Medical Specialties We Serve

General Practice

Key Billing Directive: Focus on AWV (Annual Wellness Visits) and multi-modifier code capture.

Family Practice

Key Billing Directive: Optimized pediatric vaccine administration codes and screening services.

Internal Medicine

Key Billing Directive: Accurate chronic care management (CCM) and hierarchical condition (HCC) coding.

Pediatrics

Key Billing Directive: Ensuring EPSDT compliance and immunization tracking modifiers.

Geriatrics

Key Billing Directive: Detailed Medicare Part B coordination and palliative coding rules.

Medical Clinics

Key Billing Directive: Multi-provider tax ID billing and room charge integrations.

FQHC (Federally Qualified Health Centers)

Key Billing Directive: PPS (Prospective Payment System) G-code submission compliance.

Urgent Care

Key Billing Directive: Fast S-code billing and split-bill collections logic.

General Surgery

Key Billing Directive: Managing 90-day global surgical periods and modifier -58/-59 claims.

Neurosurgery

Key Billing Directive: Complex spine and cranial pre-authorization tracking and high-value codes.

Orthopedics

Key Billing Directive: Fracture care billing, cast modifiers, and DME orthotics integration.

Plastic Surgery

Key Billing Directive: Strictly separating cosmetic procedures from reconstructive billing.

Thoracic Surgery

Key Billing Directive: Managing cardiorespiratory bypass modifiers and double assistant surgical codes.

Vascular Surgery

Key Billing Directive: Accurate ultrasound guidance capture and endovascular code bundling.

Oral & Maxillofacial Surgery

Key Billing Directive: Cross-coding medical and dental claims to coordinate coverage.

Cardiology

Key Billing Directive: Detailed bundling rules for EKGs, stress testing, and cardiac rehab.

Gastroenterology

Key Billing Directive: Colorectal screening rules and moderate sedation CPT code additions.

Hepatology

Key Billing Directive: Managing viral load testing codes and liver transplant prep logs.

Nephrology

Key Billing Directive: Monthly ESRD capitated billing (MCP) and dialysis facility coordination.

Pulmonology

Key Billing Directive: PFT (Pulmonary Function Test) coding and sleep study integrations.

Rheumatology

Key Billing Directive: Accurate JW modifier reporting for unused single-dose drug waste.

Endocrinology

Key Billing Directive: Continuous glucose monitoring (CGM) billing and diabetes training codes.

Immunology

Key Billing Directive: Allergy testing dose documentation and immunotherapy extract prep.

Infectious Disease

Key Billing Directive: Complex diagnosis linking and outpatient parenteral therapy (OPAT) billing.

Oncology

Key Billing Directive: Chemotherapy drug J-code claims and infusion administration coding.

Radiology

Key Billing Directive: Managing technical and professional split-bill modifiers (-26/TC).

Clinical Laboratory

Key Billing Directive: PAMA compliance reporting and panel code checks (e.g. CBC/CMP).

Toxicology Lab

Key Billing Directive: Definitive drug testing coding structures (G0480-G0483).

Pathology Lab

Key Billing Directive: Specimen count verification and immunohistochemistry modifier audits.

Hematology Lab

Key Billing Directive: Flow cytometry panel codes and blood smear interpretation billing.

Molecular Genetics

Key Billing Directive: Payer prior-auth checks for hereditary panel testing.

Diagnostic Testing IDTF

Key Billing Directive: Enrolling under Medicare IDTF regulations and diagnostic compliance.

Psychiatry

Key Billing Directive: Interactive complexity add-on codes (+90785) and therapy time increments.

Mental Health

Key Billing Directive: LCSW and LMFT billing, coordinating multi-tier provider coverages.

Behavioral Health

Key Billing Directive: Telehealth modifier rules (95/GT) and place of service (POS 02) codes.

Substance Abuse Rehab

Key Billing Directive: Residential treatment day rates (H0035) and medical detox coding.

ABA Therapy

Key Billing Directive: Adaptive behavior assessment codes (97151-97158) tracking rules.

Physical Therapy

Key Billing Directive: CMS 8-minute rule compliance and GP modifier therapy cap limits.

Occupational Therapy

Key Billing Directive: Cognitive function rehabilitation coding and GO modifier updates.

Speech Therapy

Key Billing Directive: Aphasia and dysphagia assessment structures and GN modifier rules.

Home Health

Key Billing Directive: PDGM (Patient-Driven Groupings Model) 30-day episode billing.

Hospice Care

Key Billing Directive: Medicare Hospice benefit transitions and per-diem billing structures.

Pain Management

Key Billing Directive: Epidural steroid injection anatomical documentation and drug codes.

Chiropractic

Key Billing Directive: Medicare spinal subluxation documentation requirements and AT modifiers.

Wound Care

Key Billing Directive: Debridement depth indicators and bioengineered skin tissue J-code claims.

Ambulatory Surgery Centers

Key Billing Directive: Facility fee claims via UB-04 forms alongside professional CMS-1500 bills.

Assisted Living Facilities

Key Billing Directive: Care level coding (POS 13) and nurse call billing compliance.

Nursing Home Care

Key Billing Directive: SNF consolidated billing exclusions and POS 31/32 claims.

Sleep Medicine

Key Billing Directive: HST (Home Sleep Test) coding and CPAP compliance compliance checks.

DME (Durable Medical Equipment)

Key Billing Directive: Supplier standards verification and CMN (Certificate of Medical Necessity) checks.

NEMT (Non-Emergency Medical Transport)

Key Billing Directive: Odometer mileage tracking logs and vehicle category billing codes.

Prosthetics & Orthotics

Key Billing Directive: Detailed measurement records and L-code pre-authorization guidelines.

Dental Billing

Key Billing Directive: ADA code sets (CDT) and coordination with commercial PPOs.

Dermatology

Key Billing Directive: Biopsy and excision coding based on lesion size, site, and margin.

Emergency Medicine

Key Billing Directive: Level 5 ER visit E/M downcoding prevention audits.

Anesthesia

Key Billing Directive: Concurrence limits, physical status modifiers (P1-P6), and minute tracking.

OB-GYN

Key Billing Directive: Antepartum, delivery, and postpartum global OB package structures.

Ophthalmology

Key Billing Directive: Eye-specific coding (92xxx codes) vs. standard evaluation visit E/M bills.

Optometry

Key Billing Directive: Vision plan billing vs. medical insurance diagnoses coding.

Podiatry

Key Billing Directive: Routine foot care guidelines, modifier -QW, and systemic vascular indicators.