Billing companies that work endocrinology claims every day. Describe your practice once and compare their proposals.
A few questions about the practice, then billing companies that fit send proposals. You are not committing to anything.
Hand off all of it or just the parts that are breaking. Say which in the form so the proposals match.
Charges entered, claims checked against payer edits, and sent daily so clean claims go out the first time.
Every denial worked, appealed, or corrected, with the root cause tracked so the same denial stops repeating.
Old balances called on and worked by payer and by age until they are paid, adjusted, or written off on purpose.
Certified coders assign CPT, ICD-10, and modifiers from your notes, or audit the codes your providers pick.
New providers enrolled with payers, CAQH kept current, and revalidations handled before they lapse.
Statements, online payment, payment plans, and the phone calls that come with them, handled in your name.
Eligibility checks, prior authorizations, and old AR cleanup go through the same request. If you only need one piece, say so.
There is no right answer for every practice. The usual tradeoffs:
Endocrinology looks like a simple specialty to bill until you read your own denials. Most of the revenue is office visits, usually established patients with diabetes, thyroid disease or osteoporosis, and those claims go through fine. The trouble sits in everything attached to the visit. Continuous glucose monitor placement and interpretation are tied to minimum days of data and limits on how often they can be reported, and each payer words those limits differently. Thyroid ultrasound and fine-needle aspiration bring bundling edits, and the guided biopsy code already includes its own imaging. If you give infusions for osteoporosis or thyroid eye disease, you are also buying and billing drugs, which means J-codes and units, plus a waste rule that somebody has to know.
Then there is the modifier 25 problem. A problem-oriented visit on the same day as a procedure or a monitor hookup needs documentation that stands apart, and payers watch those claims closely. Prior authorization is the other tax. Insulin pumps, glucose monitors and the newer injectable diabetes and weight drugs each have their own forms, and the denial usually comes down to a diagnosis code that does not match the drug. Type 2 diabetes with kidney disease and plain type 2 diabetes are different claims, and for Medicare Advantage patients the difference follows you into next year's risk scores.
In-house staff tend to miss the same things. Diagnosis codes stay unspecified, add-on time never gets captured, and small claims go unchased because the visit volume is high. A good specialty biller watches the monitor interpretation codes monthly and appeals pump and drug denials with the notes attached. They also know which plans want which diabetes supply vendor. Outsourcing makes sense when your one biller is overloaded, when you have added ultrasound, bone density or infusions and nobody has billed them before, or when your A/R is old and nobody is calling. On the form, say which procedures you do in the office and which payers send most of your visits. Your EHR and a rough monthly visit count help too.
Three steps. Most practices hear from the first billing company within a business day.
Specialty, providers, claim volume, your software, and what you want handled.
Your request goes to billing companies that work your specialty and take on practices your size.
Compare fees, scope, reporting, and contract terms side by side. Pick one, or none.
What practice managers usually ask before they fill out the form.
Describe the practice once and compare proposals from billing companies that fit. No obligation.
Request proposals