- +1 (773) 985-1869
- info@stream-rcm.com
- 14430 Ocean Point, El Paso, TX 79938
With more than 20 years of hands-on medical billing experience across the U.S., Stream RCM knows exactly what it takes to keep a pulmonology practice financially healthy. We start by auditing your current billing for compliance gaps and hidden losses, then build a process that codes every treatment correctly from the ground up. Our experts stay on top of payer and state regulations so your practice never falls out of compliance. Our pulmonology billing solutions refine your revenue cycle and drive practice revenue growth by as much as 35%.
Pulmonology billing comes with real challenges and the pulmonologists are under more pressure than ever. Studies show that 85% of physicians spend 10 or more hours every week on administrative and billing tasks. That time should be spent with the patients. Complex respiratory coding, prior authorizations, payer regulations, and claim follow-ups pile up fast and pull your attention away from clinical care. But our dedicated team understands all the complexities related to pulmonology medical billing services.
We assign dedicated pulmonology billing specialists.They understand NCDs and LCDs for services like bronchodilator response and home sleep apnea testing. Every claim is built for medical necessity from the start. We check every CPT code and HCPCS modifiers before submission to reduce 18% denials. We support complex procedures such as mechanical ventilation and EBUS, provide weekly AR reports, and manage value-based reporting and COPD readmissions. This helps improve cash flow so you can focus on patient care.
Spirometry helps diagnose asthma, COPD and other breathing conditions by measuring lung function. We ensure accurate coding, complete documentation, and payer compliance for faster reimbursements.
Bronchoscopy helps diagnose and treat conditions affecting airways and lungs. We handle billing for bronchoscopy, EBUS, and related procedures, ensuring accurate coding and modifier usage for timely approvals.
Pulmonary Function Tests help diagnose conditions like asthma, emphysema and pulmonary fibrosis by measuring lung function. We provide precise coding, proper ICD-10 linkage and documentation for faster payment.
Ventilator management provides breathing support for critically ill patients. We handle time-based coding, documentation and payer compliance across settings, ensuring timely payment for critical care services provided.
Sleep studies help diagnose sleep apnea and other disorders. We handle billing for in-lab and home studies with correct coding, authorization compliance, and CPAP claims for smooth reimbursement.
Respiratory care providers need a billing system that can handle complex treatments and ensure steady payments for long-term patient management.
We manage all denied insurance claims with full attention. Our team identifies the exact reason behind each denial. We solve a case of a pulmonology clinic who faces 28% denials due to coding errors; we fix patterns and resubmit claims. The denial rate reduced to 9% and monthly cash flow improved.
We track and manage unpaid and pending insurance claims and follow up regularly with payers. A provider had over $120,000 stuck in 90+ day receivables. We recovered most payments within 60 days, improving cash flow and reducing backlog pressure.
We convert patient services into accurate and compliant medical codes. Our certified coders ensure precision in every claim submission. A clinic faced frequent underpayments due to incorrect COPD coding patterns. We corrected the coding structure. This increased reimbursements by 22% in a short period.
We carefully review billing records to identify errors and missed charges. Our team detects issues before they impact revenue. A practice was missing multiple charge entries for PFT services. We audited and recovered lost revenue. As a result, they recovered their revenue that had previously gone unnoticed.
We manage provider enrollment and insurance credentialing processes. Our team ensures all documents are accurate and submitted on time. We reduced a provider’s approval time from 3-months to under 30 days, allowing reimbursements to arrive much faster.
We track and manage unpaid and pending insurance claims and follow up regularly with payers. A provider had a revenue that stuck in 90+ day receivables. We recovered most payments within 60 days, improving cash flow and reducing backlog pressure.
Keep your revenue cycle running smoothly with accurate coding and claim management. Our specialists manage claims with precision to support faster payments and better financial performance.
A reputable pulmonology billing service should make payments easier and reduce your billing stress. You need to consider a company with strong experience in medical billing to help lower claim denials by up to 30%. Security and compliance are also essential. Your billing partner must follow HIPAA rules and stay updated with industry changes to protect patient data and ensure smooth, accurate reimbursement.
