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 […]

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 […]

THE QUESTION: THE PATIENT HAD TOLD ME THEY’RE OK MOVING FORWARD COSMETIC AND HAVE NOW BILLED THE INSURANCE COMPANY ON THE BACKEND, FORCING US INTO THE BILLING PROCESS. ANY WAY TO AVOID THIS IN FUTURE? We were asked a really good question about insulating against patients submitting self-pay cases to their insurance after the fact- […]

THE QUESTION: I HAVE A PATIENT IN NEED OF SURGERY WITH WORKMAN’S COMP COVERAGE (WC). WILL I GET COMPENSATED FOR THIS? SHOULD I CONTINUE TO TAKE WC? THE ANSWER Will you be compensated? The short answer is yes. WC is not a network-based coverage plan.  So long as they has a claim number from her […]

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 on not only your moral mission, but the […]

So you’re a plastic surgeon or dermatologist, and you’re ready to take the next big step in your career. You’ve got some experience under your belt and you’re pretty good at what you do, so the next logical step is starting your own practice. (I mean, who doesn’t want to be their own boss?) You’ve […]

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 […]

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 […]

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 […]

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 […]