How to Choose the Best Dermatology Billing Company

The seven criteria that actually predict collections

• Specialty depth: does the team bill dermatology every day, or is derm one line in a multi-specialty book?
• Coder credentials: named CPC/CPMA coders assigned to your account, not an anonymous pool.
• Denial workflow: a documented turnaround target for first-level appeals, measured in days, with evidence.
• Reporting from your system: metrics pulled from your practice management system so they are independently verifiable.
• Legacy A/R handling: whether aged balances are worked or quietly written off during transition.
• Contract terms: month-to-month after onboarding, 30-day notice, no termination penalty, data returned on exit.
• Security posture: signed BAA before any PHI moves, encryption in transit and at rest, least-privilege access, audit logs.

Understand what the pricing model is doing

Percentage of net collections aligns the vendor with what you are actually paid, which is why most dermatology practices use it. Watch for what is excluded — credentialing, patient statements, or legacy A/R billed separately can move an apparently low rate above a higher all-in one.

Per-claim pricing rewards volume, not resolution. It pays the same for a claim that posts and one that denies, which is the wrong incentive for a surgical specialty where the difficult claims carry the money.

Flat monthly fees are predictable but disconnect the vendor from your collections entirely. They suit stable, low-complexity books and rarely suit growing surgical dermatology.

Questions that expose a generalist in ten minutes

• How do you count Mohs stages and blocks across two anatomic sites on the same day?
• When do you split 88305 into TC and 26, and how do you handle a global bill where the read happens off-site?
• What documentation do you require before you will bill a modifier 25 E/M with a same-day destruction?
• How do you bill JW and JZ wastage on a biologic, and what do you do when the authorization expired before administration?
• What is your process when a lesion destruction is denied for frequency under a local coverage determination?
• Show me your last three months of denial rate by reason code for a dermatology client.

Red flags worth walking away from

• Guaranteed collection percentages or a promised increase quoted before anyone has seen a claim.
• Multi-year lock-ins with termination fees, or notice periods measured in months.
• Refusal to sign a Business Associate Agreement before receiving PHI, or vagueness about where data is stored.
• Reporting that only exists in the vendor's own dashboard and cannot be reconciled against your system.
• No named account owner, or a different person on every call.

Run the same test on us

We bill dermatology, dermatopathology and Mohs surgery only, inside your existing EHR, on a percentage of net collections with month-to-month terms after onboarding. The claims audit is free and returns a written estimate of recoverable revenue from your own last 90 days of remittances.

If a general multi-specialty biller answers the six questions above as well as we do, that is a legitimate reason to stay with them. The point of the framework is a decision you can defend, not a decision in our favour.