Helping fellow providers overcome the reimbursement challenge
With nearly 20 years as a physician behind him, Ayyaz M. Shah, DO, has amassed an inventory of awards and recognitions beyond his years.
Dr. Shah graduated medical school at the New York Institute of Technology College of Osteopathic Medicine. He completed Family Medicine residency at Wyckoff Heights Hospital, an affiliate of Cornell University Medical Center and Dermatology training at Advanced Dermatology & Laser Center. He is board certified in Dermatology and Family Medicine and is one of few physicians who is a Diplomate of the American Board of Laser Surgery.
Dr. Shah has been named a Leading Physician of the World, Top Dermatologist in Florida and has been selected by Doctor's Choice Awards as a Top Dermatologist.
Dr. Shah is the founder, president & medical director of Global Dermatology Institute/Shah Dermatology, located in Orlando, and serves as a Medical Director of Ideal Image in Orlando. In addition, he is a Medical Director of Hair Loss Control Clinic (HLCC) and his Dermatology practice is an affiliate Laser center of Hair Loss Control Clinic.
When he is not serving his patients, he is an advocate for education, as an Assistant Professor at the University of Central Florida, as well as instructor for the Aesthetic Association of Florida, Global Dermatology Institute and Empire Medical Training.
In Other Words with Dr. Ayyaz M. Shah
The healthcare industry has been in turmoil due to the spiraling healthcare costs for years and the situation does not look like it will improve any time soon. The typical model for medical services involves 3 components: The healthcare provider, the patient who is seeking treatment for a particular disease or disorder and the insurance provider.
Many physicians especially in Primary Care are working harder and working longer hours, however their reimbursement from insurance companies is not increasing. Many of these physicians are actually seeing declining reimbursements from the insurance companies for the services rendered. ICD-10 was recently implemented, which created more confusion and anxiety among medical providers learning a new set of diagnosis codes linked to billing. Procedures improperly coded and sent for payment are denied, resulting in the need for specialists to perform the proper coding and billing which in turn increases healthcare costs.
Often, insurance companies pay only a portion of the claim, leaving patients with a balance (sometimes a large amount) due, and upon receiving a notice for requested payment for services, they become irate or simply refuse the request for payment resulting in further costs for collections on those balances owed.
Due to billing, coding, declining reimbursements from the health insurance companies, many primary care physicians are looking for other ways to supplement their income. One of the ways to achieve this goal is to offer additional services paid out-of-pocket, bypassing insurance companies altogether eliminating the need for a coder, a biller or submission of fee bills. Fees for service are collected upfront and denial of payment becomes a non-issue.
We have an Aesthetic Dermatology and Obesity Medicine Practice. We do take most insurance, however the majority of procedures we perform are not covered by insurance. This is one of the optimal times in medicine to be a part of the aesthetics industry. More people than ever are seeking services to look more attractive, slimmer, younger and rejuvenated.
There is a large need for aesthetic services for these individuals and many of the specialists such as plastic surgeons, cosmetic surgeons and dermatologists are unable to meet the demand. A gap exists between the demand for these aesthetic treatments versus providers who can bridge that gap.
The shifting paradigm in healthcare sets up a unique opportunity for primary care physicians to step in and help fill this void. One way to help fill this gap is to provide training opportunities for these family physicians, internists, OB/GYNs, Med/Peds, PAs/NPs, aestheticians, trichologists and other healthcare professionals.
Aesthetic and anti-aging procedures are very popular in the United States and abroad. A recent report from The American Society of Plastic Surgery (ASPS) that Americans spent $16 billion on cosmetic plastic surgery and minimally invasive procedures in 2016. More patients than ever are concerned about their appearance. Baby boomers while working to maintain their inner health also want to look younger, healthier and more attractive.
With the entry of social media in our lives and "selfies" there is an increase in some of these procedures for younger patients. In particular, lip rejuvenation is particularly very popular and often requested. Filling of the lips and PRP (plate rich plasma) was largely made popular by sisters and media celebrities Kylie Jenner and Kim Kardashian.
The top five minimally invasive cosmetic procedures performed in the United States in 2016 were:
- Wrinkle treatment procedures (Botox, Dysport etc.) - 7 million procedures,
- Hyaluronic acid fillers (Juvederm, Restylane) - 2 million procedures,
- Chemical Peels - 1.3 million procedures,
- Microdermabrasion - over 775,000 procedures,
- Laser treatments - over 650,000 procedures.
As the demand and number of patients seeking treatment is increasing for these minimally invasive aesthetic procedures, the number of properly trained physicians to perform these procedures is not increasing at the same rate. These minimally invasive procedures are easy to learn and perform with proper training.
There are many organizations currently that offer aesthetics training at various conferences, symposia, seminars, workshops, etc. Most of these offer a didactic portion and a live demonstration of the procedure being performed, some will offer a "hands-on" workshop. However, having been an instructor/faculty member at many of these workshops, most participants still felt that they were not comfortable at the conclusion of the workshop to confidently perform the learned or observed procedure.
Our observations during the many years of training these doctors and allied health professionals led us to the conclusion that there should be an opportunity for more immersed learning in a preceptorship allowing the provider to get more intimate one-on-one training in a much more relaxed environment. Upon the conclusion of the preceptorship and hands on training, physicians are ready and confident to perform the procedure in their own office.
Healthcare providers interested in training opportunities in these procedures with Dr. Ayyaz Shah and Aesthetiderm, can visit www.shahdermatology.com or www.aesthetiderm.com or email firstname.lastname@example.org