What we handle for infectious disease practices
Billers are assigned by specialty, so the person working your claims already knows your codes and your payers.
Inpatient consultations
Initial and subsequent hospital care billed to documented medical decision making or time.
Outpatient parenteral antibiotic therapy
OPAT billed with correct drug, administration and supply codes.
HIV and chronic infection care
Ongoing management billed with correct complexity and any applicable programme requirements.
Travel medicine and vaccines
Counselling and immunisations billed where covered, and handled as self-pay where not.
Where infectious disease claims usually go wrong
These are the four issues we see most often when we take over a infectious disease practice.
Consultation codes by payer
Medicare stopped recognising consultation codes. Many commercial payers still do. Using one rule for all payers denies claims.
Time-based documentation
Complex ID visits are often billed on time. Without documented total time the level cannot be supported.
OPAT drug and supply coding
Home infusion involves drug, administration and supply components that are frequently underbilled.
Travel vaccine coverage
Most travel vaccines are not covered. Billing them to insurance wastes time and delays patient payment.
How we work
Eligibility, every day
Every next-day scheduled patient is verified for active coverage before the visit.
Charges validated
Codes and documentation are checked after the note is signed, before the claim is submitted.
Denials appealed
Every denial is reviewed, corrected and resubmitted. Nothing is written off by default.
Monthly reporting
Paid claims and AR aging reports so you can see exactly where your money is.
Infectious Disease billing questions
Something not covered here? Call (833) 305-5528.
Do you bill inpatient consults?
Yes, with the correct code family for each payer's rules.
Can you handle OPAT billing?
Yes, including drug, administration and supply components.
Do you bill HIV care programmes?
Yes, including the documentation those programmes require.