Medical Billing Specialties

Medical Billing Specialties Expertise

Medical Billing Specialties And Revenue Cycle Management Services For Mid-Size And Large Specialty Medical Practices

At BillingParadise, we understand that medical billing specialties can be a complex and time-consuming process, especially for multi-specialty and specialty healthcare providers. That's why we offer comprehensive medical billing services that are tailored to the specific needs of different medical specialties in the United States.

Our team of experienced specialty billing experts and specialty-certified coders can help large multi-facility specialty medical practices and the largest specialty physician group practices manage their revenue cycle, and medical billing & coding processes, reduce denials and improve their bottom line.

Worked with 30+ specialties over 18 years.

Experienced staff with technology utilization.

24/7 medical billing services and revenue cycle management.

Over the course of 18+ years, we have worked with various medical billing specialties. Healthcare providers with particular specialties are always concerned
about the medical billing service providers they hire. Here is why BillingParadise differs from those medical billing companies:

Flexible and scalable staffing that can be customized according to your specialty.

Medical billers and coders with 5+ years of experience in every healthcare specialty in the industry.

Expertise in specialty-specific EMR/EHRs.

Chief of client services with over 30 years of service with large medical specialty groups.

Experienced in various specialty-specific health plans/insurance

Strong presence in various locations in the United States.

Medical billing services for 30 medical specialties

Revenue Cycle Management,Coding ,Medical Billing Specialties Expertise For Your Medical and Physician Group Practice Specialties

We offer extensive experience in medical billing and coding across more than 30 different medical specialties. For almost two decades, we have been providing top-quality specialty medical billing and coding services, as well as accounts receivable management, to healthcare providers, physician practices, medical/clinical groups, and healthcare software providers. Our team has honed its skills and refined its processes to deliver services of the highest quality.

Our expertise spans a wide range of medical specialties, including

Orthopedic

Mental-health

Neurology

Ophthalmology

Optometry

OB-GYN

Anesthesiology

Dermatology

Oncology

Pediatric

Chiropractic

Gastroenterology

Psychiatry

General-surgery

Nephrology

Cardiology

Dental

Emergency-department

Family-practice

Geriatrics

Internal Medicine

Neurosurgery

Otolaryngology

Pathology

Pulmonology

Radiology

Rehab

Urgent-care

Urology

Podiatry

Offering Speciality Revenue Cycle Management Services For

Complete End-to-end Speciality RCM Services

Patient Appointment Scheduling

Patient Registration

Patient Eligibility, and Benefits Verification

Patient Demographics

Prior-Authorization

Charge Capture and Entry

Coding and Coding Audit

Claim Transmission/Submission

Clearinghouse Rejection Resolution

Payment Posting and Reconciliation

Accounts Receivables (AR) Management

Denial Management

Submission of Additional Information and Appeals

Patient Statements

Patient Calling and Support

Analytics and Reporting

Our Standard Benchmarks In KPI Metrics Reporting For Specialties

30-40

Days in Accounts Receivable (A/R)

Percentage of A/R Over 90 Days

<5%

Non-Contractual Write-Off Percentage

25-50%

New Patient Ratio

30%

Payer Mix

25%

Referral Mix

Proven Results Of Our Medical Billing Specialties & Revenue Cycle Management Services

Up to 98%

First Pass Claim Acceptance Rate

Up to 99%

Medical Coding errors Reduced

Up to 15%

Accounts Receivables Reduced

Up to 80%

Insurance collections improved

Up to 20%

RCM Operations costs reduced

Up to 90%

Claim denials reduced

Up to 40%

RCM Operations Costs Reduced

Up to 20%

Overall Cash Flow Increased

Up to 99%

Overall RCM Accuracy

Compliance and Certifications

Top Challenges Faced by Speciality Physician Practices, Hospitals, Clinical/Medical Groups:

Specialty practice CFOs, RCM directors, and Owners often ask us to solve common medical billing issues. Here are a few FAQs

Patient access, registration, and scheduling

Obtaining Incorrect patient data.
Unable to verify patient data and eligibility/benefits on call.
Network participation issues.

Charge capture and entry

Entry-level mistakes.
Incorrect capture of encounter data.
Unable to bill a huge volume of patient data.

Medical coding

Lack of experienced coding staff.
Unable to keep up with coding guidelines and updates.
No payer-centric or specialty coding expertise.

