- +1 (773) 985-1869
- info@stream-rcm.com
- 14430 Ocean Point, El Paso, TX 79938
Stream RCM offers specialty coding and billing services for ENT. We reduce denial rates by 34% to accelerate cash flow. Our team is experienced in working in the complicated world of otolaryngology from cochlear implant procedures to sinus surgery. We provide you with specialist expertise along with our denial prevention methodology. Regardless of whether it’s a difficult modifier application or audiologic testing codes, we can handle everything.
Revenue ENT practices lose to claim errors annually
We’re an extension of your ENT practice. Our team includes certified coders with years of focused experience in otolaryngology, from rhinology to head and neck oncology. We understand that ENT coding is uniquely challenging: eustachian tube dilations, septoplasties, and allergy testing each have specific CPT and ICD-10 nuances. We use our extensive knowledge and payer intelligence to make sure that you get your payment.
Our monthly performance reviews break down denial trends, aging A/R, and coding updates relevant to ENT. We’ve helped practices reduce days in A/R by 28% and increase first-pass resolution by 42%. We don’t just process claims, we analyze payer behavior, appeal unjust denials, and provide actionable insights. Your practice deserves a billing partner who speaks the language of ENT, from acoustic neuroma surgeries to sinus balloon procedures.
We code and bill ear surgeries, tympanostomy, mastoidectomy, and hearing aid evaluations with the modifier accuracy payers require for bilateral otologic claims.
We manage sinus surgery, septoplasty, and balloon sinuplasty billing, separating diagnostic scopes from surgical sessions to prevent bundling denials
Our team bills voice and swallowing procedures, including laryngoscopy and vocal cord injections, with documentation checks built into every claim cycle.
We separate audiometric testing from physician evaluation codes, making sure our claims reflect correct technical and professional component splits.
Our experts support oncology-adjacent ENT billing, including biopsy, neck dissection, and thyroid procedure claims, coordinated with surgical scheduling.
Customized RCM solutions for otolaryngology designed to increase reimbursements, reduce denials, and accelerate cash flow using specialized knowledge.
We not only re-submit claims but reverse them. Utilizing payer-specific appeal matrices for otolaryngology, our team reverses 72% of denied ENT claims. Whether it is medical necessity denials or prior authorization issues, we stand up for what we deserve.
No ENT claim remains unpaid, nor does it remain undisbursed from our records. We track every unpaid line item on a daily basis with payer contacts, reducing 18-25 days in A/R in the first 90 days. Our professional follow-ups help with cash flow and ensure good payer relationships.
Avoid being left out when it comes to reimbursement. In our pre-submission audit process, we identify missing operative reports, improper modifier codes (-50, -51, -59), payer-specific billing rules for otolaryngology and many other errors before submitting your claims.
Our ENT coders have been trained to use CPT and ICD-10 codes for all kinds of otologic, rhinologic and laryngologic procedures like cochlear implants, sinus surgeries, laryngoscopies, vocal cord injections etc to keep every claim compliant and reimbursement optimized.
We handle all the provider credentialing and enrollment tasks in relation to Medicare, Medicaid and other commercial insurance companies to get you credentialed and enrolled with 40% faster turnaround time, allowing you to accept referrals.
Daily posting of all payments received for ENT is done while simultaneously evaluating all the payments with your contractual fee schedules. We track down all the discrepancies in payment and make sure that you do not lose out on any payments due.
We identify the exact area of loss and work on resolving it by first conducting a free review of your existing billing cycle.
The volume of prior authorization in otolaryngology has become a genuine revenue drain. The average doctor deals with 39 prior authorization requests per week, which takes nearly two whole business days from the staff to prepare for one reimbursement. In the ENT sphere, the biggest impact falls on those procedures which are really important for the field like balloon sinuplasty, cochlear implants surgery, and uvulopalatopharyngoplasty, and losing the authorization causes the re-scheduling trouble, dissatisfied patients, and the covered procedure cost that your practice has to bear. The Stream RCM is able to take up this responsibility on behalf of your ENT practice through monitoring the authorization requirements by procedure and payer, requesting authorizations before the scheduling, and renewing them in advance.
| CPT Code | Procedure | ICD-10 Pairing | How We Handle This |
|---|---|---|---|
| 31267 | Nasal , Sinus Endoscopy with Middle Meatal Antrostomy , Outsource | J32.0 | We verify imaging supports chronic maxillary sinusitis and confirm the procedure note documents extent of surgery before submission. |
| 69436 | Tympanostomy Under General Anesthesia | H65.90 | Our team confirms anesthesia documentation is complete and bilateral coding is applied only when the operative report explicitly supports both ears. |
| 92588 | Distortion Product Evoked Otoacoustic Emissions | H90.2 | We split audiologist technical and physician professional components, preventing the common billing error that collapses both into a single claim. |
| 30520 | Septoplasty | J34.2 | Rhinoplasty unbundling is reviewed every time; we bill septoplasty independently when the medical record distinguishes functional from cosmetic intent. |
| 31575 | Laryngoscopy, Flexible Diagnostic | J38.00 | We confirm the note specifies why flexible diagnostic scope was necessary, satisfying medical necessity criteria that differ by payer for this commonly denied code. |
There has been a trend where practices providing otolaryngology are also offering allergy testing and immunotherapy in addition to the services related to otolaryngology. The payers have started raising questions regarding the medical necessity in cases where allergies and sinus are both mentioned in the same claim but are not separated. It has led to the practice of raising the denial because there was no proof that the medical necessity of the allergy procedure and ENT surgery had been established individually. Stream RCM develops the claims logic for separating the allergy and otolaryngology billing streams in order to establish individual medical necessities for each of them.
We integrate effortlessly with the EHR and EMR software you already have. Our billing solutions work silently alongside your systems to improve revenue.
Unlike other revenue cycle management programs, which come to you with a whole new platform and a one-month deadline, we first go into your current system for the first four weeks. We find out how your front desk handles eligibility, how your doctors do their dictation, and all of the areas in your billing process that need help. We implement changes starting from the ones that have the biggest effect on the bottom line, resulting in improved collections within two months for most ENT offices.
We tackle the most frequent revenue roadblocks for ENT practices with targeted strategies.
We help healthcare providers with reliable billing expertise and a workflow that saves time, money, and builds trust with patients.
With our billing expertise and payer-centric approach, healthcare providers can save money and get higher payments from their insurance companies for services provided.
We ease administrative burden by providing clear claims that assist with the revenue cycle and lessen disputes on claims with health insurance providers.
Healthcare providers receive transparent performance reports about where the money comes from, when it gets delayed, and how the billing improves every month.
ENT medical billing experts provide consistent support to help healthcare practices cope with complex payer policies.
We support solo providers, multi-physician groups, and hospital ENT departments with calibrated, practice-specific billing approaches.
We separate technical and professional components based on employment arrangements and payer contract requirements for each encounter.
Yes. We manage payer enrollment, tracking, and follow-up so new providers are credentialed before seeing patients.
Yes. We prioritize aged AR recovery alongside current submissions, focusing on high revenue surgical claims first.
Reports include collections, AR aging, denial trends, and acceptance rates presented clearly for practice administrators without billing expertise.
Our team reviews annual CPT updates and payer bulletins, updating claim logic before effective dates.
Contact our billing specialist for otolaryngology and find out just where your revenue cycle is falling behind.
