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Specialized Billing for Plastic & Reconstructive Surgeries
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
Plastic Surgery Billing Services We Offer
Are you tired of insurance companies confusing your reconstructive surgery claims with elective cosmetic procedures and rejecting them? We’ve got your back! There is a delicate balance between reconstructive and plastic (cosmetic) surgeries. Plastic surgeons often face unique billing challenges because they fail to prove the medical necessity of their procedures.
MediBillMD eliminates this confusion! Our plastic surgery billing services target all your pain points, from coding and evolving payer guidelines to complex insurance claims. We specialize in both areas of this specialty and customize our solutions to your unique needs. With a specific focus on reducing your claim denials, our team of certified experts handles everything, from obtaining essential pre-authorizations to maintaining proper documentation. Try us for effortless plastic & reconstructive surgery billing.
Common Plastic Surgery Billing Challenges
So, what billing complexities are holding you back from achieving your full potential? Billing is often a major headache for many plastic surgeons. As an innovative specialty, plastic surgery incorporates advanced technologies and evolving procedures. Hence, many developing and beauty enhancement treatments don’t align with standardized coding or payers’ policies. This can hinder your financial growth.
Both plastic and reconstructive surgery billing come with unique challenges. From addressing legal and ethical concerns to verifying medical necessity and documentation requirements, the process demands accuracy and compliance. To achieve the desired outcomes, you need to understand the common plastic surgery billing roadblocks.
Medical Necessity
This is the biggest billing challenge in plastic surgery. Insurance companies only cover cosmetic (plastic) treatments if they are medically necessary. In simple terms? They treat a patient’s existing condition or injury. In contrast, you don’t have to do much for reconstructive procedures as they are always considered medically necessary.
Obtaining Pre-Authorization
It is more challenging for plastic surgeons to obtain pre-authorization for cosmetic surgeries than reconstructive procedures. Insurance companies tend to deny medical claims for elective procedures unless there is proof of their medical necessity. That is why most practices struggle if they don't maintain proper documentation.
Strict Policies & Requirements
Insurance companies thoroughly review each plastic surgery claim before approving them. They require you to uphold patient safety and ethical standards. Additionally, payers don’t cover elective procedures, like facelifts, and require extensive documentation. It is quite difficult to keep up with their specific demands and changing requirements.
High Denial Rates
Plastic surgery has significantly higher denial rates than other specialties. Coverage issues, insufficient documentation, extremely nuanced coding, and developing procedures make it difficult for plastic surgeons to receive compensation for their work. As a result, they often spend more time on claim appeals and resubmissions.
Benefits of Outsourcing Plastic Surgery Billing
Tired of coverage issues, varying policies, and pre-authorization complexities? Let us simplify your plastic surgery billing! Complex procedures and lack of standardization complicate the billing process of this specialty. The possibility of claim denials is always higher than approval. So, how can you maintain billing accuracy amidst the ever-changing rules and regulations? Through outsourcing!
At MediBillMD, we do everything to reduce your claim denials and rework. We might be a new name in the market, but our experts have years of experience in plastic surgery medical billing. Our team handles every case with special attention and ensures coding accuracy and regulatory compliance. Here is why we are one of the best choices for outsourcing in the market:
Save your precious time and resources! At MediBillMD, we have a certified team of plastic surgery billers and coders. Our experts are well-versed in the nuances of plastic and reconstructive surgery billing and coding, proving medical necessity, and obtaining pre-authorization. We use our experience to improve your revenue.
Get flexible options and enjoy complete payments! At MediBillMD, we understand the consequences of billing errors, especially in plastic surgery. Therefore, our experts carry out medical billing for plastic surgery with extra attention to ensure accuracy. We also accommodate our client’s changing requirements through scalable solutions.
Say goodbye to privacy concerns and avoid legal complications! At MediBillMD, we handle your patients’ highly sensitive information with utmost care. Our plastic surgery billing services are 100% HIPAA-compliant. Moreover, we conduct regular audits to minimize the risk of data breaches and fraud.
Enjoy fast claim processing and approvals! Our plastic surgery billing turnaround of up to 14 days is significantly faster than other billing companies. We use standard documentation practices and the latest technology to speed up the process while ensuring high-quality deliverables every time.
Access our exceptional plastic surgery billing services wherever you are! At MediBillMD, we serve every locality with precision. Our billing solutions cross every boundary to reach countless practices across the nation. So, whether you run a reconstructive surgery center in New York or specialize in cosmetic surgery in Miami, contact us to streamline your medical billing for plastic and reconstructive surgery and maximize the practice’s revenue.
Overcome Plastic Surgery Billing Challenges with MediBillMD
Are persistent claim denials draining your resources? Overcome your plastic surgery medical billing roadblocks with MediBillMD! We take your practice to the next level by taking over your most time-consuming tasks. Our team stays on top of the industry regulations and insurance updates to maintain billing accuracy and compliance. We take a personalized approach to meet your specific goals.
| Common Plastic Surgery Billing Challenges | MediBillMD Solution | |
|---|---|---|
| Incorrect Diagnostic Code (e.g., mistakenly using the ICD-10-CM code Z41.1 for cosmetic rhinoplasty instead of the ICD-10-CM code C30.0 to prove the medical necessity of a reconstructive rhinoplasty/nasal surgery) | With years of experience, our coding experts can accurately differentiate between cosmetic and reconstructive diagnoses and procedural codes. | |
| Missing Modifier 51 to Indicate Multiple Procedures | We use appropriate modifiers with procedural codes to improve your claim acceptance rates. | |
| Claim Denials Due to Missing Documentation (e.g., missing evidence for medically necessary breast reduction surgery, CPT code 19318) | We maintain proper documentation for every procedure. Our team collects your patient’s medical record, including diagnosis and current condition, to justify the medical necessity of a service. | |
| Missing Pre-authorization (e.g., for Blepharoplasty, CPT code 15823) | Our team reviews payer-specific guidelines for plastic surgeries to obtain all the essential prior approvals days before the planned surgery. | |
Lowest Prices Guaranteed
Enjoy plastic surgery billing at some of the lowest prices without any compromises! Our nationwide billing solutions are not only pocket-friendly but also pretty accurate. Contact us to get the exact quotation
Get in Touch with a
Plastic Surgery Billing Expert
Unlock plastic & reconstructive surgery billing excellence today! Connect with our billing experts to understand where your practice stands and what it needs to achieve bottom-line success. Click for a free consultation on the house!
