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With Everest's Nephrology Billing & Coding Services, you can maximize profitability and minimize errors.

Reduce denials, increase collection and fix revenue leaks

getting started with Nephrology Billing

Nephrology specific medical billing, coding & RCM solutions that boost profitibilty & improve patients experience.

By more than two decades, we are providing customized Nephrology medical billing, coding and accounts receivable services to healthcare providers, revenue cycle companies, and healthcare systems not just in Florida but all over the United States; we have the people, processes, and technology in place to deliver high-quality services. 

A nephrologist is a medical doctor who specializes in the diagnosis and treatment of kidney diseases. Nephrologists help patients manage different kidney conditions, such as diabetic nephropathy, kidney failure, renovascular hypertension, and kidney stones. Depending on the condition, some patients may require surgical procedures, while others do not. This means that your medical billing team needs to understand a broad range of documentation and codes to ensure accurate and timely billing.

Although hiring an in-house billing team and properly training your team can help avoid severe fees and penalties, the Nephrology billing process is way complicated to be handled by an in-house team. One way to reduce stress on your staff and increase reimbursement is to outsource your billing & coding requirements to a technologically empowered billing company like Everest A/R Management Group Inc. 

Our expert coders and billers can help your Nephrology practice with billing and compliance, building a business partnership to strengthen your revenue stream and improve your practice’s efficiency.

Leverage our expertise in various disciplines of Nephrology

We have certified coders not just in Florida but across the US who work 24/7 to prevent billing problems caused by incorrect use of modifiers, as well as educate your in-house billing specialist on how to avoid them. Our certified coders and billers acknowledge the list of codes (ICD-9/10) and modifiers provided by the CMS for Nephrology billing and ensure that we stick to it. We put multiple billing processes depending on whether the patient was an inpatient, outpatient, treated on the same day, or another day. Our specialized coders and billers are well aware that preauthorization is essential to avoid authorization denials.

Nephrology is the study and treatment of kidneys diseases, which is usually affected by other systemic diseases such as autoimmune diseases or diabetes mellitus. It can also cause systemic complications such as hypertension and osteodystrophy. Electrolyte imbalances, acidosis, kidney stones, polycystic kidneys, vasculitis, proteinuria and hematuria can all be linked to kidney dysfunction. In the most extreme cases, chronic renal failure can require dialysis or renal transplant. 

Our expert coders can maximize your nephrology practice’s potential income by considering all possible sources of revenue. We’re able to recognize opportunities for add-on services that most practices overlook. Thanks to our pre- and post-payment audits, we can make sure you’re getting the most out of your claims.

  • Un-bundled procedures/E-M services – Procedure-related E/M services that are provided during a face-to-face encounter with a patient, such as during a dialysis session, when obtaining a needle core biopsy, or when performing a renal ultrasound, are considered integral to the procedure and are not un-bundled. However, there may be times when additional E/M services are provided. If these services are adequately documented, they should be billed using the appropriate modifier to receive payment for medically necessary services.

  • Useful Coding for Diagnosis (ICD-10) – In ICD-10-CM diseases of the genito-urinary system fall under the code sets N00-N99. Like other ICD-10 codes, those used to describe renal conditions are greatly expanded compared to the options available in ICD-9-CM. The additional characters and the increased specificity required under ICD-10 will present a challenge to medical coders and billers as they translate the medical encounter into a reimbursable healthcare claim.

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Specialty Billing Services Florida

Our medical billing services in Florida can help you increase your revenue by reducing the number of denied and unpaid claims. Our billers in major cities like Gainesville, Jacksonville, Miami, Tampa, St. Petersburg and Orlando can provide you with less paperwork and more accurate medical claims to improve the efficiency of your practice.

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