What You Need to Know Before Undergoing A Tummy Tuck Surgery

If you are self-conscious about loose, drooping skin around your midsection or if you have weakened abdominal muscles due to excessive weight loss or pregnancy, a tummy tuck surgery or abdominoplasty may be the best way to achieve a firmer, youthful figure. Even though it is  not considered a weight reduction procedure, abdominoplasty can remove a person’s contours when exercise and diet cannot eliminate excess tummy skin.

Abdominoplasty is not the same as liposuction, although you may opt to get a liposuction along with it. Abdominoplasty is a major procedure. Thus, if you are considering it, it is important you know the facts before deciding whether to go forward.

Why do most people undergo a tummy tuck procedure?

Many patients have gained lots of benefits after undergoing a tummy tuck surgery. First, an abdominoplasty helps to eliminate significant amounts of skin and fat that has accumulated in the abdominal region. Second, it helps to tighten the rectus or vertical muscles of the abdomen, which further helps to define the tone of the abdomen. Third, abdominoplasty helps to remove a majority, if not all, stretch marks that have resulted from weight fluctuations or previous pregnancy. Generally, the outcome of the procedure better define the shape of the body and gives a more tone and defined central region to the body.

Who is an ideal candidate for abdominoplasty?

  • In general, you may be an ideal candidate for abdominoplasty if:
    You are physically healthy and at a stable weight
  • You have a loose, drooping skin around the abdomen
  • You carry excessive weight in the midsection
  • You have healthy expectations of the procedure, which can be discussed with plastic surgeon
  • You are committed to maintaining the results with a good diet and routine exercises

Note that tummy tuck surgery is a highly individualized cosmetic procedure, and you do it for yourself, not to fit any sort of ideal image or to fulfill the desires of some else.

What does tummy tuck surgery involve?

Depending on your expectations, a tummy tuck surgery can take anywhere from one to five hours. The complexity of the procedure will also determine whether it will be done as an outpatient or in-patient basis. Medication will be administered for your comfort during the surgical procedure. The choices include general anesthesia and intravenous sedation. Your surgeon will recommend the best option for you.

There are two major types of a tummy tuck surgery: complete or full abdominoplasty and partial or mini abdominoplasty.

Complete Abdominoplasty

A complete or full abdominoplasty is mostly used to address cases where the drooping skin and loose abdominal muscles are present below and above the belly area. During a full tummy tuck surgery, the incision is made across the lower tummy, from hip to hip, just above the pubic area. Excess skin is removed, muscles are tightened and liposuction may be done to contour the abdomen. A new location for the belly button is created to ensure it remains in its natural position. The procedure can take between two to five hours. Some procedures are outpatient based while others may need to stay in the hospital for a few nights.

Partial or Mini Abdominoplasty

A partial or mini abdominoplasty is ideal for patients with minimal loose, drooping skin below the navel. During the procedure, the doctor will not move your belly button. Instead, he or she will make a large incision across your lower tummy, separate the skin from the abdominal wall below the tummy button, remove excess fat and cut away excess skin. Finally, they will pull together the remaining skin and stitch it in place. The entire procedure may only take up to two hours, depending on your situation.

What is the recovery for an abdominoplasty?

After the surgery, you will need to take about 4 to 6 weeks off work and exercise. You may not be able to drive for a few weeks after undergoing the procedure (your plastic surgeon and insurance company will advise you about this). It may take several weeks before you see the full effects of the operation, and it takes about six weeks to fully recover.

During the recovery period, bandages or dressings will be applied to your incisions, and you may be wrapped in a compression garment or an elastic bandage support your abdomen and reduce swellings as it heels following surgery. Small, thin tubes may be placed temporarily under your skins to drain any excess blood or fluids that may accumulate.

More importantly, you should avoid strenuous activities in the first few weeks after the operation, to avoid putting a strain on your stitches. After the first one or two weeks, your doctor will carry out a wound check. At the sixth week, your bandage should be able to come off and you should also be able to resume to most of your normal activities.

What are the expected tummy tuck results?

The outcome of an abdominoplasty may not be very clear initially due to the swellings and your inability to stand upright. Within the first two weeks, you should be standing tall and confident with your new slimmer shape. Your tummy tuck will result in flatter, tighter abdominal contour that is proportionate with your body and weight.

