Plastic Surgery Billing Services
Is your in-house billing team struggling to cope with the coding complexities associated with plastic surgeries? Coding errors will cause claims delays or denials, resulting in revenue loss. Our HIPAA-compliant plastic surgery billing services help you reduce billing errors and get maximum reimbursement for the rendered services.
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How We Streamline Plastic Surgery Billing for Your Practice
We have great expertise in accurately coding diverse cosmetic procedures with the appropriate surgical and E/M modifier codes. Our team comprises CPRC, AHIMA, and AAPC-approved CCS, CCS-P, and CPC-certified coders and billers with firsthand experience in navigating plastic surgery billing complexities. Leveraging their extensive expertise and knowledge of billing software, we will streamline your plastic surgery billing process to enhance your practice's cash flow. Here's our approach:
- Modernize your pathology billing with seamless integration of EHR/EMR, EDI, and other tools with plastic surgery-specific software for fast and accurate electronic claims submissions and electronic payments.
- Gather all patient information, including demographics, medical history, and referrals, and verify comprehensive insurance details, such as coverage status, prior authorization validity dates, and claims address.
- Handle pre-authorization requests, providing detailed clinical justification of services to avert clearinghouse rejections and minimize the chances of claims denials.
- Align with regulatory requirements while handling cosmetic surgery financing bills, value-based bills, litigation or personal injury billing, fee-for-service billing, etc.
- Align the electronic claims processing workflow with appropriate codes and modifiers (11950–17380 cosmetic procedure CPT code range, 15780-30450 CPT/HCPCS code range, ICD-10-CM codes).
- Maintain code specificity and payer guidelines while billing for plastic surgery procedures, including facelifts or brow lifts, rhinoplasty, liposuction, abdominoplasty, breast augmentation, body contouring procedures, palatoplasty, blepharoplasty, and others.
- Adhere to fee schedules and payment guidelines specific to insurance payers (Medicare, Medicaid, ACA plans, Tricare, workers' compensation plans, and private insurers such as Cigna, Humana, Aetna, etc) while submitting claims.
- Engage with insurance payers to review Explanation of Benefits (EOBs), ensuring thorough patient benefits verification and gaining insights into each individual's deductibles, copayments, and coinsurance.
- Analyze the EOBs meticulously to identify any payment discrepancies, resolve them, and initiate the appeals process accordingly.
- Inform patients about their payment responsibilities to prevent unpaid bills for our clients.
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During the consultation, some of the issues we can discuss are:
- Your current plastic surgery billing process, inefficiencies, and their challenges.
- How we guarantee accurate billing for all aspects of plastic surgery care
- How we comply with various healthcare regulations and billing standards such as HIPAA, CMS guidelines, etc.
- Our success stories in assisting clients with the billing for various plastic surgeries.
Why Choose Invensis as your Plastic Surgery Billing Company?
We have over 25 years of experience in providing end-to-end billing solutions for plastic surgery-specific procedures. Over the years, we have served the needs of diverse clientele, including plastic surgeons, plastic surgery clinics, cosmetic surgery centers, craniofacial centers, aestheticians, cosmeticians, botox, and spa treatment providers. We owe our success to our team comprising coders (CPC) and billers (CPB), certified clinical documentation specialists (CCDS), credentialing specialists, accounts receivable management experts, and patient account representatives. Their concerted efforts have helped our clients witness a 98% clean claims rate, a nearly 95% net collections rate, and keep the denial rate below 8%. Additionally, we have helped our clients maintain AR days between 35 and 40 days.
Benefits of Outsourcing Plastic Surgery Billing
- Improved revenue management: Managing the revenue cycle for plastic surgery services is a complex process, especially for healthcare organizations that lack the required expertise. Incorrect billing and coding can result in compliance issues and revenue loss. Hence, healthcare practices prefer outsourcing plastic surgery billing services to specialized service providers to improve their revenue management.
At Invensis, our expert billing professionals utilize the latest billing technology and software to stay current with the latest billing regulations. This assists practices to ensure accurate billing by reducing the risk of claims denials leading to better financial performance. - Enhanced compliance: In plastic surgery billing, ensuring compliance is necessary to get away with legal issues and costly penalties. But to keep up with constantly changing regulations and guidelines becomes a challenge for healthcare providers. Hence, they outsource billing services for plastic surgery.
Invensis, as a leading plastic surgery billing company, has a robust compliance program in place. It ensures that all the billing processes adhere to the highest standards and regulations. - Reduced administrative burden: Administrative tasks associated with plastic surgery billing are quite overwhelming tasks to manage for healthcare providers. Also, focusing more on these tasks results in compromising the quality of patient care. Outsourcing billing services to third-party service providers helps to invest both time and effort in patient care while they take care of all the administrative work related to plastic surgery billing.
Invensis offers end-to-end billing service for plastic surgery and assures practices reduce administrative burden. A team of professionals streamlines the billing process, minimizes administrative burden, and improves the efficiency of healthcare practices. - Access to expertise: Financial operation management is one of the most challenging tasks for healthcare practices in case they lack expertise in billing. Also, the complexity of the insurance industry, continuously-changing coding standards and regulations make things more complicated. Outsourcing plastic surgery billing services provides them easy access to a team of experts who are proficient in billing.
At Invensis, we have extensive experience in managing insurance claims, submitting clean claims, and following up on claims denials. We use advanced technology and tools to streamline the billing process and boost your reimbursement.
Trends in Plastic Surgery Billing
- Increased focus on pre-authorization: Pre-authorization is becoming an important aspect of plastic surgery billing services. Failure to obtain the same can lead to a claims denial, revenue loss, and additional administrative work. At Invensis, we are increasingly focusing on pre-authorization to ensure that claims are processed effectively, leading to quicker payment and minimal denials. We also stay current with the latest insurance guidelines and requirements to achieve success in pre-authorization.
- Utilization of artificial intelligence (AI): Artificial intelligence is revolutionizing the healthcare industry, and plastic surgery billing is no different. It helps with verifying patient eligibility, claims processing, payment posting, and minimizing the workload of billing professionals. Invensis, as a leading plastic surgery billing service provider, increasingly uses AI to identify and prevent billing errors and fraudulent claims, reduce administrative burdens, and improve efficiency.
- Focus on patient communication: In recent times patients have been more informed and focused in their healthcare decisions. They expect clear and transparent communication from their healthcare providers, especially about their billing. Hence, there has been a growing focus on patient communication in plastic surgery billing services. Invensis has adapted to this trend by offering patients clear and detailed billing information. It includes insurance coverage, deductibles, and guidance on different payment plans or options for those who are unable to pay in full.
What Our Customers Say
We have been working with Invensis for the past two years, and they have helped us overcome many revenue cycle management challenges. The team often walks the extra mile to ensure that our needs are met.
Invensis has been our revenue cycle management healthcare outsourcing partner for the past 5 years. They have always delivered on their commitments, whether it is meeting our Service Level Agreement (SLA) or improving our billing process.
Invensis has been a great partner providing quality medical coding and billing services. The team is extremely responsive to every query we pose, and the turn-around time for deliverables is always as committed.
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