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Pulmonologist reviewing a chest X-ray with a patient
Specialty Billing

Specialty Medical Billing Services

Billing built for every specialty we serve.

Our billing process includes specialty-specific payer rules, coding validation, and compliance requirements, built for the details of each specialty we serve.

  • HIPAA compliant
  • AAPC/CPC Certified Coders and Billers
  • EHR compatibility: we work inside your existing EHR/PM system
Core specialties

Deep Expertise Where Complexity Demands It

Each specialty below has its own page with the coding and payer rules we work with.

  • Radiology Billing

    Technical and professional component split billing (modifiers TC and 26), contrast coding, the multiple procedure payment reduction (MPPR) on imaging, and teleradiology billing.

  • Pain Management Billing

    Epidurals, facet injections, RF ablation and spinal cord stimulators, with prior authorization and NCCI checks.

  • Gastroenterology Billing

    Screening vs. diagnostic colonoscopy coding, plus procedure and anesthesia coding.

  • ENT Billing

    Modifier 25 with office endoscopy, global periods, sinus NCCI edits, audiology and allergy billing.

  • Urology Billing

    Cystoscopy, prostate biopsy pathology, urodynamics, UroLift and Rezūm prior authorization, global periods and drug claims.

  • Pathology Billing

    Panel coding, Advance Beneficiary Notice (ABN) tracking, medical necessity checks against Medicare coverage policies, and reference lab billing for independent labs.

  • Pulmonology Billing

    PFT interpretation checks, 94010 vs. 94060 coding, sleep-study professional and technical components, and bronchoscopy NCCI edits.

  • Ambulance & EMS Billing

    For fire departments and ambulance companies: HCPCS A-codes, ALS/BLS levels, mileage, modifiers and PCS rules.

  • Rheumatology Billing

    Biologic infusions: J-code units, JW/JZ modifiers, infusion coding, buy-and-bill and prior authorization.

  • Nephrology Billing

    Monthly capitation payment (MCP) billing for ESRD-related physician services, so recurring revenue stays on track.

  • Oncology Billing

    Chemotherapy administration coding, discarded drug reporting with the JW and JZ modifiers, multi-day treatment cycle tracking, and prior authorization for specialty drugs.

  • Home Health Billing

    Billing for home health agencies, with claims checked against payer rules before they go out.

  • IDTF Billing

    Billing that follows Medicare IDTF rules, including written orders from the treating physician, technical component coding, imaging accreditation requirements and mobile unit workflows.

  • Don't see your specialty?

    We also bill for Cardiology Billing · Orthopedic Billing · OB/GYN Billing · Neurology Billing · Psychiatry Billing.

    Ask us about your specialty. We'll tell you plainly whether we're a good fit.

    Book a Free Consultation
Specialty deep-dive

What Specialty Billing Looks Like in Practice

Generic billing treats every specialty the same. Here's how we handle two of the hardest.

Pathologist examining a slide under a microscope

Pathology Billing

Panel Coding and ABN Tracking

Lab billing needs precision, from panel component vs. individual test coding to Advance Beneficiary Notice tracking.

Challenges We Solve

  • Panel component vs. individual test coding
  • ABN tracking with patient financial responsibility
  • Reference lab billing with proper revenue allocation
  • Medical necessity checks against Medicare local and national coverage determinations (LCDs and NCDs)
Pathology Billing
Row of small glass medication vials on a table

Oncology Billing

Drug Units, JW/JZ and Prior Auth

A denied drug claim costs more than most, because the practice has already paid for the drug. That's why we check units, modifiers and authorization before drug claims go out.

What We Check

  • Drug units checked against the HCPCS code descriptor before submission
  • JW and JZ modifiers applied as Medicare requires for single-dose container drugs
  • Prior authorization for high-cost oncology drugs
  • Underpayment checks by drug and by payer
Oncology Billing
Getting started

How It Works

  1. 1

    Book a Free Consultation.

    We learn your specialty, payers and current workflow, and give you your rate in writing. See how pricing works.

  2. 2

    Plan the Transition.

    Our transition plan is designed to minimize billing disruption and support continuity of collections. We work inside the EHR/PM system you already have. Your staff keep their usual tools, and your data stays yours.

  3. 3

    Prevent, Detect, Recover.

    AAPC/CPC Certified Coders and Billers who know your specialty's codes, modifiers and payer rules work your claims.

  4. 4

    See Where You Stand.

    Clear reporting by payer, provider, location and CPT, so you know where to focus.

Services

Services That Fit Every Specialty

All services
  • Medical Billing

    Charges entered, codes checked, claims submitted and followed up, step by step.

  • Revenue Cycle Management

    One team for the full cycle, from registration to final payment.

  • Eligibility & Benefits Verification

    Coverage checked before the visit, so specialty services aren't denied for eligibility.

  • Medical Coding

    AAPC/CPC Certified Coders and Billers turn documented services into accurate, complete codes.

  • Prior Authorization

    Authorized CPT, units, provider, location and dates checked against the claim before it's submitted.

  • Denial Management

    Recurring denials traced to their root cause and fixed upstream.

  • Provider Credentialing

    Medicare, Medicaid and commercial payer enrollment, tracked through to billing readiness.

FAQ

Specialty Billing Questions

We provide multi-specialty billing. Our specialty pages cover ambulance and EMS, ENT, gastroenterology, home health, IDTF, nephrology, oncology, pain management, pathology, pulmonology, radiology, rheumatology and urology. We also bill for cardiology, orthopedics, OB/GYN, neurology and psychiatry. If your specialty isn't listed, get in touch.

Yes. Groups that combine specialties can keep all of their billing with one team.

Yes. AAPC/CPC Certified Coders and Billers work your specialty's codes, modifiers and payer rules, and our coding and claim checks are tailored to each specialty.

Find Your Specialty's Revenue Potential

Book a free, specialty-specific consultation with our team to talk through your coding, denials and billing workflow.

Book a Free Consultation