20+ Clinical Specialties
RCM & Coding Defense
Specialized billing architectures and clinical coding defense engineered across 20+ high-complexity medical and surgical disciplines.
Master Clinical Taxonomy & Procedural Matrices
Mental Health & Psychiatry
Specialized billing for psychiatric diagnostic evaluations, psychotherapy add-ons, and tele-mental health parity compliance across all US commercial payers.
Behavioral Health & ABA
Mastery over complex Applied Behavior Analysis (ABA) multi-tier authorizations, unit utilization caps, and state Medicaid waiver compliance.
Orthopedics & Sports Medicine
Forensic operative report deconstruction to defend legitimate unbundled arthroscopic procedures and bypass unfair multi-procedure surgical discounting.
Spine Surgery & Neurosurgery
Precision coding for multi-level spinal instrumentation, osteotomies, and NCCI edit deconstructions via anatomical segment modifiers.
DMEPOS & Respiratory
Deterministic Medicare Part B DME MAC LCD compliance, Standard Written Order (SWO) verification, and 6-month Face-to-Face recertification gating.
Interventional Cardiology
Precision hierarchy coding for coronary angiography, mechanical thrombectomy, and SPECT myocardial perfusion imaging LCD parameters.
Internal Medicine & Primary
Optimizing clinical revenue through accurate Medical Decision Making (MDM) level selection, Chronic Care Management, and Annual Wellness Visits.
Neurology & Sleep Medicine
Detailed reimbursement management for nerve conduction studies, needle electromyography, and diagnostic sleep study interpretation.
Interventional Pain Mgmt
Strict LCD policy alignment for transforaminal epidurals, facet joint injections, and radiofrequency ablations to eliminate pre-payment audits.
Gastroenterology & GI
Navigating preventive-to-diagnostic colonoscopy conversions, polypectomy techniques, and multiple endoscopy procedure pricing rules.
Dermatology & Mohs Surgery
Forensic staging and closure coding for Mohs surgical excisions, lesion destructions, and complex tissue transfers.
Urology & Urological Surgery
Reimbursement management for stone removal, prostate biopsies, urodynamic studies, and robotic urological procedures.
Obstetrics & Gynecology
Deconstructing global obstetric care packages for transfer patients, high-risk antepartum monitoring, and gynecological laparoscopies.
Pediatrics & Adolescent Care
Optimizing developmental screenings, EPSDT Medicaid requirements, preventive medicine visits, and vaccine administration counseling.
Ophthalmology & Eye Care
Bilateral modifier -50 execution, premium IOL non-covered patient waivers, and diagnostic retinal scan medical necessity linkage.
Podiatry & Wound Care
Overcoming Medicare systemic routine foot care exclusions via qualifying systemic condition class finding modifiers (Q7, Q8, Q9).
Medical Oncology & Infusion
High-value drug waste (Modifier -JW / -JZ) auditing, initial vs sequential infusion hierarchy, and prior authorization clearance.
Diagnostic & Interv. Radiology
Professional (-26) and Technical (-TC) component split billing, contrast vs non-contrast documentation, and pre-auth enforcement.
Physical & Occ. Therapy
Managing timed 15-minute 8-minute rule calculations, Plan of Care (POC) physician signatures, and Medicare therapy cap threshold KX modifiers.
Urgent Care & Walk-In
High-velocity encounter coding, rapid point-of-care lab billing, minor surgical laceration repair, and commercial urgent care add-on fees.
OON Emergency & Trauma
Challenging artificially depressed Qualifying Payment Amount (QPA) downcodes through structured 30-day Open Negotiation Notices and certified Federal IDR filings.
Configure Custom Billing Rules for Your Specialty NPIs
We map and customize rule engines directly inside Epic, AthenaHealth, Kareo, AdvancedMD, and Brightree to prevent denials before claims drop.