You can view a few tummy tuck / abdominoplasty before and after photos below (tummy tuck photos courtesy of Allure Plastic Surgery http://www.newyorkplasticsurgeryallure.com/tummy-tuck-abdominoplasty)

Example of a tummy tuck procedure, before and after.

Photo courtesy of Allure Plastic Surgery, Staten Island / New York, NY.

Example of a tummy tuck procedure, before and after.

Photo courtesy of Allure Plastic Surgery, Staten Island / New York, NY.

Example of a tummy tuck procedure, before and after.

Photo courtesy of Allure Plastic Surgery, Staten Island / New York, NY.

 What are some common side effects you should expect?

If you had a complete abdominoplasty, you will be left with a scar around your belly button. If you had a partial abdominoplasty, you will be left with a scar running across your lower tummy. It is also common after the procedure to:

  • Have pains and bruises
  • Have difficulties standing upright
  • Feel numbness in your tummy for the first few months
  • Have a temporary fluid swelling on top of the scar
  • Have red, raised scars in the first five to six weeks.

Like any other surgical operation, a tummy tuck surgery can sometimes go wrong and the outcome may be what you expected. If you think the procedure was not carried out correctly or are not happy with the results, you should take up the matter with doctor who performed the operation. However, most patients who undergone a tummy tuck surgery were contented with the final results and have reaped numerous benefits.

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An Inside Look at the 2016 NACHC CHI Expo in August

The National Association of Community Health Centers’ (NACHC) Community Health Institute (CHI) is one of the biggest and the most important yearly conferences for health centers and professionals in the general medical community. Taking place in Chicago on August 28-30th, the 2016 NACHC CHI expo will host over 2,000 community health center managers, clinicians, employees, practice management professionals, board members and leaders – bring all of these professionals together to collaborate and address key matters in today’s health and medical climate.nachc chi 2016

The 2016 NACHC CHI event is set to be one of the biggest so far, with topics ranking from FQHC billing reimbursements to meeting today’s digital demands in tele-medicine. There has been a large growth in health care centers which aim to meet the growing demands for primary care services. The inconceivable changes in the social insurance environment get under way by the Affordable Healthcare Act’s implementation. The ACT raises a wealth of new issues for Community Health Centers and their patients in every aspect ranging from operations, finance, business, marketing and event management. The NACHC CHI expo aims to unite the most informative people and give one. The apparatuses to stay strategically competitive in the new Health Insurance Marketplace.

NACHC CHI Topics of Discussion

It is a great opportunity for health centers to attend this meeting. The attendees will have the chance to learn be more informed and updated about various issues in the current medical climate. Some of these issues include:

  • Various funding opportunities
  • Outreach, marketing and enrollment opportunities
  • Negotiating and socializing with contracts with a pre-planned way and vendors
  • Workforce which includes veterans and succession planning
  • Clinical care group integration
  • PCMH recognition and accreditation
  • Tele-behavioral health
  • Trust, quality, compliance and sustainability

It is a great idea for health center practices and medical professionals to attend NACHC CHI expo because one gets to interact with lots of industry thought-leaders, discover and leverage new resources, and learn great insights on cutting-edge ideas.

Expo Events at the 2016 NACHC CHI Conference

This 2016 expo, the NACHC CHI conference will focus on the following events:

  • Hiring, growing and retaining a strong workforce
  • Realizing the full benefits of affordable care act
  • How to build a strong community with the social media
  • Helping to influence the future of health centers through strategic thinking
  • All information in detail related to FTCA
  • How to manage better quality with persistence at a lower cost and an amazing experience

All in all, attending the NACHC CHI expo in August is a great choice for any healthcare professional seeking to learn and grow in the industry.

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Compelling Spine Surgery Statistics Reshaping The Medical Mindset

A recent report from the Agency for Healthcare Research and Quality found that there are 27 million adults who suffer from back problems. This population spends around $30.3 billion for health and medical treatment, ranging from chiropractor visits, pain management and physical therapy, and other non-invasive therapies.spine surgery

However, a major chunk of money is invested in spine surgery operations. Not only is spine surgery costly, but some forms of spinal surgery include advanced spinal surgery technologies and thus are are very complicated, especially when involving the fusion of two or more vertebrae. As per the study published in July, spine surgical operations have increased by eightfold in just 15 years.

