All About Our Story
✅ Specialty-Specific Coders: Familiar with billing regulations and dermatology terminology.
✅ Handling of patient data and PHI in a HIPAA-compliant manner
✅ Reduce mistakes and boost first-pass acceptance rates with AI-powered claim scrubbing
✅ Custom Reports: insightful data to monitor financial performance
✅ Available when your practice needs us, 24/7 Support is there.
Dermatology Billing Services
You treat skin and lives; we treat the claims. Dermatology billing has its own rules — medically necessary vs. cosmetic splits, pathology and biopsy nuances, device/laser supplies, and telederm complexities. At Sirius Solutions Global we pair experienced dermatology coders with AI-assisted claim scrubbing so clean claims go out fast and denials come down. No filler — just dependable revenue so your practice can focus on patients.
The full-service dermatology billing suite
1. Front-end patient verification & prior auths
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Pre-visit insurance verification, benefit extraction, and identification of cosmetic vs. covered services.
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Prior authorization triage for high-cost treatments (phototherapy packages, advanced imaging, biologics support services when required).
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Patient financial estimates and recommended point-of-service collection for cosmetic/co-pay responsibilities.
2. Accurate dermatology coding & chart alignment
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Coding for E/M, procedure codes, biopsy and excision codes, suture and repair coding, CPT/HCPCS mapping, and correct modifier use.
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Cosmetic vs. medical determination workflow so cosmetic services are billed separately and patient consent/payment captured.
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Charge capture reconciliation against clinical notes and operative logs.
3. Mohs surgery & dermatologic surgery billing
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Split-billing strategies where applicable (facility vs. professional), pathology handling, layer-by-layer documentation checks, and cure rates tracking for billing completeness.
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Coordination with pathology for specimen handling charges and correct revenue routing.
4. Dermatopathology & biopsy reconciliation
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Reconcile lab invoices and pathology charges to ensure specimens and CPTs align.
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Proper linking of biopsy to clinical diagnosis and ensuring ICD-10 supports medical necessity.
5. Cosmetic & aesthetics billing workflows (compliance-first)
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Clear intake & consent capture, separate patient-pay workflows, and optional patient financing setup.
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Avoid cross-billing cosmetic services to medical insurance; document medical necessity where applicable (e.g., removal of lesions for medical reasons).
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Manage manufacturer and supplier billing for high-cost devices or implants used in cosmetic reconstruction.
6. Teledermatology & virtual visit billing
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Correct place-of-service, modifier usage, and documentation for e-visits, virtual check-ins, and synchronous telehealth visits.
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Billing for image-based consultations and store-and-forward workflows where supported by payers.
7. Claim scrubbing, submission & clearinghouse management (AI-assisted)
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Automated scrubs for demographic mismatches, missing modifiers, and payer edits plus human review for edge cases.
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Clearinghouse submission, daily rejection management, and corrected resubmissions.
8. AR, denial management & appeals
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Prioritized AR workflows by expected collectible value.
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Appeal packet assembly for medical necessity denials (with chart extracts, biopsy reports, provider notes).
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Root-cause analysis to remove repeat denial sources.
9. Payment posting & patient billing
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Precise posting of payer and patient payments, EOB/EIR reconciliation, and patient-friendly statements and payment-plan options for large cosmetic balances.
10. Reporting & provider scorecards
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Monthly KPIs: days in AR, denial rates, net collection rate, first-pass acceptance, procedure-level revenue.
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Provider-level scorecards with documentation coaching points for improved coding capture.
Why dermatology practices pick us
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Deep dermatology expertise: medical dermatology, cosmetic procedures, Mohs surgery, dermatopathology, and telederm workflows.
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AI-assisted claim scrubbing and denial prediction that reduces rejections.
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Clear cosmetic vs. medically necessary separation to protect compliance and revenue.
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Pathology and biopsy reconciliation: ensure the clinical link and CPT/HCPCS alignment.
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End-to-end RCM: eligibility, coding, submission, AR, appeals, and reporting.
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Practice-friendly reporting that ties clinical activity to dollars and decisions.
Typical dermatology workflows
New patient (medical + potential cosmetic)
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Intake captures insurance, reason for visit, and cosmetic interest.
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Pre-visit verification confirms coverage — cosmetic items flagged for separate collection.
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On visit: clinician documents diagnosis and procedure rationale.
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Post-visit: charges entered, AI pre-scrub applied, claim submitted.
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If pathology/biopsy sent, the lab invoice reconciled and linked to claim.
Mohs + repair workflow
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Mohs stages documented with layer counts and margins.
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Reconstruction repair codes captured along with any graft/implant supplies.
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Pathology charges matched to professional/facility flows and billed accordingly.
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Follow-up visits and dressings posted and tracked.
Cosmetic procedure (patient-pay)
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Pre-visit quote and consent captured (non-insurance).
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Deposit processed; practice billing system flagged to exclude these charges from insurance claims.
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Post-procedure statements and optional financing processed.
Common denial drivers in dermatology
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Medical vs. cosmetic confusion — we separate workflows and collect patient-pay up front.
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Biopsy/pathology mismatches — we reconcile lab invoices and attach pathology reports to appeals.
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Modifier and bundling errors — our coders and AI scrub catch missing or misused modifiers.
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Telehealth billing errors — correct modifier & place-of-service use plus documentation templates.
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Prior authorization lapses for specialty meds or procedures — proactive triage and follow-through.
Documentation & coding tips that actually move the needle
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For biopsies and excisions: document precise location, size, and clinical indication (e.g., suspicion vs. cosmetic).
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Capture pathology specimen linkage in the note and ensure lab requisitions include the clinical ICD-10.
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For Mohs: record stage-by-stage detail and reconstruction specifics (graft vs. flap, method).
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For cosmetic services: capture signed consent, pre/post photos (with patient permission retention policy), and explicit patient-pay acknowledgement.
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For telederm: log modality, time, images submitted, and clinician interpretation to support billed services.
Small documentation changes often unlock significant revenue.
How AI helps
AI in our workflow accelerates repetitive tasks and highlights risk, but humans make the final call:
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Automated claim pre-scrub catches the common rejections (demographics, missing modifiers, payer edits).
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Denial-prediction scoring surfaces claims most likely to fail so an expert can fix them pre-submission.
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NLP chart parsing extracts operative details, biopsy notes, and pathology links to assemble stronger appeals.
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Batch verification & sweep automates recurring checks (e.g., telederm uploads vs. billed services).
Outcome: faster throughput, fewer rejections, and more time for clinical staff.
Our Story in Numbers
Working as a complement to your practice, our certified medical billing and coding specialists let you concentrate on patient care while we expertly and compliantly handle your revenue cycle.
Clean Claims
98%
Specialities
50+
Boost Revenue
15%
States Served
35
Compliance and Achievements
Team up with Sirius Solutions Global for dermatologic billing perfection
While you concentrate on delivering excellent dermatological care, our objective is straightforward: maximize your income, minimize your denials, and keep your cash flow good.
📞 Contact us right now to book a no-cost consultation for your dermatology billing needs.