Blogs

We stay up to date on the ever-changing insurance market's impacts on your specialty for you...because it's basically a full time job in and of itself.

June 2, 2026
by John Gwin

Outsourced vs. In-House Dermatology Billing

Outsourced or in-house billing for your dermatology practice? The real cost, where revenue leaks, and five questions to answer before you switch.

June 1, 2026
by John Gwin

The 2026 Skin Substitute Rule: Margin Gone, Flap Intact

On January 1, 2026, Medicare cut skin substitute pay ~90% to a flat $127.14/cm². What survives for plastic surgery and dermatology — and what doesn’t.

May 9, 2026
by John Gwin

Gender-Affirming Surgery Billing: What the Code Actually Pays (And What It Doesn’t)

The Core Problem: One Code, Many Techniques The technique changes depending on the patient. The CPT code doesn’t. For top surgery — augmentation, reduction, mastectomy with nipple reconstruction — reimbursement is tied to the standard diagnosis for that procedure type. A reduction for macromasty and a reduction for masculinization carry the same code, same reimbursement, […]

May 9, 2026
by John Gwin

Clean Claim Rate, AR Aging, and DRO: The 4 Billing KPIs Every Practice Should Track

What Is a Good Clean Claim Rate? Ninety-five percent. That’s the floor. The reciprocal is a 5% denial rate — which sounds manageable until you see how many follow-up hours that 5% generates downstream. Most practices below 95% aren’t losing to payer behavior. They’re losing to their own intake process. Three variables move this number […]

February 24, 2026
by John Gwin

Plastic Surgery Billing Red Flags That Impact AR, Denials, and Cash Flow

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 […]

November 7, 2025
by John Gwin

AI and ML in Billing: How They’re Changing the Game

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 […]

October 29, 2025
by John Gwin

Next-Gen Billing: Emerging Technologies Revolutionizing Medical Billing

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 […]

October 24, 2025
by John Gwin

Medical Billing Services for Small Practices

Medical billing services for small practices help independent doctors and clinics manage claim submissions, payments, and denials so they can focus on patient care instead of paperwork.  Outsourcing these services improves cash flow, reduces overhead, and provides access to billing experts without adding staff. The Hidden Struggle of Small Medical Practices Running a small medical […]

October 17, 2025
by John Gwin

CPT 15877: Complete Guide

CPT 15877 Overview Procedure: Suction-assisted lipectomy (liposuction) of the trunkCategory: Integumentary system – Other Repair (Closure)Typical Use: Liposuction of abdomen, flanks, or backGlobal Period: 90 daysCommon Modifiers: 59, 51, 22, 50, 52 What Is CPT 15877? CPT code 15877 describes suction-assisted lipectomy of the trunk, the medical term for liposuction of areas like the abdomen, […]

October 10, 2025
by John Gwin

CPT 15832: Complete Guide to Coding

If you code or bill for reconstructive or plastic surgery procedures, accuracy can make or break your claims.  CPT 15832, excision of excessive skin and subcutaneous tissue (includes lipectomy); thigh, is one of those codes that looks simple but requires precision to document and bill correctly. This guide from The Auctus Group breaks down CPT […]

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