Rapid Increase in Spine Surgery Operations in the U.S.

Spine surgery is booming rapidly. Every year, around 500,000 Americans undergo surgery for lower back problems alone. According to the findings of Agency for Healthcare Research and Quality, people spend more than $11 billion every year on spine surgeries. Unfortunately, spine surgery does not always provide much desired relief.

Spine and back operations are successful for those who suffer from serious structural diseases or problems. However, spine surgery may not be an ideal treatment option for most people. According to Johns Hopkins Medicine, surgery is successful for fewer than 5 percent patients.

However, this ultimately depends on the spine surgeon, the patient’s condition, and the prescribed treatment. One New Jersey spine surgeon, Dr. Joshua Rovner is a great model in orthopedic medicine, as he advocates spine surgery as a last resort for his patients.

Pinpointing the Sources of Back Pain

Surgery must be conducted only if a doctor can locate the structural cause of your pain. Surgery is effective for conditions such as deformity, infections, spinal tumors, or nerve damage. You can also undergo a surgery if your spine is weakened by diseases or fractures, narrowing of spinal column that causes weakness, pain, tingling and numbness in legs along with back pain, or persistent leg pain caused by spinal stenosis. Even in these cases, seeking a second opinion is a good idea.

Herniated or ruptured disks can also be treated successfully with surgery. However, surgery is unnecessary in this case too. Many people have ruptured or herniated disc problems, but most of them do not know about it. More than 80 percent of patients get better in 6-12 weeks without undergoing surgery, Johns Hopkins report says. In extreme cases, herniated disc can cause loss of bladder and bowel control due to its pressing against nearby nerves. Surgery is the only method to get relief from this condition.

If back pain is your only complaint, do not correct it through surgery. But, unfortunately, many patients with simple back pain undergo surgery for getting relief.

Different Types of Spine Surgeries

Some of the different types of spine surgeries that are most common include:

  • Spinal fusion surgery
  • Laminectomy
  • Discectomy
  • Disc replacement
  • Interlaminar Implant

Discectomy is the removal of herniated portion of a disc. Surgery is conducted for getting relief from irritation and inflammation of a nerve. Laminectomy is the removal of bone that overlay the spinal canal. Spinal fusion is the permanent connection of two or more bones in your spine. It is done for providing stability to a spinal fracture. Artificial discs are implanted between two backbones in your lower back. This is helpful for maintaining the space between.

All surgeries carry some degree of risk. General complications of spine surgery are:

  • Heart attack
  • Blood clots
  • Infection
  • Bleeding
  • Reactions to anesthesia
  • Nerve damage
  • Recurrent disc herniation
  • Stroke
  • Weakness
  • Paralysis
  • Loss of bowel or bladder control

According to the opinion of Spine Society of North America, spinal fusion surgery must be adopted as the last resort for patients. You should try some other treatment options if you have simple back pain. In such cases, you can try pain relievers, gentle activities, heating pads, ice packs, etc.

If your problem is really complicated and your doctor recommends surgery, it is always better to seek a second opinion. Back pain is miserable, aggravating and even agonizing. But, it becomes an emergency very rarely. So, you have enough time to work with your doctor. Therefore, you will get enough time to take the right decision.

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Chiropractic Care: Striking a Balance With Other Physical Therapies

chiropractic care Chiropractic care is a holistic health and wellness practice that focuses to relieve pain and help restore your normal body function through spinal adjustment or manipulation. There are countless reasons to seek for chiropractic care like poor organ function, blood pressure, lung capacity, headaches.

In this article, you will learn more about the importance of combining spine muscle strengthening exercises and physical therapies and treatments with chiropractic care so that your spine can be rehabilitated and you regain optimal mobility as soon as possible. Chiropractors believe that they help the body heal itself.

The Importance of Strength With Chiropractic

Chiropractic care works like magic to relieve spine related pains and is very effective when coupled with exercises that strengthen the muscles surrounding the spinal cord as well as other physical therapies. For instance, core and back exercises tailored according to your level of pain and condition can be the best supplement to chiropractic adjustments.

As supported by a Bloomington chiropractor IL, core exercises will enable your abdominal muscles support your back muscles so that they are not overloaded when supporting your upper body. The exercises are combined with regular stretching and physical therapies like low impact aerobics for the best results. When exercising, ensure that you master the right posture and techniques to avoid more injuries.

