Medical billing for dermatology professionals is very complex and requires a highly trained staff to help ensure accurate and timely reimbursement. From simple lesion removals to complex skin grafts, dermatology billers face unique challenges in the struggle to keep practice revenue flowing.

From ensuring every allergen is counted to avoiding scratch and patch test underpayments, the dermatology medical billing specialists should be well-versed in ICD, CPT and HCPCS coding systems specific to dermatology. Along with that they should have high proficiency in medical terminology, skin disease processes and pharmacology.

As a dermatologist you see a lot more patients than physicians in other specialties. And logically, you do think that would automatically translate into higher reimbursements and higher revenue.  However, consumer driven high-deductible insurance plans are causing a national increase in bad debt write-offs. Along with that Medicare is reducing provider fees in an attempt to balance the national debt. 

Dermatology medical billing companies have the expertise and technology needed to produce the very best reimbursements possible for your dermatology practice.  They can increase your revenue and lower your overhead costs as well.

Advantage of having Specialty dermatology medical billers is to Increased Revenue

With specialty medical billers and coders, you are rest assured that medical coders are certified by the AAPC (American Association of Professional Coders). They will work hand in hand with, and your practice to help identify problem areas. They could be the correct use of modifiers, and also educate your practice on best-in-class billing practices and procedures.

From elective cosmetic procedures to the sale of skin care products, specialty dermatology medical billing service providers manage all aspects of your dermatology practice’s billing. This helps to ensure you receive proper compensation for services rendered.

Skin graft procedures are determined by size and by the graft material used

  • The medical record must clearly document the graft material. If any information is missing from the medical record, a clean claim cannot be submitted for procedures performed.
  • In addition to ensuring that the CPT codes submitted for payment match the contents of the patient record, specialty dermatology coders know the requirements established by third-party payers to ensure prompt payment.
  • The AMA has established common guidelines to assist in code selection, but payers are free to fine tune the definitions, requiring some codes to be combined with others when two procedures are performed during the same patient encounter.
  • The Medicare program utilizes the National Correct Coding Initiative (NCCI) to determine which codes must be bundled when performed together. Commercial health insurers generally follow NCCI guidelines while also establishing their own interpretations.  When a dermatology practice agrees to participate in a healthcare plan, they agree to submit bills according to that payer’s standards.  Every payer has different exacting rules.
  • ICD-10 codes entail greater specificity of the information communicated between physician and insurer. This is good news for a dermatology practice because it means that medical necessity will be more clearly established for services provided.  The transition may require greater detail in medical documentation, but when the new coding system goes into effect, it should reduce billing denials and appeals.

Dermatology practices that employ specialty medical billing service providing company so their claims paid promptly and without confusion.  If a payer performs an audit, as CMS routinely does through its RAC program, practices with specialized billing services won’t suffer from insurance take-backs or penalties.  Keep in mind that clean claims ensure business solvency.

Published By - Medical Billers and Coders
Published Date - Apr-17-2018 Back

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