eye […]

July 18, 2022
by Admin

CAN A MED SPA BILL INSURANCE?

The short answer? Yes. “Med” is in fact short for “Medical,” and therein lies your ability to bill insurance in a med spa. You might ask, “Why would I bother to bill insurance when I could just charge cash pay only and rake it in?” Our answer: Why play checkers when you should be playing […]

July 6, 2022
by Admin

HOW TO BILL FOR YOUR MEDICAL ASSISTANT. YEAH. THAT’S RIGHT. YOU CAN BILL FOR 99211 WITHOUT MD FACE TIME!

Our very own @KarenCorso wrote up a nice little cheat sheet we wanted to share. Here’s the long and the short of it…you can make some money without changing your clinical workflow if you do this the right way! The top 10 Tips/Requirements for billing without an MD present… PREAMBLE: Sure, you can monetize your […]

June 5, 2022
by John Gwin

WHAT’S THE DEAL WITH LIPEDEMA BILLING?

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 […]

May 21, 2022
by Admin

CLIENT QUESTION – IS A RHINOPLASTY A COVERED PROCEDURE?

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 […]

April 16, 2022
by Admin

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 […]

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