Physician Billing and Coding Services

Hand us the billing. We run the whole revenue cycle, and we charge 5% of what we collect.

Our Services

You already know how much work accurate coding takes. Every specialty has its own procedures, and each one has to be coded right before it can be collected.

That needs specialists, not generalists. We have spent years across the full range of specialties, and it shows in the results.

What benefits are provided by our Surgical Billing Services and Surgical Coding Services?

  • Incorporation

    Some physicians work in one area, some in several. What makes us the right physician billing services partner is the team. We keep hiring the best people in this industry, because that is what good service actually depends on.

    Acceptance icon

  • Acceptance

    We are straight with you. If we cannot answer something, we say so. If we have caused your practice a problem, we own it, whatever the specialty involved.

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Procedures

Coding and billing services tailored for physicians, delivered with equally proficient expertise:

  • Obstetricians and Gynecologists
  • Psychiatrists
  • Neurologists
  • Emergency Physicians
  • Radiologists
  • Internists
  • Anesthesiologists
  • Family Physicians
  • Cardiologists
  • Pediatricians

Billing for Solo Doctors and Physician Groups

Most physician practices do not lose money on the first claim. They lose it on the six to ten per cent that come back, and on whether anybody reads the denial, fixes the cause and refiles inside the timely filing window, or quietly writes it off.

We work the whole cycle: eligibility before the visit, charge capture reconciled against the schedule so no encounter goes unbilled, coding from the note, claim scrubbing against each payer's own edits, denial management with appeals where the claim is defensible, payment posting checked against contracted rates, and patient balances collected without alienating the patient.

A solo physician gets the same coder, the same denial work and the same monthly reporting as a large group. What changes is the volume, not the standard.

Practices using NPs and PAs should also read the incident-to rules on our medical billing services page, and the enrollment side on nurse practitioner credentialing. Coders are assigned by specialty, see billing by specialty.

Where physician billing actually loses money

Most practices do not lose revenue on complicated claims. They lose it on ordinary visits billed slightly wrong, thousands of times a year.

Evaluation and management levels

Office visit levels are chosen on medical decision making or on total time for the day, and you pick whichever supports the higher level. Time now includes the work you do before and after the patient is in the room: reviewing outside records, ordering tests, documenting, and coordinating care on the same calendar day. Practices that still think of time as face to face minutes undercode almost every complex visit they see.

The reverse problem is just as expensive. A level chosen by habit rather than by the note is the first thing an auditor finds, and the refund request covers the whole sample period, not the one visit.

Modifier 25

When a separate, significant evaluation happens on the same day as a procedure, modifier 25 is what keeps the visit payable. It is also one of the most audited modifiers in medicine. The rule that survives review is simple: the note has to stand on its own without the procedure in it. If removing the procedure leaves nothing to read, the visit was not separate.

Incident to and split or shared visits

Billing a nurse practitioner or physician assistant under the physician's number pays more, and it has conditions that are easy to fail. The physician has to have seen the patient for that problem and established the plan, has to be in the office suite while the service happens, and the patient cannot have a new problem that day. In a hospital setting the rules are different again, and the visit goes to whoever performed the substantive portion.

We check these two against the schedule rather than against intent, because that is how a payer checks them.

Global periods

Minor procedures carry a ten day global period and major surgery carries ninety. Visits inside that window for the same problem are not separately payable, and visits for something unrelated are, with the right modifier. Both halves of that sentence cost money when they are ignored. Writing off everything inside a global period gives away legitimate revenue, and billing everything inside it invites a review.