CollectionPro, a specialized revenue cycle and out-of-network (OON) claims management partner, has successfully helped a well-known plastic surgery practice recover significant revenue from complex out-of-network claims that had previously been underpaid by insurers.

Out-of-network billing continues to be one of the most challenging areas in modern healthcare reimbursement. Plastic surgery practices often face increased scrutiny from insurers when submitting OON claims, leading to delays and underpayments. For many practices, managing these cases internally can quickly become overwhelming due to evolving payer policies, administrative requirements, and regulatory frameworks such as the No Surprises Act (NSA).

The client, a highly respected plastic surgery practice with a strong reputation for advanced surgical outcomes and patient care, encountered growing difficulties in managing all its out of network reimbursement problems. A significant number of claims had already been underpaid, creating mounting administrative pressure and substantial revenue loss.

Recognizing the complexity of the situation, the practice partnered with CollectionPro to handle the intricate process of OON claim recovery.

CollectionPro handles all complex underpaid OON claims:

CollectionPro conducted a comprehensive audit of the practice’s underpaid claims and quickly identified multiple opportunities for revenue recovery. The team then implemented a structured strategy that included claim reconstruction, payer communication, regulatory compliance review, and escalation protocols where required.

Through this focused approach, CollectionPro successfully reopened many previously underpaid claims and pursued reimbursement through proper payer channels. Several of these claims, which had earlier been written off as unrecoverable, were ultimately processed and paid after strategic intervention.

“Our goal is to help healthcare providers recover revenue that rightfully belongs to them but is often lost due to the complexity of out-of-network reimbursement,” said the spokesperson David Nissanoff from CollectionPro. “Plastic surgery practices frequently face challenges with insurers questioning medical necessity, coding structures, or reimbursement levels. Our team specializes in navigating these barriers and ensuring that claims receive the attention and follow through they deserve.”

CollectionPro delivers results for all OON claims:

The engagement has already resulted in multiple previously underpaid claims being successfully overturned and reimbursed. In addition to recovering revenue, CollectionPro also streamlined the practice’s ongoing OON claims workflow, reducing administrative burden and improving overall claim tracking.

Healthcare providers across the country continue to struggle with insurer underpaying them, particularly in specialized fields such as plastic surgery, cardiology, and advanced outpatient procedures. Experts note that many OON claims remain underpaid simply because practices lack the resources or expertise required to pursue appeals and dispute processes effectively.

This is where CollectionPro’s specialized focus on out-of-network claims management allows providers to concentrate on patient care while experts handle the OON complexities. Be it payer negotiations, appeals, NSA regulations or reimbursement recovery; these expert take care of it all.

By leveraging its deep experience in OON claims resolution, regulatory compliance, and payer communication, CollectionPro continues to help healthcare organizations recover their lost revenue and bring financial stability to practices dealing with increasingly complex reimbursement environments.