The Pettibon System

pettibon system chiropractorThe Pettibon System is a science-supported approach to chiropractic care that is highly recommended by most doctors. The Pettibon System is designed to realign or manipulate your spine so that it gets an upright posture for optimal function. It focuses on the nervous system integrity restoration and involves highly-targeted adjustments from a Pettibon System chiropractor, as well as spine correction and posture exercises that can help cultivate strength and balance in the surrounding muscles of the spine (perhaps the most important yet overlooked component to chiropractic care.)

When performing these exercises, there are special weights that have been designed to be worn on the head, hips and shoulders for approximately 20 minutes every day to correct your spine displacement and give you optimal mobility. These exercises will help minimize pain over time, making the muscles surrounding the spine strengthened and conditioned. The Pettibon System has received thousands of rave reviews from satisfied users and will without doubt help you regain your life.

Effective Complements to Chiropractic Care

Apart from the chiropractic care and the back strengthening exercises mentioned above, there are many other unique modalities that are employed today for long term spinal correction and regaining optimal mobility. They include:

Hot/Cold Therapy

Heat therapy works by causing relaxation and comfort on the muscles surrounding the spine. Cold therapy works by causing the injured area to become numb and minimize pain transmission. The combination can be a highly effective supplement to chiropractic care around the spine.


Ultrasound can help in the correct diagnosis and coupled with other treatments is very effective. It should be employed in the late stages of the injury.


Electrotherapy involves the passing of electrical current to catalyze the relief of nerve ending pain. It is recommended in the early stages of spinal injury. Some chiropractors apply this therapy for their patients.


Iontophoresis is the use of electrical potential to facilitate the transfer of ions into the soft tissues and specific site of injury. Although not very common, Iontophoresis therapy can be highly-effective when using in conjunction with chiropractic care.

Pool Physical Therapy

A number of physical therapy exercises can be done in a pool to relieve pain originating from spine injuries caused by muscular strains. This low-impact atmosphere is a great way to strengthen and cultivate balance in muscles around the spine.

Light Massage

You can be massaged using ointments containing therapeutic agents that pass through the skin to relieve pain. Working on tight spots in the spine’s surrounding muscles can be a great complement to the work of professional chiropractor.

Braces & Taping

Braces, splints or taping are tailored to your specific needs to support injures muscles and joints. These therapies are often helpful for acute and traumatic injuries.

You never know when you will encounter an unfortunate event or pain originating from musculoskeletal structures that may leave your spine displaced, affect nerve impulse transmission and deny you optimal mobility. Chiropractic care, when combined with various other treatments, can be extremely effective for individuals that need help minimize pain and optimizing mobility.

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Top 5 Spine Surgeons in New Jersey Worth Mentioning

top new jersey spine surgeonsNew Jersey is home to some of the top spine surgeons in the country. With debilitating spinal conditions on the rise, the demand for professional spine specialists and spinal surgeons is also increasing. So if you’re based near the eastern seaboard of the U.S., the following are the top spine surgeons in New Jersey.

Dr. James Dwyer (New Jersey Spine Institute)

Dr. James Dwyer is a fully board-certified; fellowship trained orthopedic surgeon who practices in Bedminster, NJ. His practice incorporates both surgical and conservative spine treatment methods. Such methods include outpatient discectomies/laminectomy, minimally invasive spine procedures, as well as a full complement of trauma and reconstructive surgeries for the lumbar spine and cervical spine.

Dr. James works closely with Dr. Paul P. Vessa at the New Jersey Spine Institute. The New Jersey spine center utilizes multi-disciplinary approaches to spinal disorders through the use of tactics such as comprehensive spinal surgeries, rehabilitation, pain management, as well as modern spinal diagnostics.

Dr. Gordon Donald (New Jersey Spine Group)

The New Jersey Spine Group is committed to helping spine patients regain their normal lives back. Dr. Gordon is a qualified medical director and the chief of spinal surgery at the group. Equipped with 25 years of private practice, he is renowned for his major accomplishment as an educator to other spine surgeons.

The spine surgeon in New Jersey is also known for his superior patient care. He has lectured and taught on the surgery internationally and throughout the country. He has been very instrumental in the development of minimally invasive spinal procedures. He is committed to the best patient care that guarantees efficient return to normal life activities.

