Our Specialties
Nephrology Billing Services
Specialized billing solutions for nephrology practices and dialysis centers to optimize revenue, reduce denials, and streamline billing for complex renal procedures and ongoing dialysis services.
Specialized billing solutions for nephrology practices and dialysis centers to optimize revenue, reduce denials, and streamline billing for complex renal procedures and ongoing dialysis services.
| Code | Description |
|---|---|
| 90935 | Hemodialysis procedure with single evaluation by physician |
| 90945 | Dialysis procedure other than hemodialysis with single evaluation |
| 36818 | Arteriovenous anastomosis for dialysis access |
| 90940 | Hemodialysis access flow study to determine blood flow |
| 36901 | Diagnostic angiography of dialysis circuit, including imaging |
Our comprehensive approach ensures maximum revenue and minimal administrative burden for your nephrology practice and dialysis centers.
We verify nephrology-specific insurance benefits and coverage for dialysis and other renal procedures before services are rendered, including:
Our nephrology coding specialists ensure accurate code assignment for all renal services:
We achieve a 98% clean claim rate for nephrology services through our thorough process:
Our specialized approach to nephrology claim denials includes:
Our nephrology-specific reporting and analytics help optimize your practice:
Get answers to common questions about our nephrology medical billing services, coding challenges, and revenue optimization strategies.
Our team has extensive experience with Medicare's complex ESRD payment system. We manage the Monthly Capitation Payment (MCP) structure, ensure proper documentation for the number of visits per month, coordinate primary and secondary insurance billing, and navigate the 90-day global period for vascular access procedures. We also help ensure proper reporting for the ESRD Quality Incentive Program.
We specialize in home dialysis billing, including peritoneal dialysis and home hemodialysis. Our approach includes proper coding for training sessions, equipment and supply billing, monitoring documentation requirements, and coordinating the complex payment schedules. We help practices maximize appropriate reimbursement while maintaining compliance with Medicare and commercial payer guidelines.
Our vascular access procedure billing includes detailed documentation review to support medical necessity, proper coding for the specific access type (fistulas, grafts, catheters), coordination with surgical and interventional teams, and management of global period regulations. We track frequency limitations and ensure proper modifier usage for procedures performed within the global period.
We manage the complex coordination of benefits requirements for ESRD patients, including determining primary payer status during Medicare's 30-month coordination period. Our team tracks the specific dates when Medicare becomes primary, ensures proper submission to all applicable payers in the correct order, and reconciles payments to maximize total reimbursement while maintaining compliance.
Contact us today for a free consultation and learn how our specialized nephrology billing services can benefit your practice and dialysis centers.
I can help with nephrology billing questions, insurance information, or scheduling assistance.