From pulmonary function testing to bronchoscopy to sleep study interpretation, every procedure carries coding nuance that generic billing companies miss. Med Claims specializes in the revenue cycle needs of pulmonology practices, so your claims go out right the first time, and your reimbursements come back faster.
Pulmonology is one of the highest-denial specialties in outpatient medicine. Prior authorization requirements for CPAP and BiPAP. Bundling restrictions on pulmonary function tests. Modifier errors on bronchoscopy and thoracentesis. Payer-by-payer inconsistencies that shift without notice.
When your billing team isn’t built for this, the revenue doesn’t disappear overnight. It erodes slowly. Denied claims sit in queues. Underpayments go unchallenged. Write-offs accumulate.
The problem is not that your practice doesn’t work hard. The problem is that pulmonology billing requires a level of specialty-specific expertise that most in-house teams and general billing vendors simply don’t have.
Med Claims has built its practice around pulmonology. Over the past decade, our team has processed hundreds of pulmonology claims across private practices, hospital-affiliated groups, and multi-physician pulmonology and sleep medicine centers.
We understand the coding nuances that separate a paid claim from a denied one. The documentation requirements for polysomnography. The distinction between diagnostic and therapeutic bronchoscopy. The payer-specific rules for respiratory therapy bundling.
Our billers work as an extension of your team, not a vendor you hand files to and wait on. You get dedicated specialists, proactive denial prevention, and clear reporting that shows you exactly where your revenue stands at any given moment.
We audit your claim data before we submit anything. Patient eligibility, prior authorization status, modifier accuracy, and diagnosis linkage are all verified upfront. The goal is a clean claim every time, not a denial to chase later.
Claims are tracked from submission to adjudication. When payers delay or underpay, we follow up immediately, not at the end of the month. You see the results in your AR timeline, not just in a report.
Our certified coders apply pulmonology-specific coding standards, including CPT, ICD-10, and payer-specific guidelines, on every claim. Accurate coding means fewer audits, fewer take-backs, and reimbursements that reflect the care you actually delivered.
Underpayments are common in pulmonology, and most practices never catch them. We benchmark every payment against contracted rates, flag discrepancies, and pursue recovery on your behalf.
No more ambiguous reports. You receive clear, practice-level dashboards showing open claims, denial reasons, payment trends, and recovery status, so you always know where you stand.
Complex claims, appeals, peer-to-peer requests, and audit responses, our specialists handle them directly. Your front desk and clinical staff stay focused on patients, not payer disputes.
We begin with a complete review of your current billing setup, including denial patterns, coding accuracy, payer contract terms, and workflow gaps. Most practices discover recoverable revenue they didn’t know existed within the first two weeks.
We connect with your existing practice management system and EHR. No ripping and replacing at all. No retraining your staff. Our team adapts to your workflow, not the other way around.
Before any claim goes out, we verify patient coverage, confirm prior authorizations, and apply the correct codes. This step alone eliminates the majority of preventable denials.
Claims are submitted electronically with real-time tracking. Payer responses are monitored daily. Denials are worked on immediately, not queued for a monthly review cycle.
You receive regular reports with clear metrics, including clean claim rate, denial rate by payer, days in AR, and revenue recovered. We also flag recurring billing issues before they become patterns that cost you.
Denials are worked on immediately, not batched for a monthly review. Our team identifies the denial reason, prepares the appeal or correction, and resubmits as quickly as possible. We track every denial to completion and report on root causes, so recurring issues get fixed at the source.
We don’t make guarantees we can’t back with data. What we do offer is a free billing audit before you commit, so you can see exactly where your current process is leaking revenue and what improvement looks like for your specific practice.
We believe in earning your business through performance, not locking you into terms. Contract details are discussed during your initial consultation and customized to your practice’s needs.
Yes. We work with all major practice management systems and EHR software. Our team adapts to your existing tools, so there is no need to switch systems or retrain staff.
Every denied claim, underpayment, and unchallenged write-off is revenue your practice earned and never collected. Med Claims gives pulmonary practices a billing operation built for their specialty, one that catches problems before they cost you, and recovers the money you’re already owed.
The first step is a free billing audit. No commitment. No obligation at all. Just a clear picture of where your revenue is going and how to keep more of it.