Guide
How to Choose a Dermatology Billing Company
Most billing companies will say they handle dermatology. The difference between a specialty partner and a generalist shows up in specific answers — about lesion counting, about Mohs stages, about who works denials and how fast. These are the questions worth asking before the contract, in roughly the order that matters.
Coding depth questions
- Who codes our charges — certified coders, or the same staff who post payments?
- How do you handle destruction unit counts and excision sizing when the note is ambiguous?
- What is your position on appending distinct-service modifiers when documentation is thin?
- How do Mohs stages and blocks reach the claim, and who checks them against the operative log?
- How is dermatopathology split between professional and technical components in our setup?
Denial and A/R questions
- How quickly is a denial touched after it posts, and who decides whether it is appealed or corrected?
- Do you report denials by cause, payer and rendering provider, or only as a single rate?
- What do you do about the cause upstream, and how does that reach our providers?
- How is aged A/R handled during transition, and is legacy cleanup included?
Transparency and contract questions
- Do we keep direct access to our own PM/EHR and our own data?
- What is the notice period, and what happens to open A/R if we leave?
- Is the fee on net collections, and what is explicitly excluded from the base?
- Who is our named point of contact, and how often do we review the numbers together?
Security and compliance questions
- Is a BAA executed before any PHI moves?
- How is access controlled and logged, and how quickly is it revoked at offboarding?
- What subprocessors touch our data, and are they BAA-covered?
Frequently asked questions
Is a lower percentage a better deal?
Only if the scope matches. A lower rate that excludes denials, prior authorization or patient billing usually costs more once the excluded work is staffed internally.
Should we ask for references?
Yes, and specifically from dermatology practices of a similar size and case mix. Generic references tell you little about specialty coding depth.