Florida Dermatology Billing: The Vendor Evaluation Questions That Reveal CO-50 Defense and Mohs Billing Capability

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Choosing a medical billing or RCM vendor for a Florida dermatology practice requires more than comparing collection percentages and monthly fees. Dermatology billing has specialty-specific risks, particularly when a practice performs Mohs micrographic surgery, pathology-related services, biopsies, and other procedures where documentation, medical necessity, coding, and payer policies directly affect reimbursement. One important area to examine is the vendor's ability to prevent and defend CO-50 denials . CARC 50 indicates that a service was considered non-covered because the payer did not determine it to be medically necessary. CMS guidance also shows that CO-50 can be used following medical review when a payer determines that coverage requirements have not been met. For a Florida dermatology practice, the vendor evaluation process should therefore go beyond asking, "How much do you collect?" The better question is: "How do you protect our revenue when a payer challe...
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Outsourcing Physician Credentialing to MBC

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As a practice owner, you might have a team of professional physicians who possess the right qualification and licenses but without properly credentialed providers you invite the risk of losing payments. To enhance the performance of your practice you must complete the entire credentialing process including collecting provider documentation & validation; identifying top payers; applying for top payers; follow-up on the application; obtaining enrollment, and periodic updates of payer documents for credentialing. If you lack the know-how to navigate the physician credentialing process, you need to outsource provider credentialing and enrollment services to professionals like us.

Our Provider Credentialing Services 

Our credentialing experts deeply understand payer enrollment guidelines and credentialing policies. Based on your geographical area of practice and patient mix, we identify top payers who need to get credentialed. Whether you own a group practice or are a solo provider, we have a customized credentialing service. For a single-payer, our physician credentialing services include the following:

  • CAQH attestation includes CAQH application filing; and CAQH quarterly attestations. In case you don’t have a CAQH account created, we will ask for all required information and documentation and will create a CAQH account. We will also enable it for payer review in case of credentialing and enrollment process.  
  • Filling up applications for all top payers. It will include completing the required documentation and identifying exceptions. Verifying practitioner/ facility information from physicians and obtaining missing documents and updating the payer’s database.
  • Enrollment for electronic transactions. Our team will enroll providers for electronic transactions like Electronic Data Interchange (EDI), Electronic Remittance Advice (ERA), and Electronic Fund Transfer (EFT).
  • Provider data maintenance includes provider demographic updates in payers’ records i.e., updates of the provider’s specialty or additional educational qualifications, checking the payer website and verifying provider details like Phone and Fax #, Zip code, updating the correction to payers, and tracking expiry date for State DEA License, Board certificate, and Malpractice Insurance. 
  • Contracting includes new group/individual practitioner contracts, adding/deleting providers in the existing contract, and rate negotiations.

To know more about Outsourcing Physician Credentialing to MBC, click here: https://bit.ly/44ihrQu Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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