• Revenue Cycle is the heart behind the Financial health of your Practice, never compromise on the people working on it

Optimizing Billing for Pulmonary Practices

Pulmonary billing is a complex process that deals with diagnosing and treating lung-associated disorders. The process involves several complexities which require expert guidance to meet efficiently. Field experts have in-depth knowledge of errors, coding, and required documents. Their professionalism prevents denial claims and improves financial stability for patients and service providers. Their efficient guidance optimizes time and resources for monetary reimbursement. Wise Medical Billing is a renowned name for having all this expertise. We offer tailored solutions for a stress-free billing process. Patient health is our primary focus; hence, we offer our dedicated services to promote quality health. From diagnosis to treatment, our customized services navigate to solve billing complexities.
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Challenges in Pulmonary Billing

Pulmonary billing procedures and treatments have numerous unique challenges that need experts’ help.

  • Accurate documentation and coding are crucial for successful billing reimbursement. Unique coding are needed, which often receive regulatory updates and changes. Documents related to the patient’s history and medical treatment must be filed accurately.
  • Pulmonary disorders require special diagnosing tools and complicated treatments that are not covered by general insurance. Inaccurate documents or faulty codes can result in claim denial, which affects the specialists’ and their practice financial stability.
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Advantages of Partnering with Pulmonary Billing Experts

● Experts know the field requirements in pulmonary billing, so they reduce billing errors by filling in accurate coding with document completion and following the exact regulations to enhance billing efficiency.

● Expert management follows up on the process and reduces denial errors, resulting in adequate revenue flow and increasing the reimbursement rates. They stay up-to-date with regulatory changes, and help achieve peace of mind by ensuring their billing matters are in the professional’s hands.

● Experts’ proactive approach ensures complete compliance with healthcare regulations, which minimizes the chances of costly billing errors. Both healthcare providers and billing services focus on revenue optimization to enhance their annual collections.

Patient Eligibility Verification and Authorization

The first step involves verifying the patient’s eligibility for pulmonary services. Billing management evaluates the insurance policy and contacts providers for real-time verifications. The need for prior authorization is also assessed, and experts collect all required documents for authorization approval. Record forms and applications are collected at this stage and attached to the claim application.

Accurate Claim Submission

Experts perform pre-audits of all available documents and information. They ensure accurate ICD-10 codes and recheck all clinical documents to justify medical services. The CPT codes refer to special pulmonary services, such as expensive diagnostic tests or specialist consultations. After verification, most claims are submitted through an electronic platform, which helps in timely submission and prevents manual errors.
Denial Management and Resolution
Electronic platforms allow continuous assessment of claims submissions and highlight denials promptly for proactive strategies to resolve them. Billing management utilizes denial reports to understand the reasons behind rejection, which could be the absence of prior authorization, lack of documents, or error in coding. After knowing the exact cause, the objection is resolved by providing the required information, and a re-appeal letter is submitted to clear the claims.
Accounts Receivable Optimization
Manage the receivable accounts by generating aging reports, which help identify account management's follow-up efforts. Use the KPI tracking method to evaluate the overall performance and rate of debt collections in accounts receivable. Conduct periodic staff training to enhance their efficiency in recovering AR issues and use data analytical tools to know the current trends of the market. Prepare flexible negotiation terms to resolve the payment issues positively and increase the reimbursement rate.

Why Choose Wise Medical Billing?

Join Wise Medical Billing to maximize your practice revenue. Our team has expertise in pulmonary billing practices. Our comprehensive services are optimized solutions to meet all sizes of practice needs. Our innovative strategies and proactive team ensure optimal financial performance. We offer our dedicated support from claim to cash flow and handle all relevant hurdles seamlessly.

We take care of Everything:

As part of our Pulmonary billing services, we handle patient scheduling, coding, and submitting claims. We also handle denials and rejections, compliance charting and coding, payer adjustments and paybacks, as well as bill collection. Due to our process effectiveness, clients tell us that our services increase their revenue so much that they do not consider them a cost.

