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Plastic Surgery Billing Services California, CA

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.

Running a medical practice in California can be quite challenging when it comes to medical billing and coding. Our billers and coders in all the major cities of California including Los Angeles, San Diego, San Jose, San Francisco, Fresno can help you settle your requirements here are some of the services which our expert medical billers and coders specializes in:

  • Tracking and follow-up on unpaid claims
  • Preparing Patient statements and payment posting
  • Customizing billing reports for better control
  • Primary and secondary insurance claims filing

Value Our California Billers Bring:

Our medical billers and coders are not limited to just the big cities such as Fresno, San Francisco, and San Diego but also all other smaller cities and towns in California. Moreover our billers are compliant with HIPAA guidelines and are updated with all industry updates through medicalbillerandcoder.com. This makes sure that your practice is run in the most efficient and legally safe conditions. Our Billing specialists also ensure that your patients are hassle free and their billing queries are answered well.

The expertise of our billers is vast and includes but is not limited to Past Due Collections, Electronic Medical claim filing, Medicare Audit Protection, coding and diagnosis analysis for maximum allowable reimbursement, customized accounts receivable and revenue cycle financial analysis, electronic claims submissions, denials management and payment posting, dedicated and relentless insurance follow-up, patient statements and patient-centric support, provider enrollment support, and standardized reporting.

Our Specialties:

Our medical billing specialists are committed to improving your productivity by utilizing finest processes and health care information technology such as Electronic Medical Records. These medical billers and coders maximize your revenue, ensure timely compensation, and offer medical billing and coding services in specialties including Family Practice, mental health , pain management, Physical Therapy, radiology, Internal Medicine, neurology, orthopedic, and numerous other areas.

Our Software Experience:

The fact that physician shortage is set to quadruple in the next decade according to AAMC (Association of American Medical Colleges) makes it vital that physicians utilize professional and accurate medical billing and coding services. The various software that we provide in addition to the value added services mentioned above ensures that physicians are capable of keeping up-to-date with the healthcare IT sector reforms and improvements. Some of the medical coding and billing software that our billers have experience on include Medisoft, Misys Tiger, Eclinicalworks, Advance MD, GE Centricity, and Altapoint.

Difficulties & Challenges California physicians Face:

The most common challenges faced by physicians in big cities such as San Jose and Los Angeles are underperforming accounts receivables or collections and claims denial. Both these situations along with other errors may lead to decreased revenue. Our billers provide the solutions to these problems by making the denial management efficient and offering services such as integrated medical billing with EMR along with numerous other value added services like sending patient statements and processing refunds to Medicare in order to preserve your practice from RAC audits.

As a physician in California, it becomes difficult to keep track of all the changes taking place in the legislation related to your practice. This is where the expertise and experience of our medical billing specialists can be of immense help. It almost seems that payers are in the business of claim denial and can afford to make mistakes at your expense. Although the new HIPAA guidelines would ensure a smoother process, the amount of patient-doctor encounters would increase in the future making it difficult to extract time for coding, billing, claim denial and compliance with HIPAA regulations. Specialized medical billers and coders such as ours can ensure that your practice not only flourishes but is also HIPAA compliant.

Outsourcing to MBC:

MBC’s medical billing and coding services cover the entire range of insurance-claim-related requirements for plastic surgery, starting from eligibility verification of the patient to claim submission and post submission follow-ups. With years of experience in dealing with plastic surgery cases in particular and insurance claim preparation and submission in general, our medical billers and coders understand the nature of your organization, its size and scale and bring to you an approach that’s customized to your specific needs. It helps you meet your administrative and technical responsibilities involved in claim preparation and submission and improve your finances.

MBC delivers this both through a consulting model where it helps you to streamline your revenue management cycle by recommending appropriate software applications, helping plug sources of revenue leakages and trainings where required, and also outsource your entire billing and coding responsibilities to MBC.

Some of the popular procedures that our billers and coders recommend could be problem areas in your revenue leakage:

Breast Reconstruction : Although a type of plastic surgery, it is for the most part a complex reconstructive or health-related procedure, where, if the attendant health risks are not adequately addressed, the patient would go through long suffering and be faced with serious health hazards. This being the nature of the surgery, it often presents the physician with the challenge of separating the parts of the procedure that are covered by Medicaid and the parts that aren’t. Our medical billers are coders are adept in handling these complexities and helping you prepare an air-tight claim with minimal chances of denial.

Palatoplasty : A surgery to repair cleft palate, this procedure involves parts that are not purely cosmetic but reconstructive presenting the challenge to physicians or clinicians to identify such parts of the procedure as would be eligible for insurance reimbursement. Our medical billers are coders are skilled in helping you conclusively separate the parts of the procedure that have reconstructive character and therefore insurance eligibility from parts that don’t.

Blepharoplasty : A procedure to correct hooded eyelids, even though it’s cosmetic in nature, it is a surgical correction of a defect with the potential to damage a body part – the eye – and therefore reconstructive in parts at least. We help you identify the reconstructive areas of the procedure to ensure you are reimbursed for them.

Rhinoplasty (nose job): It involves correction of a part of the nose that, if not properly aligned, can affect the functioning of the nose. However, as Rhinoplasty is broadly cosmetic in nature, physicians often overlook this reconstructive element which is eligible for reimbursement.

MBC’s billing and coding professionals have helped health care providers involved in plastic surgery bring down their insurance denial rates substantially leading to timely payment of their services and optimal use of their staff either by helping them to focus solely on healthcare or by providing consultancy services so that they handle their revenue management responsibilities more effectively with the help of appropriate software applications and smoother and easy-to-follow processes.

MBC will help you perform the perfect plastic surgery by taking over what MBC does best so that you have to only do what you do best – surgery.