Allergy & Immunology Billing Services
Allergy testing units, immunotherapy vial and injection coding, biologics and E/M visits.
allow us to handle your billing responsibilities through Comprehensive Revenue Cycle Management at a 5% collection rate.
Allergy billing turns on units. Percutaneous and intradermal testing are billed per test, not per session. Payers cap how many are payable in one encounter. So a full panel billed without checking that limit is partly written off before anyone even reviews it. Our allergy & immunology billing services apply each payer unit limit at charge entry.
Immunotherapy is the other half, and it is billed in two separate pieces: preparing the vial, and giving the injection. Each has its own code and its own frequency rules. If you give biologics, settle the drug benefit at contracting too, because several payers now route them through a specialty pharmacy.
Our Services
Late Collections and Lost Revenue
Two problems come up again and again in allergy and immunology billing: money collected late, and money never collected at all. If that sounds familiar, it is probably why you are reading this page.
Our team are specialists in allergy and immunology billing and the coding that goes with it. We start by reading each insurer criteria properly. Once we know what a payer wants, we can file it their way, which means faster submissions, faster collections, and revenue that stays where it belongs.
What attributes are provided by our Allergy & Immunology Billing Services?
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Data Security and Compliance
We follow HIPAA, so your patients' data stays safe. We look after each patient from the first contact with your practice, through pre-registration, coding and billing, all the way to the claim and the payment. If you want us to call patients with reminders or check-ups, we can do that too.
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Live Monitoring
Most practices are not hitting their numbers, and usually it is small errors doing it. A little attention fixes that. What you need is an allergy and immunology billing company that also handles the accounting side, so the revenue is clean and you can see where the cash is going.
Structuring
On a busy day it is easy to lose track of an appointment. That costs you money and it costs you goodwill. We keep the schedule straight with reminders and alerts, so your day runs the way you planned it.
Reporting
This is a practical service, not a bolt-on. We are available around the clock, and we will send you whatever report you want: test reports, patient history, anything else you need.
Procedure
Procedures We Bill
We do not limit ourselves to one part of allergy and immunology. Our billing and coding covers all the procedures below:
- Reproductive Immunology
- Immunotherapy
- Classical Immunology
- Clinical Immunology
- Developmental Immunology
- Diagnostic Immunology
- Evolutionary Immunology
Testing and immunotherapy are billed by count
Allergy is one of the few specialties where the unit, not the code, decides most of the payment. Get the counting wrong and the claim is wrong every time.
Skin testing is per test
Percutaneous and intradermal tests are billed by the number of tests performed, not by the session. A panel of forty is forty units. The record has to show the number and, on review, the antigens used.
Payers set limits on how many tests are reasonable in one sitting and how often testing may be repeated. Exceed either and the excess denies, even when the panel was clinically sensible. Check the policy before you set your standard panel, because the panel is what generates the denials.
Immunotherapy has two separate charges
Preparing the antigen and injecting it are different services.
- PreparationBilled by dose when the vial is made up, which is often on a different date from any injection. Units are counted from the vial, and this is where most under-billing happens.
- InjectionBilled on the day it is given, with one code for a single injection and another for two or more.
A practice billing one unit per visit for preparation is losing a substantial amount across a full immunotherapy panel, quietly, every month.
Office visits alongside injections
An injection visit is usually not an office visit. When the patient is genuinely evaluated for a new or worsening problem the same day, that is billable with the right modifier and a note that stands on its own. Adding an office visit to every injection is a pattern payers look for.
Biologics for asthma
Biologic therapy needs prior authorisation tied to the drug, the dose and the interval, and the drug and its administration are billed separately. Units on the drug code rarely match one vial. Wastage from a single use vial is usually billable on its own line with the amount discarded documented.
Many plans move these drugs to a pharmacy benefit, which decides whether the practice buys and bills at all. It varies by plan for the same drug, so it is checked per patient rather than assumed.
Allergy and Immunology Credentialing
Allergy and immunology follows standard physician credentialing. That means CAQH ProView, Medicare through PECOS, state Medicaid and its managed care plans, and each commercial panel. Record the subspecialty correctly, because that is what makes testing and immunotherapy payable under your contract.
Two details are worth settling at enrollment. If you mix your own immunotherapy vials, ask each payer how they want the mixing and the injection reported. They are separate services and the rules vary. If you give biologics, settle the drug benefit before you sign. Several payers now send high-cost biologics through a specialty pharmacy instead of letting you buy and bill, and that changes the economics completely.
We file the enrollments and read the contract terms before you sign. See our medical credentialing services.