What we handle for nephrology practices
Billers are assigned by specialty, so the person working your claims already knows your codes and your payers.
Monthly capitation
ESRD MCP codes billed to the documented number of face-to-face visits in the month and the patient's age band.
Home dialysis
Home and peritoneal dialysis billed on the correct monthly codes.
Vascular access
Access placement, revision and thrombectomy coded to the operative note.
Transplant and CKD care
Pre- and post-transplant management and chronic kidney disease education billed correctly.
Where nephrology claims usually go wrong
These are the four issues we see most often when we take over a nephrology practice.
Visit counts driving MCP codes
Two, three or four or more visits pay differently. If the count is not documented, the claim pays at the lowest tier.
Hospital days inside the month
Inpatient days change what can be billed for the month. Ignoring them causes overpayment takebacks.
Access procedures inside globals
Revisions and thrombectomies during a global period need the correct modifier.
CKD education underbilling
Kidney disease education is payable for qualifying patients and is routinely never billed at all.
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.
Nephrology billing questions
Something not covered here? Call (833) 305-5528.
Do you bill for dialysis facilities?
We bill professional services for nephrologists. Facility billing is handled separately where required.
Can you handle home dialysis?
Yes, including peritoneal and home hemodialysis monthly codes.
Do you bill CKD education?
Yes, for patients who meet the coverage criteria.