Grow Pulmonology Practice Revenue Up to 35%

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 Services

Trusted Billing Support for Pulmonology and Respiratory Practices

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. 

Specialized Pulmonology Medical Billing Services

Spirometry

Spirometry helps diagnose asthma, COPD, and other breathing conditions by measuring lung function. We ensure accurate coding, complete documentation, and payer compliance to reduce denials. Our team helps your practice to receive faster reimbursements.

Bronchoscopy

Bronchoscopy helps diagnose and treat conditions affecting the airways and lungs. We handle billing for bronchoscopy, EBUS, and related procedures. We ensure accurate coding, modifier usage, and documentation to support timely claim approvals.

Pulmonary Function Testing (PFT)

Pulmonary Function Tests (PFTs) help diagnose conditions like asthma, emphysema, and pulmonary fibrosis by measuring lung function. We provide precise coding for all PFT components, proper ICD-10 linkage and documentation to receive faster payment.

Ventilator Management

Ventilator management provides breathing support for critically ill patients. We handle time-based coding, documentation, and payer compliance for inpatient and outpatient settings to reduce billing issues.Our goal is to make sure timely payment for critical care services.

Sleep Studies (Polysomnography)

Sleep studies help diagnose conditions like sleep apnea and other sleep-related disorders. We handle billing for in-lab and home sleep studies with correct ICD-10 coding. We also handle authorization compliance, CPAP/BiPAP claims and documentation for smooth reimbursement.

Pulmonology Revenue Cycle Performance Operations

Respiratory care providers need a billing system that can handle complex treatments and ensure steady payments for long-term patient management.

Denial 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.

Accounts Receivable

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.

Medical Coding

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.

Medical Billing Audit

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.

Medical Credentialing

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.

Payment Posting

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.

Sleep study approval rate
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Fewer auth rejections
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Faster Rehabilitation Payments
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Higher PFT acceptance
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Improve Cash Flow with Expert Pulmonology Billing Support

 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.

The Benefits of Working with a Pulmonology Billing Team

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.

Pulmonary Billing and Coding Procedures

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.

Pulmonary Billing and Coding Procedures

CPT Code

94729

Description

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.

CPT Code

31624

Description

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.

CPT Code

94664

Description

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.

CPT Code

95811

Description

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.

CPT Code

E0431

Description

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.

Why Outsource Pulmonology Medical Billing to Stream RCM

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.

Integrated Billing Support for Pulmonary Systems

 Stream RCM integrates seamlessly with your pulmonology EHR and EMR platforms without disrupting respiratory clinical workflows or replacing existing systems.

specialties_(T)

Prior Authorization Clearance Team

Payer Appeal Experts

Respiratory Documentation Auditors

Revenue Outflow Detectives

Build Long-Term Financial Strength for Pulmonary Practices

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.

Resolving Pulmonology Billing Obstacles Efficiently

Don’t let pulmonary billing complications crush your operations. Stream RCM delivers solutions that prevent problems before they start.

Why Pulmonary Providers Prefer Stream RCM

We stop pulmonary billing denials upfront with specialized respiratory coding expertise, delivering faster payments so you can focus entirely on patient care.

Respiratory Coding That Actually Fits

We don’t treat pulmonology like general billing. Every service is coded with a real understanding of how respiratory care actually works. No copy-paste coding, no guessing. Just accurate, specialty-focused work that reflects what the doctor actually did and what payers expect to see.

Denials Stopped Upfront

We fix problems before they turn into denials. Every claim is checked properly that could slow payment. Instead of chasing rejected claims later, we make sure things go out clean the first time. That means less stress, fewer follow-ups, and quicker payments for your practice.

Simple Reports You Can Use

We keep reporting straightforward so you don’t have to dig through confusing data. You can easily see what got paid, what’s still pending, and what we’re actively working on. Everything is broken down in a clear, practical way so you always know where your revenue stands.

Payer Rules Always Fresh

Insurance rules in pulmonology change all the time, and keeping up with them is a full-time job. We stay ahead of those updates for you. Whenever a payer changes a requirement or guideline, we adjust our process so your claims stay accurate.

Frequently Asked Questions (FAQs)

Why do pulmonology claims get denied?

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.

Connect with a Pulmonology Medical Billing Expert

 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.