24/7 Support and Transparent Communication

We build trust between patients and healthcare providers by developing transparent communication and 24/7 support. Our inquiry desk is available round the clock to answer billing-related queries. We have a robust communication system, and patients or healthcare providers can raise their concerns via call, email or quick text without generating tickets and waiting for a response. We deliver clear information about needed documents and the billing process.

Customized Reporting and Analytics

Wise Medical Billing offers detailed financial reports to meet individual’s specific reporting needs. Our billing process provides access to real-time data, which helps the provider to make the right decision. Our dedicated team allows insight access to revenue cycle analysis. This approach allows them to resolve mistakes and deficiencies in their policies. Our tailored practices and insight approach allow healthcare providers to improve their revenue cycle management, ultimately ensuring patients’ quality care.

Expert AR Management:

As a company, we are proud of our ability to successfully pursue the difficult task of obtaining payment for old and aging claims for our clients. Our firm believes that every single dollar our clients provide is worth every single cent. By utilizing an aggressive AR management system and a professional AR team, we pursue those old and aging claims our clients have lost hope of collecting.

Maximizing Financial Benefits

Our experienced strategies reduce coding errors and enhance revenue through constant follow-ups, which facilitate timely approvals. Wise Medical Billing is a name of perfection because we accurately fulfill the claim forms and minimize the resource cost of billing claims. We efficiently manage denial claims and lower financial risks with our strategic approach. We minimize out-of-pocket expenses for patients and arrange the best reimbursement for service providers by negotiating with insurance providers.

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Call to Action

Contact Wise Medical Billing and experience hassle-free billing solutions customized to satisfy your specific needs. Let us handle your pulmonary billing and focus on your patients’ health because they deserve the best services.
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Injection & Pain Management

We provide compliant billing for foot injections, nerve blocks, and pain management procedures with accurate documentation and proper modifier usage.

Advanced Treatments

We handle advanced podiatric treatments with proper prior authorization management and comprehensive clinical documentation for high-value services.

Nail & Skin Procedures

We ensure accurate coding for nail debridement, callus removal, and skin lesion treatments with proper medical necessity justification and frequency compliance.

Surgical Procedures

We manage complex podiatric surgeries with accurate modifier usage, justified gaps between claims, and transparent timeframe documentation for all procedures.

Diabetic Care Management

We coordinate diabetic foot care services with proper medical necessity documentation and systematic condition correlation for comprehensive treatment.

Orthotic Services

We provide specialized billing for custom orthotics and devices, ensuring proper HCPCS and ICD-10 code pairing to justify fitting and delivery documentation.

Routine Care & Diagnostics

We handle routine foot care according to strict medical necessity criteria, ensuring precise paperwork and accurate coding for debridement and mycotic nail care, with proper frequency documentation.

Wound Care Partnerships

We provide accurate code coordination to prevent overlapping, ensure transparent tracking for pre- and post-surgical services, and deliver complete operative notes with reduced errors.

Graft & Skin Substitute Procedures

We select accurate application and graft codes based on location and wound size, audit surgical documents to ensure correct Q-code pairing for procedures and supplies, and assist in navigating state-specific Medicaid nuances through proactive prior authorization.

DME Billing

Robust compliance for orthotics, diabetic shoes, walking boots, and offloading devices. We ensure that certified coders are used for accurate coding and a perfect match for every claim. We evaluate the signature requirements of every payer and employ proactive strategies for expedited prior authorization.

Injection Therapies

We handle foot injection procedures with accurate MCO compliance, ensuring proper documentation and modifier usage for maximum reimbursement in the NY market.

Nail & Skin Care

We provide compliant billing for nail debridement and skin lesion procedures, meeting eMedNY-specific documentation requirements and ensuring proper medical necessity justification.

Advanced Treatments

We manage advanced podiatric treatments with NY-specific requirements, ensuring proper Q-code usage, comprehensive clinical packets, and expedited prior authorization processes.

Diabetic Care Management

We coordinate diabetic foot care services with wound care partnerships, ensuring proper documentation and transparent billing coordination for all involved providers.

Surgical Procedures

We handle complex podiatric surgeries with MCO coordination, ensuring accurate service sequencing and proper documentation to prevent overlapping claims and denials.

