Generic billing treats every claim the same. But the rules that decide whether you get paid — the modifiers, the units, the documentation a payer expects — are specialty-specific, and that is where most denials come from.
Claim submission is the same everywhere. What differs is what a payer will reject, and a biller who does not know your specialty finds out the slow way — after the denial, on your money.
Independent physician groups, specialty practices, clinics, behavioural health organisations, therapy practices, laboratories, urgent care centres and ambulatory surgery centres — across all 50 states.
The common thread is not size or specialty. It is that billing is somebody’s second job, or that one person leaving takes the whole revenue cycle with them.
PT claims fail in specific, predictable ways. Units miscounted against the 8-minute rule. Visits billed past a cap nobody was tracking. Authorizations…
Behavioral health practices lose money in two places: months spent waiting on payer panels before a single claim can go out, and…
Chiropractic has one of the highest denial rates in outpatient care, and a low per-claim value that makes every denial expensive to…
Podiatry claims are denied more often for coverage policy than for coding. The routine foot care exclusion, and the systemic-condition exceptions to…
A lab runs thousands of claims against payer coverage policies that change without notice. One misconfigured rule does not cost you a…
Urgent care combines high claim volume, thin margins and patients nobody has a relationship with. Eligibility is unverified, coverage changes between visits,…
Ambulatory surgery centers carry the highest per-claim values in outpatient care, which means errors are expensive in a way they simply are…
New practices do not fail at medicine. They run out of cash while enrollment sits in a queue, first claims code wrong,…
We would rather tell you we are not the right fit than take on work we cannot bill well. Send us a month of denials and we will tell you honestly whether we know your specialty well enough to improve on what you have.
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