Behavioral health
Time-based codes, session limits and authorization tracking. Most of the money lost here goes to units billed against an exhausted authorization.
Specialties
Denials are specialty-shaped.
A generalist biller treats every claim the same way and gets the same denials back. The rules that actually decide whether a claim pays are specific to the specialty, the payer and often the state.
Where the rules differ
Physical therapy
Therapy caps, KX modifiers, and the eight-minute rule. Documentation has to support the units before the claim goes out, not after the denial.
Cardiology
Bundling and global periods drive the denial pattern. Modifier discipline on the same-day diagnostic plus procedure is where the recovery is.
Urgent care
High volume, thin margins, heavy patient responsibility. Front-desk eligibility is worth more here than any downstream appeal.
DME
Documentation-driven from the start: orders, medical necessity, proof of delivery. Audits are routine, so records are kept audit-ready.
Ambulatory surgery
Implant and multiple-procedure reductions, plus payer-specific carve-outs. Contract rates need checking against every remit, not assumed.
Full list
Internal medicineFamily practiceCardiologyBehavioral healthPhysical therapyChiropracticPodiatryDermatologyOB/GYNPediatricsUrgent carePain managementOrthopedicsRadiologyAmbulatory surgeryHome healthDMEOptometrySleep medicineTelehealth
Not listed? Ask anyway. If we have not billed your specialty before we will say so rather than learn on your claims.
Your specialty
Tell us your specialty and payer mix.
We will come back with the denial patterns we would expect to see, and what we would check first in your aging.