Dr. Joshua Rovner (Progressive Spine & Orthopaedics in Englewood, NJ) new jersey spine surgery centers

Surgery-specific spinal conditions are often more than physical as they affect the state of the mind as well as social interactions. Efficient treatment should consider all factors for them to succeed. Dr. Joshua Rovner takes the time to determine the source of your pain, identify all the factors unique to your condition, and explains them to you. As the head New Jersey spine surgeon at Progressive Spine & Orthopaedics in Englewood, NJ Spine Surgeon Dr. Joshua Rovner educates his patients on all possibilities, including both surgical and non-surgical options.

Dr. Rovner empowers patients and helps them go through the treatment process with positivity. His goal is to help his patients regain their quality lives through combining quality care with integrity and compassion. Patients are seen by appointments without wait times.

Dr. Ari Ben-Yishay (Comprehensive Spine Care, Emerson, NJ)

Dr. Ari is also board certified and fellowship trained and boasts of a strong background in conservative, non-surgical approaches. He believes in exhausting all available options before opting for surgery.

When invasive approach is warranted, he has extensive training and experience in the minimally invasive procedures, conventional and other modern surgical techniques. He performs procedures such as work and sport related spine injuries, tumor surgery, scoliosis, cervical disc replacements, and revisions of failed spine surgeries.

Dr. Jonathan D. Lewin (Center for Spinal Disorders, Englewood, NJ)

Dr. Jonathan D. Lewin is a board certified and fellowship trained New Jersey spine surgeon with experiences of over ten years ranging from relatively conservative approaches to minimally invasive surgery. He is the head of the Center for Spinal Disorders.

Dr. Jonathan is among the few doctors in New Jersey and New York area who are experienced enough in undertaking endoscopic fusion surgery. He also specializes in the treatment of degenerative disc disease, scoliosis, spondylolisthesis, and other spinal disorders. He is also professionally affiliated to the Medical Society State of New Jersey, helping patients embrace spine surgery in the most mindful and graceful way possible.

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An Inside Look the Cardiology Billing Services of Practice Management

When it comes to specialized medical billing solutions, such as cardiology billing services, only some companies can provide the level of service and expertise needed to establish an effective and seamless cardiology billing system.cardiology billing services

Practice Management is committed in providing its clients with giving them the best cardiology billing services available. The purpose of these services include:

  • Reducing overhead costs you may have
  • Reducing payment turnaround times
  • Increase your patient’s’ satisfaction with your Cardiology service
  • Increasing your cash-flow
  • Maximizing revenue

It is important to note that Practice Management keeps its practice up to date with the latest cardiology billing practices, codes, and regulations stated by governmental authorities.

A Typical Cardiology Billing Service Program

Practice Management’s cardiology medical billing services are provided for the following procedures:

  • Nuclear studies
  • Stent procedures
  • Implantable and wearable cardiac device assessments
  • Angiography
  • Angioplasty
  • Cardiovascular monitoring
  • Cardiac Catheterization
  • Echocardiography

Maximum Protection at Practice Management

Practice Management will give you a specific ID and password so you can have remote access to data regarding your cardiology practice. Practice Management follows the most strict and ethical security codes, so whenever a client stops working with them, the user’s ID and password are removed from the system. To ensure no data is lost, files are backed-up on a daily basis and they are also taken off the site for major protection.

Along with cardiologist medical billing and coding services, Practice Management also offers credentialing services to those institutions that are interested in making the reputation even more solid. It has been shown also that credentialing allows practitioners to avoid many cash-flow pitfalls that would otherwise remain undetected and unsolved.

NPI and CAQH updates and applications are also offered at Practice Management. It is important for the client to note that in every credential process, all information along with communication is maintained from the first stages (collection) up until the last stages (follow-up). All applications are also reviewed to see if any documents are missing and the company will let you know if there’s something missing so the client will have the time to present it.

Credentialing Services for Cardiologists

Here are some of the credentialing services offered:cardiology billing

  • Medicaid credentialing
  • Medicare credentialing
  • Blue Cross
  • Blue Shield
  • Workers Compensation Payers
  • Hospitals
  • Physician Organizations
  • Durable Medical Equipment
  • Commercial Payers
  • NPI registry

Why Choose Practice Management for Cardiology Billing and Coding Services?