Orthotic Services

We provide specialized eMedNY-compliant orthotic billing with precise HCPCS coding, accurate ICD-10 pairing, and comprehensive modifier knowledge for maximum reimbursement.

Routine Care & Diagnostics

We ensure eMedNY compliance for routine foot care services with systematic condition documentation, proper modifier alignment, and comprehensive medical necessity justification for all procedures.

Graft & Skin Substitute Procedures

We prepare comprehensive clinical packages for fast approval, ensure thorough compensation for graft products and application, and prevent claims denials through accurate coding and correct submission.

Wound Care Partnerships

We provide accurate code coordination to prevent overlapping, ensure transparent tracking for pre- and post-surgical services, and deliver complete operative notes with reduced errors.

DME Billing

NY Medicaid’s top coverages include diabetic shoes and inserts, ankle-foot orthoses, braces, and custom-molded orthotics. We ensure eMedNY compliance through precise documentation, proper ICD-10 coding, and in-depth knowledge of modifiers to prevent denials.

Robotic Procedures

We deal with complex billing for radical prostatectomy, partial nephrectomy, and cystectomy by elaborative documents for the used devices. Our accurate codes and modifiers ensure successful approvals.

Telehealth

Our coders ensure accuracy for pre-op consultations, follow-ups, and LUTS/OAB management. Our optimized POS and use of modifiers have lower denial rates, as we demonstrate their necessity with clinical documents.

Urodynamics & Diagnostics:

We handle multi-channel involvement and billing complications with detailed CPT/ICD pairing. Our proactive prior authorization handling and expert claim structuring ensure error-free approvals.

Cystoscopy & Endoscopy:

We capture every detail and require evidence to ensure a smooth claim approval for office-based and hospital-based endoscopic procedures. We offer robust billing claims for biopsies and stone removals.

Lithotripsy (ESWL) & Stone Management:

We understand the complex bundling of ESWL, URS, and stone procedures, including device charges, anesthesia, and supplies for ongoing care. This in-depth knowledge ensures coding accuracy for each component.

Prostate Procedures & Biopsy:

We offer meticulous billing for targeted biopsies and imaging-guided prostate procedures, ensuring proper coordination of involved pathology and detailed capture of all allowable charges.

Implants & Prosthetics

We strictly follow the payer’s rules for high-value penile prostheses and testicular implants, ensuring proper coverage for device charges. Our coders ensure proper coding pairs, transparent vendor contracts, and logs for implants.

Pathology & Imaging

Our team possesses in-depth knowledge of the working principles of pathology and imaging centers. We collaborate with service providers to obtain accurate clinical information, ensuring that we capture all allowable charges.

Botox & Neuromodulation

For these complex services, we provide thorough coverage by handling prior authorization approvals and ensuring coding accuracy for both trial and permanent procedures. Our modifier’s accuracy provides high compliance with diverse payer requirements.

DME & Catheter Supplies:

We provide streamlined billing claims for catheter and drainage bag supplies, ensuring smooth and timely payment collections. Our proof-of-delivery and proactive SOPs save practices from financial loss.

DME & Catheters

We handle catheter supplies, ongoing maintenance claims, and billing for incontinence aids. We complete clinical documents with proof of need, supply evidence, and other supporting elements according to Medicaid requirements.

Pathology & Advanced Imaging

Outpatient labs and imaging services face facility-based billing cuts due to poor classification. We manage all complexities with professional splits and ensure compliant claims for radiology reads and pathology services.

Botox & Neuromodulation

We perfectly align the trial with a permanent implant and explain all stages with accurate codes. Our precise and error-free claim submission ensures maximum reimbursement for all elements.

Implants & Prosthetics

We offer support for commercial or Medicaid billing claims through transparent device tracking, fair vendor contracts, and compliant pre-auths, resulting in the successful implantation of penile prostheses, urinary sphincters, or slings.

Prostate Procedures & Biopsies

Pairing of biopsies with MRI-guided prostate means additional care for billing documents. These coordinated services required accurate pathology linking, ensuring that our robust component captures the necessary information.

