Question 1

What is a dermatology billing company?

Accepted Answer

A dermatology billing company specializes in revenue cycle management for dermatology practices. Unlike general medical billing services, a derm-focused billing company understands the unique coding complexities of dermatology — including Mohs surgery staging (CPT 17311–17315), biopsy-pathology reconciliation, skin graft CPT code families (15100–15261), modifier usage (25, 59, 76, 79), and cosmetic vs. medical service separation. PACT RCM is a dermatology billing company that manages the full revenue cycle for multi-location derm groups.

Question 2

How much does dermatology billing cost?

Accepted Answer

Dermatology billing services typically cost between 4%–8% of collections, depending on practice size, volume, specialty mix (Mohs vs. general derm), and the scope of services included. PACT RCM offers transparent percentage-based pricing with no hidden fees, covering front office (eligibility, prior auth), mid-cycle (coding, charge entry, claims), and back office (denial management, AR follow-up) services.

Question 3

Why do dermatology practices need specialized billing?

Accepted Answer

Dermatology is one of the most billing-complex specialties in medicine. General billing companies routinely miss revenue from: incorrect modifier application on multi-procedure visits, failure to reconcile biopsy and pathology codes across providers and labs, improper cosmetic vs. medical coding that triggers denials, underbilling Mohs surgery stages and reconstruction codes, missing donor site billing on skin grafts ($200–$500 per case), and referral workflow gaps causing 25–40% of referred patients to never convert to clean claims.

Question 4

What is biopsy-pathology reconciliation in dermatology billing?

Accepted Answer

Biopsy-pathology reconciliation is the process of matching biopsy procedure codes with their corresponding pathology interpretation codes. Every skin biopsy generates two claims — one for the procedure and one for the pathology read. When these don't match, revenue disappears. PACT RCM's 6-step reconciliation workflow recovers $93K–$156K per year for typical multi-provider derm practices.

Question 5

How does PACT RCM handle Mohs surgery billing?

Accepted Answer

PACT RCM bills Mohs surgery using the complete CPT code hierarchy (17311–17315) with stage-by-stage documentation. We ensure each additional stage, tissue block beyond 5, and all repair/reconstruction codes (simple, intermediate, complex closures, adjacent tissue transfers, and grafts) are billed separately and correctly. Our Mohs billing checklist prevents the most common underbilling errors that cost practices thousands per case.

Question 6

What clean claim rate should a dermatology practice expect?

Accepted Answer

The industry average clean claim rate is 92–94%. PACT RCM maintains a 96% clean claim rate across dermatology clients through dermatology-trained coders, same-day charge entry, automated claims scrubbing, and modifier-specific validation rules. This 2–4 point improvement translates to faster payments and fewer denials.

Question 7

How do you reduce denials for dermatology practices?

Accepted Answer

PACT RCM reduces dermatology denials through a prevention-first approach: real-time eligibility verification with derm-specific coverage checks, modifier validation before claim submission, biopsy-pathology code matching, cosmetic vs. medical service separation at charge entry, and payer-specific prior authorization workflows. When denials occur, our back-office team uses root-cause analysis to prevent recurrence.

Question 8

What dermatology billing software and EHR systems does PACT RCM integrate with?

Accepted Answer

PACT RCM integrates with all major dermatology EHR and practice management systems including Modernizing Medicine (EMA), AdvancedMD, DrChrono, Nextech, athenahealth, eClinicalWorks, and Epic. We work within your existing systems — no migration required.

Question 9

How do I know if my derm practice is losing money on procedures?

Accepted Answer

Use accounts payable (AP) profitability analysis to compare procedure-level costs against collections. Many derm practices discover that certain procedures — particularly low-reimbursement biopsies or complex Mohs cases with specific payers — cost more to perform than they collect. PACT RCM's AP profitability framework helps identify money-losing services and build data for payer contract renegotiations.

Question 10

What should a dermatology practice look for in a billing company?

Accepted Answer

A strong dermatology billing company should understand specialty-specific coding, Mohs surgery billing, modifier usage, biopsy-pathology reconciliation, payer-specific rules, denial prevention, and AR follow-up. For multi-location dermatology groups, the billing partner should also provide transparent reporting, front-office workflow support, and measurable performance improvement. PACT RCM supports dermatology groups with full-cycle RCM workflows across eligibility, coding, claim submission, denial management, pathology reconciliation, and AR recovery.

Specialized Dermatology Billing for Multi-Location Practices