For pulmonology practices, specialty billing experience matters because accuracy and promptness of claim submission may significantly influence reimbursements. A strong billing team can help lower administrative costs by up to 40% and improve cash flow. Billing partners should be able to manage receivables, pursue unpaid claims and generate necessary reports. Our team provides you all benefits to boost revenue performance and supports better financial management for your practice.
| CPT Code | Description |
|---|---|
| 94729 | Diffusing capacity testing (DLCO) measures how well oxygen passes from the lungs into the bloodstream. Accurate documentation of test results and patient information is essential for proper claim submission. Our billing team ensures correct coding and claim processing to support timely reimbursements and reduce denials. |
| 31624 | Bronchoscopy with lavage is performed to examine the airways and collect fluid samples from the lungs. Because this procedure is more complex, detailed documentation and accurate coding are required. We help submit clean claims to avoid reimbursement delays and coding-related issues. |
| 94664 | This service involves teaching patients how to properly use inhalers and respiratory devices. Proper documentation helps demonstrate medical necessity and supports claim approval. Our team ensures accurate billing so providers receive appropriate reimbursement for these services. |
| 95811 | CPAP titration sleep studies help determine the correct treatment settings for patients with sleep apnea. These services often require prior authorization and detailed clinical records. We manage the billing process carefully to improve claim acceptance and payment timelines. |
| E0431 | This code is used for portable oxygen concentrators prescribed for patients with respiratory conditions. Insurance payers often require extensive supporting documentation before approving claims. Our billing specialists ensure all requirements are met to reduce denials and support faster reimbursements. |
We don’t just process claims. We bring real experience to your pulmonology practice. Our team has deep expertise in PFTs, bronchoscopies, sleep medicine, COPD billing, and oxygen therapy. We manage over a million specialty claims each year, so we know what works. We stay authoritative by tracking every CMS update and payer policy change. And we earn your trust with transparency, honesty, and results like we help pulmonology practices keep AR under 45 days and fewer denials for your respiratory services. For simpler services like PFTs and office visits, we aim for under 30 days. For complex claims like oxygen therapy and bronchoscopies, we work hard to get you paid within 50 days. Patients notice when billing gets resolved quickly. Faster claim resolution leads to better satisfaction scores on CAHPS and Press Ganey. That’s good for your reputation and your bottom line.
Stream RCM integrates seamlessly with your pulmonology EHR and EMR platforms without disrupting respiratory clinical workflows or replacing existing systems.
The focus of pulmonologists should be more on ensuring that the health outcomes of their patients are better rather than spending time on issues like claim denials and slow refunds. Stream RCM takes care of everything related to the revenue cycle management for pulmonology patients right from the respiratory coding process till the end of claim processing and payment collection.
Don’t let pulmonary billing complications crush your operations. Stream RCM delivers solutions that prevent problems before they start.
We stop pulmonary billing denials upfront with specialized respiratory coding expertise, delivering faster payments so you can focus entirely on patient care.
We treat pulmonology as its own specialty, coding every service with real understanding of respiratory care.
We fix problems before they become denials, checking every claim thoroughly so it goes out clean.
We keep reporting straightforwardly, showing what got paid, what’s pending and what we’re actively working on.
Insurance rules in pulmonology change constantly, and we stay ahead of every update and requirement change.
Pulmonology claims usually get denied due to coding errors, missing documentation, or incorrect modifiers. Common issues also include unmet medical necessity or expired authorizations. Even small mistakes in respiratory billing can easily trigger payer rejection.
Pulmonology billing mainly includes PFTs, bronchoscopy, oxygen therapy, and sleep studies. It also covers asthma/COPD management and ventilator services in many cases. Each procedure requires specific coding and documentation for proper reimbursement.
Yes, many pulmonology procedures require prior authorization depending on the payer. Sleep studies, advanced imaging, and some diagnostic tests are commonly pre-approved. Without authorization, claims are often denied even if the service is medically necessary.
Yes, outsourcing helps reduce billing errors, denials, and payment delays. It allows your team to focus more on patient care instead of administrative work. Overall, it improves cash flow consistency and speeds up the revenue cycle.
We use specialty-trained coders who understand pulmonology procedures in detail. Every claim is double-checked against payer rules before submission. This reduces errors, prevents denials, and improves first-pass claim acceptance.
Facing delays with pre-authorizations for complex pulmonology procedures? Our billing specialists are here to help. Book a free consultation today and let us simplify your billing process.
