Specialties

Billing Specialties We Cover

Physical Therapy

OMS Surgery

Dental

Chiropractic Care

Mental Health

Pain Management

Cardiology

Radiology

Family Practice

Pediatric Practice

Orthopedic

Urgent Care

General Surgery

Anesthesia

DME

OB & Gynecology

Internal Medicine

Workers’ Compensation

Comprehensive Medical Billing Guidelines for Different Specialties

Medical billing is a complex yet essential process for healthcare providers to ensure accurate reimbursements, reduced denials, and a streamlined revenue cycle. Each specialty has unique billing requirements, making it crucial to follow the latest ICD-10 guidelines and payer policies for proper claim submissions.

At Heave Billing Services, our expert medical billing team ensures that every claim is processed accurately and efficiently, minimizing denials and maximizing revenue for healthcare providers.

Physical Therapy Billing

Physical therapy (PT) billing involves documenting and billing for initial evaluation, follow-up assessments, therapeutic and rehabilitation sessions. The challenge lies in ensuring that all services are documented correctly and billed per insurance policies.

How Our Medical Billing Team Ensures Payment:

  • Accurate Documentation & Coding: We ensure that all therapy sessions are properly documented to reflect medical necessity.
  • Claims Submission & AR Follow-up: We process claims quickly and follow up on any rejected or denied claims to secure full payment.
  • Pre-Authorization & Insurance Verification: We handle pre-approvals for therapy sessions to avoid claim rejections due to policy limitations.

OMS (Oral & Maxillofacial Surgery) Billing

Oral & Maxillofacial Surgery (OMS) billing involves both dental and medical claims, requiring expertise in insurance cross-billing, surgical procedure coding, and pre-authorization requirements.

How Our Medical Billing Team Ensures Payment:

  • Seamless Coordination Between Medical & Dental Insurance: We ensure correct claim routing, so providers get paid accurately.
  • Medical Necessity Documentation: We review documentation and ensure proper justification for jaw surgeries, TMJ treatments, and bone grafting.
  • Pre-Authorization & Compliance: Our team obtains necessary approvals before services are performed, ensuring smooth claim processing.

Chiropractic Billing

Chiropractic billing requires proper documentation of initial evaluation, follow up evaluations including all pain management procedures, therapeutic exercises, and rehabilitative care. Insurance policies for chiropractic care vary widely, requiring expert billing management.

How Our Medical Billing Team Ensures Payment:

  • Ensuring Medical Necessity: We verify that all chiropractic services are supported by proper diagnosis codes and treatment notes.
  • Medicare & Private Insurance Compliance: Our team navigates payer restrictions, ensuring only billable services are submitted.
  • Handling Denials & Appeals: We actively follow up on denied claims, providing additional documentation when necessary.

Mental Health Billing

Mental health billing covers Psychological Evaluation/Psychotherapy sessions and behavioral health evaluation and treatments.

How Our Medical Billing Team Ensures Payment:

  • Accurate Time-Based Billing: We ensure all therapy sessions are correctly billed based on session length and documentation.
  • Pre-Authorization for Higher-Level Services: Our team secures prior approvals for intensive outpatient programs (IOPs) and psychiatric treatments.
  • Insurance Verification for Telehealth: We confirm payer coverage for virtual sessions, ensuring smooth reimbursement.

Pain Management Billing

Pain management billing includes initial evaluation and follow up evaluations, interventional procedures, medication management, physical therapy, and chiropractic therapy. Claim denials in this specialty often result from documentation errors or lack of pre-authorization

How Our Medical Billing Team Ensures Payment:

  • Ensuring Proper Documentation for Injections & Procedures: We ensure that pain management treatments are well-supported with medical necessity justification.
  • Insurance Authorization Management: Our team handles pre-approvals for opioids and controlled substances treatments, nerve blocks, and radiofrequency ablations
  • Denial Management & Appeals: We analyze and resolve denied claims quickly to recover lost revenue.

Cardiology Billing

Cardiology billing involves consultation, surgeries, and follow ups, EKGs, stress tests, Holter monitoring, echocardiograms, ambulatory blood pressure monitoring, and cardiac catheterization & interventional procedures.

How Our Medical Billing Team Ensures Payment:

  • Pre-Authorization & Compliance: We obtain approvals for stress tests, imaging, and interventional procedures before claim submission.
  • Detailed Claims Submission: Our team ensures that every claim includes necessary reports and medical documentation to meet payer guidelines.
  • Follow-Up on Unpaid Claims: We track pending payments, appealing any denials to ensure full reimbursement.

Radiology Billing

Radiology billing covers X-rays, CT scans, MRIs, and ultrasounds, requiring precise insurance verification and compliance with billing regulations.

How Our Medical Billing Team Ensures Payment:

  • Insurance Eligibility Verification: We confirm coverage before imaging tests are performed, reducing claim rejections.
  • Ensuring Correct Claim Submission: Our team submits claims accurately to avoid errors related to global vs. professional component billing.
  • Handling Denials & Resubmissions: If a claim is denied, we quickly review and correct it to secure reimbursement.

General Medical Billing

General medical billing includes primary care, preventive screenings, and chronic disease management. Proper billing ensures full reimbursement for patient visits and routine check-ups.

How Our Medical Billing Team Ensures Payment:

  • Annual Wellness Visit Billing: We ensure that preventive care services are correctly billed and covered under insurance plans.
  • Chronic Care Management Support: Our team coordinates long-term care billing, helping providers get reimbursed for ongoing patient management.
  • E/M Billing Compliance: We apply the latest evaluation & management (E/M) guidelines, ensuring accurate claim submissions.