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Plastic surgery billing

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PMRNC:
With a specialty such as that and really with any other surgical practice there are always going to be added paper to send, op reports, etc. What I would do is run a report based on CPT code and by carrier so maybe you can take a look to see if it's something that can be addressed. Does he have a contract with Cigna or maybe he has claims being reduced due to U&C? Try to determine if you can find a common denominator with the troublesome carrier. It may just be their policy to request op reports for certain procedures.

Michele:
Question makes much more sense now.  :)

You may also want to see if there is a provider rep that you could talk to.  Maybe there is something you can do when the claim is submitted to include all that they require to cut down on some of the processing time.

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