Payment posting

Unaware of overpayment recoupment.
Incorrect write-offs.
Less staff to perform payment reconciliation on paper checks.

AR and denial management

No staff to work piled up AR.
Lack of prioritization on AR days.
No denial tracking systems.
Inexperienced staff to perform denial management.

Reporting

Lack of standard KPI and daily, weekly, and monthly reports.
No transparency regarding outsourced or in-house RCM performance.
No designated project manager or supervisors to contact directly.
Failing to hold up 24-hour problem resolution TAT.

Frequently Asked Questions

1. Do you specialize in behavioral health and mental health billing?

Yes, behavioral health is one of our core specialties. We handle psychiatry, psychology, counseling, LCSW, LMFT, and group therapy billing. Our team understands modifier requirements (95, GT, HO), place of service codes, crisis intervention billing, and payer-specific behavioral health policies. We also manage the unique challenges of mental health billing including session-based documentation and carve-out plans.

2. Do you support telepsychiatry and telehealth billing?

Absolutely. We're experts in telehealth billing across all specialties, including telepsychiatry. We manage platform requirements, originating and distant site billing, audio-only services, state-specific telehealth regulations, and payer coverage variations for virtual care delivery.

3. Can you handle inpatient and outpatient hospital billing?

Yes, we provide comprehensive hospital billing for both inpatient and outpatient services including DRG-based claims, APC billing, UB-04 submissions, revenue codes, and chargemaster management while ensuring compliance with Medicare IPPS and OPPS regulations.

4. Do you offer pathology and laboratory billing services?

Yes, we specialize in pathology and laboratory billing including clinical pathology, anatomic pathology, molecular diagnostics, and reference laboratory billing. We handle TC/PC/global billing splits, LCD compliance, ABN processing, and complex panel coding.

5. Do you support cardiology billing such as EKG, ECHO, and hospital reading services?

Yes, cardiology is a key specialty for us. We manage billing for EKGs, echocardiograms, stress tests, cardiac catheterization, EP studies, and hospital reading services with correct modifier usage and compliance.

6. Do you handle podiatry billing?

Yes, we provide specialized podiatry billing including routine foot care determination, class findings documentation, nail and callus procedures, diabetic shoe programs, and surgical billing.

7. Do you provide anesthesia billing services?

Yes, we offer comprehensive anesthesia billing including time-based calculations, base unit assignments, physical status modifiers, monitored anesthesia care (MAC), and CRNA versus anesthesiologist billing scenarios.

8. Do you support physical therapy and occupational therapy billing?

Yes, we manage PT, OT, and speech therapy billing including therapy caps, KX modifiers, evaluations, re-evaluations, and Medicare therapy documentation requirements.

9. Do you offer ophthalmology and neuro-ophthalmology billing?

Yes, we support ophthalmology billing including cataract surgery, glaucoma management, retinal procedures, routine vs medical eye exams, and vision plan vs medical insurance billing.

10. Do you support ABA therapy and substance abuse treatment billing?

Yes, we provide expertise in ABA therapy billing including H-codes and CPT codes, treatment plans, and Medicaid programs. For substance abuse treatment we manage MAT, IOP/PHP programs, and confidentiality compliance.

11. Do you handle Workers’ Compensation billing and TPA submissions?

Yes, we specialize in workers’ compensation billing including state fee schedules, TPA submissions, bill review responses, treatment plan documentation, and lien filing when required.

12. Can you submit WC claims even while credentialing is pending?

In many cases yes. Workers' compensation often allows claims submission using provider license numbers while credentialing is still in process depending on state and carrier requirements.

13. Do you provide ambulance and medical transportation billing?

Yes, we handle emergency and non-emergency ambulance billing including ALS/BLS classification, base rates, mileage billing, trip logs, and Medicare ambulance fee schedule compliance.

14. Do you support DME billing and eligibility verification?

Yes, our DME billing services include prior authorization, CMN processing, HCPCS coding, rental vs purchase determination, supplier enrollment, and Medicare competitive bidding compliance.

15. Do you handle home health and hospice billing?

Yes, we provide home health and hospice billing including PDGM episode management, OASIS coordination, LUPA prevention strategies, hospice cap monitoring, and CMS compliance.

16. Can you manage mobile clinic and pop-up facility billing?

Yes, we manage billing for mobile clinics, community health units, and temporary service locations including correct place-of-service coding and payer coordination for multi-location operations.