What we handle for plastic surgery practices
Billers are assigned by specialty, so the person working your claims already knows your codes and your payers.
Reconstructive procedures
Breast reconstruction, skin grafts and flap procedures coded to the operative note.
Post-trauma and post-cancer repair
Reconstruction after injury or cancer excision billed with the documentation payers require.
Hand and functional surgery
Functional procedures separated clearly from cosmetic ones.
Cosmetic care
Kept off insurance claims entirely and handled as self-pay.
Where plastic surgery claims usually go wrong
These are the four issues we see most often when we take over a plastic surgery practice.
Cosmetic services on insurance claims
Submitting cosmetic work to a payer is not just a denial, it is an audit risk. We keep the two streams separate.
Functional documentation
Procedures like blepharoplasty are covered only with documented functional impairment, usually including visual field testing.
Staged reconstruction modifiers
Staged procedures need modifier 58. A fresh claim inside a global period denies.
Prior authorisation on reconstruction
Most reconstructive procedures need authorisation with clinical photographs and documentation.
How we work
Eligibility, every day
Every next-day scheduled patient is verified for active coverage before the visit.
Charges validated
Codes and documentation are checked after the note is signed, before the claim is submitted.
Denials appealed
Every denial is reviewed, corrected and resubmitted. Nothing is written off by default.
Monthly reporting
Paid claims and AR aging reports so you can see exactly where your money is.
Plastic Surgery billing questions
Something not covered here? Call (833) 305-5528.
Do you handle cosmetic and insurance billing separately?
Yes. Cosmetic work is handled as self-pay and never submitted to a payer.
Can you help with prior authorisation packets?
We track requirements and flag what documentation is needed before scheduling.
Do you bill hand surgery?
Yes, including functional procedures with the required documentation.