Navigating the Complexities of Medical Billing for Your Dermatology Practice

If I were to ask you why you became a dermatologist, what would your answer be? 

I could be wrong, but I have a feeling you answered one of the following (if not both): 

• You have a deep passion for skin and skin-related conditions
• You have a deep passion for helping others regain their confidence 

Now, there might be other reasons (family business, high-paying salary, the use of innovative technology, trendy industry), but I can tell you one thing that most (if not all) dermatologists dislike about their job. 

And that’s medical billing. 

It’s time-consuming. It’s complex. Codes are always changing. It’s not what they studied (or trained) for. You never seem to get paid on time. And, perhaps most importantly, it keeps you away from your patients. 

Yet, at the same time, it’s one of the most important aspects of running a successful dermatology clinic. 

It’s what pays the bills. It’s what pays your salary. When done correctly, it’s what allows you to maximize your profits – and stabilize your cash flow. It’s, quite literally, the lifeblood of your career in this industry. 

Don’t worry – Millenium Medical Billing is here to help.

Medical Billing: Understanding Our Tried and True Process

Medical billing is the process of billing insurance providers and patients (depending on eligibility) for the services you provide. For dermatologists, that could be the cost of an appointment, check-up, or surgery. 

The problem most dermatologists have with medical billing is how long that process takes – and how frustrating it is in the meantime. It could take weeks, even months, before you see any form of payment.

That’s where we come in. 

At Millenium, we have an extensive amount of experience working with people like you – and clinics like yours. Our goal is to minimize that timeline and get you paid as quickly – and error-free – as possible. 

Here’s how we do it…

1. Register Patient

The first step in the process is registering the patient. A lot of this is handled when the patient walks in for their first appointment. You’ll have them fill out a series of forms or paperwork to gather their information.

Name. Date of birth. Address. Phone number. Email. Insurance. And, of course, the HIPAA consent form. 

There are three things to keep in mind here – accuracy, confidentiality, and updates. 

Patient information that’s inaccurate or not up-to-date could result in claim denials and payment delays. And not securing that information could result in hefty fines, lawsuits, and a complete loss of credibility.

Don’t worry – Millenium will help you record, verify, store, and secure every last bit of that information.

2. Financial Responsibility

Once we have your patient’s information, we need to dig into their insurance coverage a little deeper. Just knowing their provider isn’t enough – we make sure we understand every inch of their plan and coverage. 

Of course, that means understanding the difference between medical and cosmetic procedures:

• Medical - most health insurance providers only cover conditions and treatments that are deemed medically necessary, such as alopecia, rosacea, eczema, skin cancer, acne, and much more.
• Cosmetic - most health insurance providers don’t cover procedures that are based on ‘want,’ rather than ‘need.’ Some examples of such procedures include Botox, fillers, and skin tightening.

With that said, every insurance provider is different. At Millenium, we take the time to verify your patient’s coverage – after all, the goal is to maximize approvals to avoid sending your patient home with a bill.

3. Gather the Codes

At the heart of every insurance claim are medical codes. These codes not only identify what services you performed, but also why you performed them and for how long you performed them – among other things. 

There are three primary code systems used in dermatology – let’s take a closer look: 

ICD Codes. This system of codes was developed by the World Health Organization (WHO), and it identifies the condition being treated. The ICD-10 is the current system, but it will change in 2025.

CPT Codes. This coding system was developed by the American Medical Association, and it identifies the different treatment methods used for the patient’s condition. They’re updated annually every Jan. 1.

Modifiers. These allow the dermatologist to ‘report or indicate that a service or procedure has been performed and altered by some specific circumstance but not changed in definition.’ 

Using the wrong code is one of the biggest reasons why insurance providers deny a claim. To avoid this, our medical billers and coders stay up-to-date on all the latest changes to the codes and/or standards. 

4. Submit Claim & Monitor Progress

Once we have the patient information, insurance provider, and medical codes, we can start to compile all that information into what we call a ‘superbill.’ It essentially acts like an invoice for the insurance provider. 

The superbill is then sent to the payer, who reviews it and issues one of the three designations: 

• Accepted Claim - this is what every dermatologist dreams of. An accepted claim is one that the payer approves of, which means you’ll be reimbursed for whatever the provider covers. 
• Denied Claim - this isn’t the worst-case scenario, but it’s annoying. A denied claim is one that the provider found one or more issues with (such as an error, typo, or inaccurate information). 
• Rejected Claim - this is the worst-case scenario. A rejected claim, unlike a denied claim, can’t be resubmitted. Once it’s rejected, the amount due becomes the responsibility of your patient. 

At Millenium, we firmly believe no claim should get left behind or forgotten about. That’s why we keep a close eye on every claim we submit – ensuring you get paid as soon as possible – if not even sooner!

5. Managing Patient Statements 

There comes a time when a patient doesn’t have insurance, wants to undergo something not covered by their insurance, or has insurance that only covers part of the bill. Either way, the patient will owe money.

It’s important to make sure the patient understands the financial responsibility involved, but it’s also important to follow up with them when they don’t stick to the plan – and always maintain transparency. 

You can also help avoid late or delayed payments by making the payment process easy for them. Establish a patient portal on your website and give them several payment options to choose from.

Millenium Medical Billing: Your One-Way Ticket to Success!

Are your insurance claims constantly getting denied or rejected? Are you drowning in collections? Do you have a hard time keeping up with the latest standards, regulations, and requirements for medical billing? 

If you answered ‘yes’ to any of those questions above, then contact us today at (718) 356-1337. 

At Millenium Medical Billing, we have one goal and one goal only – help your business succeed by getting you paid as much and as quickly as possible. We have more than 15 years of experience working alongside practices just like yours. Reach out to us today to learn more about how we can assist you.