Components & challenges of plastic surgery billing
Although plastic surgery is generally indentified as a looks-enhancement medical procedure, in many cases it’s done to address genuine health concerns. And often a singular treatment episode may include both: measures to address health concerns (reconstruction) and improve looks (cosmetic). This tangled nature of plastic surgeries often presents a considerable challenge to patients and surgeons as surgeries done purely for cosmetic purposes are not covered under insurance while the ones performed to address genuine health issues are.
This leads to incorrect verification of insurance entitlement often leading to time spent on preparing claims for surgeries that don’t enjoy insurance eligibility or oversight of components of a surgical treatment that come under insurance coverage. Both instances affect the revenues of the plastic surgeon or the clinic of which he/she is a part.
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