Managing a nephrology practice is no easy task. The complexity of CKD care, long-term treatments, and coordination with multiple providers often leads to nephrology billing challenges that slow down or stall claims. Our professional nephrology billing company ensures accuracy across claim types, including ESRD and dialysis.
Why Us
Renal billing challenges can significantly impact revenue for nephrology practices. Our renal care billing services help reduce preventable denials through AI-powered denial prevention and automated claim submission tools, ensuring more accurate and timely reimbursement.
Our specialty-specific nephrology billing solution includes:
Complete Solutions
Dialysis billing is complex, with ever-changing CMS rules, bundled payments, and strict documentation. Our nephrology billing company ensures that every service is coded accurately, that claims are compliant, and that reimbursements arrive quickly, so you can focus on patient care, not on lost revenue.
End-to-End
We enter all billable charges for dialysis, E/M visits, procedures, and surgeries. Our system integrates with EHR/EMR platforms to eliminate duplicate entries and correct diagnosis mapping.
To avoid delays, we perform comprehensive insurance verification to ensure that every patient's coverage is accurate and up to date before services are rendered, preventing rejections.
Our team of certified coders applies accurate nephrology-specific ICD-10, CPT, and HCPCS codes to procedures and ensures precise claim submissions.
We utilize RPA bots for claim submission. Our AI dashboards provide real-time claim tracking, enabling instant visibility into claim acceptance or rejection.
We accurately post insurer and patient payments, including adjustments, write-offs, and patient responsibility, keeping your accounts receivable clear and balanced.
We monitor outstanding claims and follow up promptly with payers to resolve delays. We monitor unpaid claims with predictive analytics and resubmit them with proper documentation.
Billing Expertise
| Billing Challenge | How We Solve It for You |
|---|---|
| ESRD PPS (Bundled Payments) | We handle all bundled vs. non-bundled dialysis services, capture outlier payments, and prevent costly errors. |
| Home Dialysis (HHD & PD) | Our experts apply the correct home dialysis codes and payment adjustments, including training sessions. |
| CKD Staging & HCC Coding | We check every CKD claim for the correct stage, preventing under-coding and maximizing reimbursement. |
| Vascular Access Procedures | Accurate coding for AV fistulas, grafts, catheters, and dialysis interventions, with global period tracking. |
| Medicare Secondary Payer (MSP) Coordination | We track each patient's 30-month ESRD coordination period and bill the correct primary payer each time to avoid denials. |
End-to-End
Still relying on paperwork for renal care billing? Today,, nephrology billing demands more. Our RCM outsourcing combines RPA for repetitive tasks, AI for coding accuracy, and pre-error detection.
Direct patient data transfer eliminates redundant entry and reduces errors.
Digitize repetitive tasks for faster turnaround times and operational efficiency.
Provides insights into payer trends, revenue cycle gaps, and compliance risks.
Built for nephrology practices, multi-physician groups, and large national nephrology networks.
Advanced AI tools to scrub your claims not once but twice, eliminating any chance of errors.
Track your claims, payments, and overall billing performance in a few clicks.
AI-powered solutions minimize errors, boosting your revenue.
Support the ESRD bundled payment model and quality metrics aligned with KDOQI guidelines.
— Proven Expertise in
50+ EHR/EMR/PMS
— Choose Your Plan
Transparent Pricing With No Hidden Fees
Starter
For Solo & Small Practices
*Based on collections
Most Popular
Growth
For Group Practices & Clinics
*Based on collections
Enterprise
Hospitals & Large Systems
Volume-based pricing
Coding Mastery
| Code | What It Covers | Why It Matters for Your Practice |
|---|---|---|
| 90951–90962 | ESRD monthly dialysis care | Core of nephrology revenue; missing visits or miscounts directly reduce monthly payments |
| 90935 / 90937 | Hemodialysis sessions (non-monthly billing) | Ensures you're paid correctly when not billing under ESRD monthly services |
| 99202–99205 | New patient visits | Prevents undercoding of complex CKD and referral cases |
| 99211–99215 | Follow-up visits | Keeps routine CKD care properly billed and consistent |
| N18.3–N18.6 | CKD Stage 3–ESRD | Most commonly used stages, critical for medical necessity and approvals |
| Z99.2 | Dialysis dependence | Required to support ESRD claims and avoid denials |
| 36821 / 36830 | AV fistula & graft procedures | High-impact procedures where coding errors lead to major revenue loss |
Nationwide
Do you need state-specific or payer-specific coverage for nephrology billing services in the USA? Talk to us! Our affordable nephrology billing outsourcing services cover every state, including:
We Cover Your Speciality
Frequently asked questions
Stop Revenue Loss
Our ESRD PPS billing excerpts catch underbilling, prevent denials, and optimize every claim.
