Medical Specialties We Serve

Why specialty-specific billing is not a marketing line

Every specialty gets denied for different reasons. A biller who is excellent at one can be genuinely bad at another, because the knowledge that matters is not general billing skill — it is knowing the twenty or thirty rules that decide whether your particular claims get paid.

Consider how little the specialties have in common. In pediatrics, the money leaks through vaccine administration components that get undercounted and same-day sick and well visits that get bundled. In OB/GYN, a single decision — whether the global maternity package was intact — determines whether nine months of care gets paid. In orthopedics and pain management, the denials are mostly authorizations that were never obtained and post-operative global periods nobody tracked. In cardiology, they are bundling edits and coverage policies governing which diagnosis justifies which study.

None of those overlap. A billing company that treats them as one process will be adequate at all of them and good at none.

What we do differently, per specialty

We build the rules for your specialty into the workflow before the first claim goes out, rather than discovering them one denial at a time on your money. That means the modifier conventions your procedures require, the coverage policies your payers apply, the frequency and unit limits that will silently cap your claims, the authorization gates that sit in front of your high-dollar services, and the documentation your notes need to carry for any of it to survive review.

Then we work the account to a fixed cadence regardless of specialty: claims submitted within 24 hours of the charge, denials worked within 48 hours, insurance aging worked at 25 to 30 days rather than at 90 when it is already hard, and a 98% clean-claim rate that comes from scrubbing before submission instead of reworking afterward.

Specialties with dedicated pages

Each of these covers the denial patterns specific to that specialty, how we work them, and the questions practice administrators actually ask:

• Cardiology billing — bundling edits, coverage policies, device monitoring frequency limits and underpayments on high-dollar procedures.
• Pediatric billing — vaccine administration components, VFC, same-day sick and well visits, screenings and Medicaid managed care.
• Internal medicine billing — office visit levels under current rules, Medicare wellness visits versus physicals, and unbilled care management.
• OB/GYN billing — the global maternity package, split billing, antepartum visit counts and ultrasound medical necessity.
• Orthopedic billing — prior authorization, surgical global periods and their modifiers, DME enrollment and injection units.
• Behavioral health billing — carve-outs, session limits, timed psychotherapy codes and telehealth place of service.
• Dermatology billing — lesion measurement, what is already bundled into a procedure, modifier 25 and the cosmetic line.
• Physical therapy billing — the 8-minute rule versus the rule of eights, KX and CQ modifiers, and plan of care certification.
• Urgent care billing — walk-in registration errors, S codes and contract rates, CLIA waived labs and time-of-service collection.
• Radiology billing — professional and technical component splits, authorization for advanced imaging and medical necessity.

If your specialty is not listed

We take it on. Twenty years of medical billing means most of what looks unfamiliar is a recombination of rules we already work — component splits, global periods, timed units, frequency limits, authorization gates. What we will not do is pretend a specialty is simple before we have read your payer contracts and looked at your denials.

The honest test is the free practice audit. We look at your aging, your denial reasons ranked by dollars and your clean-claim rate, and tell you what we would change and what it is worth — before you commit to anything. If we do not think we can improve on what you have, we will say so.

What every engagement includes

Insurance eligibility verification, medical coding, provider credentialing and enrollment, and a monthly Practice Performance Report are included at no additional charge rather than billed as add-ons. We work remotely inside your existing practice management and EHR system — eClinicalWorks, athenahealth, Epic, NextGen, Kareo or Tebra — so you do not change systems and you do not buy anything new.

We are HIPAA-compliant, we work under a signed Business Associate Agreement, and we have been doing this from Aurora, Illinois for twenty years with a combined US and India team. There is a 30-day free trial, no long-term contract, and a 90-day money-back guarantee on full revenue cycle management. See revenue cycle management, pricing and why practices choose us.