Practice Management has been on business for several years. What sets them apart from their competition is the fact that they use the latest technology to keep track of the billing and coding done for their clients. On top of that, Practice Management specializes in having an efficient revenue cycle management. The goal of contacting and hiring Practice Management for your cardiology practice is to increase your revenue as well as the actual physical money coming into your company.

More and more cardiologists have been encouraged to outsource their billing and coding services so they can focus in their “core” business which is providing excellent health-care services to their patients. On top of that, you can maximize your revenue at the same time you reduce overhead costs.

Practice Management handles each case in a personalized manner. While the principles and values behind an aggressive revenue cycle management are kept when working with all clients, each cardiologist has specific needs in regards to billing and coding services. On top of that, you may also opt for a credentialing service to ensure your business’ finances stay in shape in the long term.

To learn more about this professional medical billing company or to inquire about Practice Management’s cardiology billing services, visit MaximizedRevenue.com for more information.

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3 Most Proficient Providers of Surgery Billing Services

When it comes to outsourcing surgery billing services, many medical billing companies claim to have expertise in all aspects of patient billing – surgery, OB/GYN, pediatrics, FQHCs, etc. However, the quality-spectrum of specialized billing practice is vast. In short, if you’re a surgeon (or you help operate a surgery center or professional practice,) then it’s smart to stick with medical billers who are experienced experts in the art of surgery billing.

To help shed light on such medical billing companies, below we have pinpointed and profiled three of the most proficient providers of surgery billing services.

1. Practice Management best surgery billing services

Practice Management is one of the most successful and well-known providers of surgery billing. The firm aims at providing the best surgeon billing services leveraging a wide range of resources and skillsets. Client satisfaction is the primary goal of this service medical billing company, and it shows having been providing surgery medical billing services for many years.

Practice Management started in 1995, since then the company has succeeded to deliver reliable solutions for the billing needs of various surgeons and physicians in their practices. The company makes sure that the bills are claimed with highest returns in a timely way.

This reputable surgery billing service company has various services to offer. It provides a comprehensive medical billing and coding that will reduce the burden of billing needs to a great extent. The surgeons will find enough time to spend on their patients rather than working on the billing details. This will give an opportunity for the surgeons to concentrate more on their practices, thereby, progressing well in their professional.

Practice Management has a legitimate billing service fee calculation for its clients and takes three main factors for the calculations. They are the medical specialty, payer mix, and practic’s volume. All the calculations are transparent and the clients can always contact the service provider for any concerns.

2. 5 Star Billing Services

The services from 5 Star Billing Services are more professional and organized compared to most other providers of surgery billing services. The company works with various medical specialists and surgeons across the nation. The expertise team from this surgery billing service company works with their clients to enable surgeons to maximize revenue streams while minimizing overhead expenses and wasted time. surgery billing service

5 Star Billing Services provides both the complete billing solutions as well as the intermediate billing needs, thereby, making their services flexible. The company has maintained its quality of services for many years by working in coordination with its surgeon clients. With the changing requirements of billing needs, the services are continuously updated to suit today’s scenario of the clients.

By using the billing services from 5 Star billing services, surgeon clients can avoid the hurdles of billing preparations. The medical billing consulting services offer various features like temporary staffing, practice analysis, physician credentialing, etc. The company provides the medical coding that will help in the maximization of claim reimbursement.

5 Star Billing Services allocates the right medical codes based on the client’s records and practice. By doing so, this service provider makes sure that the clients obtain maximum reimbursement which they deserve. This billing service company also provides various security aspects to ensure that the information of the clients is secured.

3. Mederi Services

Mederi Services provide services that are customized and developed according to the needs of the clients. This is favorable for the surgeon clients because they need not have to pay for the redundant services. This means the service fees will be largely saved for the clients by using this surgery billing service provider. The primary goal of Mederi Services is to increase the value of claims for the clients without compensating on services and patient support.

Mederi Services provides the highest claim returns for their clients through their unique medical billing services. The claims are professionally prepared with accurate medical codes. The company uses a “proprietary appeals” software that will be used for a faster and accurate processing of the client’s appeal. The follow-up of all the claims is persistently done here. The concerns related to any billings are addressed without any delay.

The company also provides patient statements to its clients through the mail by analyzing the patient information. The service fees levied on the clients depend on the claim amount collected and it is generally 5% to 10% of the total amount.

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