Customized Coding & Rules for 30+ Medical Specialties
Each specialty has its own payer rules and edge cases. Our teams are trained for yours.
- No long-term lock-in
- Dedicated account team
- Transparent reporting
Built Around How Your Specialty Bills
Pick a specialty to see where claims tend to get stuck and how we handle it.
Cardiology
Cardiology mixes office visits, imaging and procedures, often on the same day, and each one follows its own rules.
What we pay attention to
- Complex procedure and imaging claims
- Frequent prior authorizations for imaging and procedures
- Correct modifiers and bundling rules
How we handle it
- Authorizations checked before scheduled imaging and procedures
- Modifier and bundling edits applied before submission
- Denials sorted by code so repeat problems get fixed
Orthopedics
Surgical cases, implants and DME create long claim chains where one missing detail can hold up payment.
What we pay attention to
- Surgical coding and global period rules
- DME billing and documentation
- Implant and multi-procedure claims
How we handle it
- Global period tracked on every surgical case
- Documentation checked for DME before claims go out
- Multi-procedure claims reviewed line by line
Radiology
Professional and technical components, advanced imaging authorizations and modifiers decide whether a read gets paid.
What we pay attention to
- Professional versus technical component billing
- Accurate modifier use
- Authorization rules for advanced imaging
How we handle it
- Component and modifier checks built into claim edits
- Advanced imaging authorizations confirmed before the scan
- Payer rules mapped for each type of imaging
Dermatology
Medical and cosmetic work share a room and a schedule, but they do not share a payer.
What we pay attention to
- Separating medical and cosmetic services
- Procedure coding for biopsies and excisions
- Pathology and lab coordination
How we handle it
- Visit types separated at charge entry
- Biopsy and excision codes checked against documentation
- Pathology results matched to the right claim
Mental Health
Sessions are billed by time, authorizations come with visit limits, and telehealth rules vary by payer.
What we pay attention to
- Time-based session coding
- Authorization and visit limits
- Telehealth billing rules
How we handle it
- Session length matched to the right code
- Authorized visit counts tracked so renewals are not missed
- Telehealth rules checked payer by payer
Urgent Care
High volume, walk-in patients and a mixed payer base leave very little room for slow billing.
What we pay attention to
- High patient volume and E/M leveling
- Walk-in eligibility checks
- Occupational health and varied payer mix
How we handle it
- Same-day eligibility checks for walk-ins
- E/M leveling audits to keep coding consistent
- Occupational health claims routed to the right payer
Gastroenterology
Screening and diagnostic procedures look alike on the schedule and very different to a payer.
What we pay attention to
- Endoscopy and ASC billing
- Screening versus diagnostic coding
- Pathology claims
How we handle it
- Screening and diagnostic logic checked before submission
- Facility and professional claims kept in sync
- Pathology claims followed through to payment
Family Practice
Family practices see every age and every kind of visit, so one schedule can mix preventive care, sick visits, chronic care and vaccines.
What we pay attention to
- E/M leveling across many visit types
- Preventive versus problem-oriented visits on the same day
- Chronic care management and vaccine billing
How we handle it
- E/M levels audited against documentation
- Modifier 25 checked when a preventive and a problem visit share a day
- Chronic care time and vaccine claims tracked so they are not missed
Sleep Medicine
Sleep studies, home testing and CPAP supplies each follow different payer rules and authorization steps.
What we pay attention to
- Prior authorization for sleep studies
- Attended versus home sleep test coding
- CPAP and supply documentation
How we handle it
- Authorizations confirmed before the study is scheduled
- Study type matched to payer policy before billing
- CPAP compliance and supply documentation tracked
Neurology
Neurology combines long office visits with EEG, nerve testing and injectable treatments, each with its own coding and authorization rules.
What we pay attention to
- EEG, EMG and nerve conduction coding
- Botulinum toxin and infusion drug billing
- Professional and technical component rules
How we handle it
- Testing codes checked against reports and payer policy
- Drug units and injection codes matched to documentation
- Authorizations tracked for treatments that need approval
Speech Pathology
Speech therapy is billed by visit type, plan of care and visit limits, and payers watch documentation closely.
What we pay attention to
- Evaluation versus treatment coding
- Plan of care and recertification dates
- Visit limits and therapy threshold rules
How we handle it
- Plan of care dates tracked so claims are not denied for lapses
- Visit counts watched against plan limits
- Documentation checked before claims go out
One Size Does Not Fit Every Practice
Payer rules by specialty
Each payer treats procedures differently. We build edits around the rules that affect your claims.
Coders who know your field
Coding teams work with your specialty regularly, so documentation gaps are caught early.
Rules kept up to date
Code sets and payer policies change. We update our edits so your claims stay clean.
How We Learn Your Specialty
Specialty Questions
Do you support my specialty?
We support the specialties listed above and many more. Tell us about your practice and we will confirm.
Are your coders trained in my specialty?
Our coding teams apply specialty-specific rules, and we match your account to people familiar with your field.
What if my payers have unusual rules?
Tell us during onboarding. We build payer-specific edits so claims follow each payer requirements.
Do Not See Your Specialty?
We support many more. Tell us about your practice and we will confirm how we can help.