Every medical specialty carries unique documentation protocols, modifier complexities, and payer medical necessity guidelines. Our certified RCM teams know the exact rules that apply to your clinical field.
Therapy billing requires strict adherence to timed 15-minute intervention units, Medicare 8-minute rule calculations, Plan of Care (POC) certifications, and complex New York Workers' Comp (WCB) / No-Fault fee structures.
Specialized Medicaid Managed Long-Term Services & Supports (MLTSS) billing for adult medical day cares. We manage daily attendance roster reconciliation, per-diem authorizations, and monthly Medicaid HMO capitations.
Managing multimillion-dollar chemotherapy margins using Unlimited Financials. We ensure exact J-code units, mandatory JW/JZ drug waste compliance, complex NCCN compendia authorizations, and copay foundation assistance.
Cardiovascular billing demands absolute precision across echocardiography, nuclear stress testing, catheterizations, and pacemaker interrogations. We ensure diagnostic reports meet strict payer criteria.
High-dollar surgical global periods, arthroscopies, fracture care, intra-articular injections, and Durable Medical Equipment (DME) require diligent prior authorizations and meticulous modifier usage.
From complex multi-condition E/M leveling (99211–99215) and prolonged service codes to preventive medicine visits and Chronic Care Management (CCM), we ensure thorough reimbursement while safeguarding documentation integrity.
Mental health billing involves strict payer session duration rules, concurrent E/M + psychotherapy billing, tele-mental health parity regulations, and distinct licensing credentialing boundaries.
Vaccine administration counseling, developmental screenings, well-child visits, and Medicaid EPSDT schedules require meticulous charge capture to prevent underbilling.
Skin biopsies, lesion destructions, excisions with margin measurements, and Mohs surgery stages carry frequent payer audit risks without ironclad pathology notes.
ASC facility fees, implant carve-outs, multiple procedure payment reduction (MPPR) rules, and Medicare modifier conventions managed with certified surgical coder expertise.
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