Lithotripsy & Stone Procedures

We offer coding accuracy from ESWL to ureteroscopy by managing compliant documents for anesthesia, professional components, and prior authorization for such high-value services.

Cystoscopy & Endoscopic Interventions

Our technical expertise ensures billing accuracy for stent removals, cystoscopy, and facility-based endoscopy procedures. We separate each component of treatment to bring payment for all.

Urodynamics & Pelvic Testing

We justify the clinical necessity for urodynamic services. We offer hands-on support for authorization, ensure claims accuracy with diagnosis justifications, and document compliance for revisits.

Telehealth Evaluation Services

We have current information about eMedNY and MCO policies, ensuring coding accuracy with proper place-of-service designations, relevant modifiers, patient consent forms, and explanations of rendered services.

Robotic Procedures

We cover high-value procedures such as prostatectomy and nephrectomy, among others, by accurately documenting device costs in clinical documents and justifying their necessity under APG and facility-based insurance rules.

Pathology & Imaging Coordination

We resolve coding conflicts for these pairing services and ensure a justified coordination in documents to prepare a clean claim with reduced denial risks.

DME & Catheter Supply Managemen

The Medi-Cal and commercial payers have strict compliance requirements for DME. We streamline your claims with transparent usage tracking to ensure quality care and justified reimbursement.

Botox, Neuromodulation & OAB Treatments

We simplify the staged billing process for trials by managing prior authorization, the device’s paperwork, and submitting claims to accurate insurers to make it more manageable.

Implants & Prosthetics

We expedite your operation by handling authorization and vendor contracts, managing paperwork for pre-approvals, ensuring coordination, and maintaining inventory logs for stents and penile implants.

Prostate Procedures & Biopsies

Our experts accurately sequence the complex billing claims for MRI-fusion biopsies, prostate services, and imaging pairings across various payers to ensure maximum reimbursement for practices.

Lithotripsy & Stone Procedures

We navigate the complex process through accurate coding, transparent anesthesia reports, and the use of durable equipment, resulting in maximum coverage for every service.

Cystoscopy & Endoscopic Interventions

We capture each detail about scope procedures, stent placements, and biopsies performed in facility or ASC settings to prepare compliant claim documents.

Urodynamics & Pelvic Testing

We understand the unique compliance requirements, from bladder studies to pelvic floor testing, which prove the clinical necessity to ensure robust prior authorization and successful billing claims.

Telehealth Evaluation Services

California has broader telehealth services, with high Medi-Cal reimbursement for these services. We cover modality, consent, and explain facility settings so that you can get maximum advantage from every allowed charge.

Robotic Procedures

We precisely document robotic-assisted surgeries, negotiate with insurers, reflect the procedure’s complexity, and complete all paperwork in accordance with payer requirements to ensure a justified payment.

AB 72 – Surprise Billing Law

For podiatrists providing surgical services in out-of-network facilities, California’s AB 72 limits balance billing. Navigating this requires precise billing strategies.

Prior Authorization Hurdles


Increasingly, California payers require prior authorizations for DME, orthotics, skin grafts, and advanced wound care procedures. Failure leads to non-payment.

Workers’ Compensation Complications

California’s Workers’ Compensation system demands strict adherence to the Official Medical Fee Schedule (OMFS) and highly detailed documentation—especially for podiatric injury care, fracture management, and surgical interventions

Complex Wound Care & Skin Graft Billing

Podiatrists collaborating with wound care centers for diabetic ulcers, pressure sores, or limb salvage procedures face frequent denials related to skin substitute grafts (e.g., Apligraf®, Dermagraft®) and advanced wound treatments like NPWT (vacuum therapy).

Medi-Cal Restrictions

Medi-Cal limits podiatry services unless directly related to chronic disease management. Denials are common without proper coding and documentation.

Routine Foot Care Scrutiny

California insurers, including Medi-Cal and major HMOs (Kaiser, Blue Shield CA), often classify foot care (like nail debridement and callus removal) as non-covered unless medically justified by conditions like diabetes or peripheral vascular disease.