Cardiology
Connect complex procedures with the documentation and coding they require.
- Echo, stress testing and cath-lab coding
- Procedure bundling and supported modifiers
- Professional and technical components, when applicable
Specialty medical billing. Built around your practice.
Complex care brings complex claims. Dastify Solutions helps U.S. specialty practices connect documentation, coding, payer requirements and follow-up, so preventable billing issues get attention before they become a recurring drain on collections.
Free consultation · Start with your specialty, systems and billing priorities
Specialty-specific claim reviewSupport in your existing systemsVisibility into denials and unpaid claims
A connected specialty billing workflow
Each handoff matters. Each exception needs a next step.
- 01Coverage & authorization
- 02Documentation & coding
- 03Submission & payer response
- 04Payment & follow-up
Your specialty changes the billing checklist.
An infusion, a surgical case and a therapy session need different checks. Explore the procedures, documentation and payer issues that shape your specialty's revenue cycle.
Gastroenterology
Keep procedure intent, findings and claim details aligned.
- Screening, diagnostic and converted colonoscopies
- Payer-specific modifiers and coverage criteria
- Coordination of endoscopy, pathology and anesthesia claims
Pain management
Review the clinical and procedural details behind interventional claims.
- Procedure levels, laterality and repeat services
- Included versus separately reportable image guidance
- Authorization and medical-necessity documentation
Orthopedics & spine
Follow the full surgical episode, from procedure coding to postoperative care.
- Multiple procedures and anatomic modifiers
- Global surgical periods and related services
- Payer-specific DME, orthotic and implant payment rules
Oncology & infusion
Account for the drug, the administered dose and the administration service.
- Drug HCPCS codes, including J-codes, and billed units
- Infusion administration coding and documented time
- Authorization and applicable Medicare JW/JZ reporting
Behavioral health
Match services, time and provider eligibility to the right billing pathway.
- Documented psychotherapy time and E/M add-on rules
- Telehealth modality, place of service and payer requirements
- Visit authorizations and behavioral health benefit carve-outs
Ambulatory surgery centers
Distinguish facility payment rules from professional billing requirements.
- Covered procedures and facility claim requirements
- Packaged supplies, implants and permitted separate payment
- Coordination with surgeon and anesthesia billing teams
Diagnostic & specialty labs
Build claims around the ordered test and its coverage requirements.
- Molecular testing, genetics and pathology workflows
- Orders, diagnosis support and medical necessity
- Applicable authorization, coverage and lab billing rules
Managing ongoing care across specialties? Discuss E/M documentation, care-management time, consent and remote-monitoring requirements as part of your scope.
Requirements vary by payer, plan, provider type, setting and date of service. Specialty fit and the services included are confirmed before engagement.
Address the claim. Fix the recurring issue.
A corrected claim helps today. Understanding why it failed helps the next one. We connect claim-level work with the upstream changes your team can act on.
01
Check coverage before care
Review eligibility, benefits, referral requirements and authorization status within the agreed front-end scope. Flag mismatches between the approved service and the planned procedure, drug, units or location. An authorization is not a guarantee of payment. Other coverage, coding and claim requirements still apply.
02
Review the claim in context
Check supplied codes, diagnoses, units, modifiers and available documentation against applicable edits and payer policies. Raise documentation questions with the practice rather than assuming a missing clinical fact. For Medicare, this includes applicable NCCI edits and national or local coverage policies. A modifier is used only when the documented circumstances support it.
03
Resolve and learn from nonpayment
Track rejections, denials, underpayments and aging balances. Prioritize by value, deadline and recovery potential, then document the correction, appeal or payer follow-up needed. Recurring findings feed back into authorization checks, claim edits and documentation guidance for your team.
Claim submission, payment posting and reporting connect these steps. Coding from clinical documentation, authorization work and patient-balance support are defined separately in your proposal.
Automation supports the work. People review exceptions.
Where available in your systems, claim edits and automation support routine checks. Coding questions, documentation gaps and unusual payer responses still need review against the record and applicable rules.
Know what changed. Know what needs attention.
Start with your practice's baseline. Review trends by payer, specialty and procedure, with consistent definitions and a clear reporting period.
Clear reporting. Actionable next steps.
Claim quality
Where does rework begin? Separate clearinghouse rejections from payer denials. Identify recurring coding, eligibility, authorization and documentation issues.
Denial resolution
Which issues keep returning? Track denial reasons, balances, corrective actions and appeal outcomes. Assign a next step to unresolved claims.
A/R aging
What is still waiting to be paid? Review days in A/R and aging buckets alongside payer status, filing deadlines and the collectibility of older balances.
Payment accuracy
Does payment match the claim? Review collections, adjustments and possible underpayments against available contract terms and fee schedules.
Agree on targets after reviewing the baseline. Claim acceptance, payment timing and total collections measure different things; they should not be presented as interchangeable results.
Start with your workflow. Build from there.
From a solo specialist to a multi-location group, the transition should make responsibilities clear. We review your current systems and agree on scope before live billing begins.
- 01
Understand the practice
Review specialties, locations, payer mix, procedure volume, denial patterns and aged A/R. Identify the work to transfer and what stays with your team.
- 02
Define access and handoffs
Complete the service agreement and BAA, arrange practice-approved system access, and define documentation queries, escalation contacts and reporting.
- 03
Validate, launch and review
Check representative workflows, agree on a go-live plan and monitor early claim activity. Review payer responses and refine the process as claims are adjudicated.
Keep your existing EHR where practical
Dastify Solutions can often work within your EHR, practice management system, clearinghouse and payer portals. Compatibility, access requirements and any workflow changes are confirmed during discovery. Platforms discussed during system-fit review
- athenahealth
- eClinicalWorks
- AdvancedMD
- Tebra / Kareo
- NextGen
- DrChrono
Platform names identify systems to evaluate, not a claim of partnership or a universal integration.
Clear responsibilities for patient data
A Business Associate Agreement and approved access are part of onboarding before patient information is handled. Review access controls, data handling and the responsibilities of both teams as part of your due diligence.
A clear scope before a quote.
Specialty, claim volume, payer mix and the work you need all affect pricing. Review a written proposal that separates included services, optional work, third-party charges and your practice's responsibilities.
Ongoing specialty billing
For solo specialists, growing practices and multi-specialty groups Build coordinated support for claim review, submission, posting, denial work, payer follow-up and reporting. Agree on the collections basis and the services included before starting.
Focused billing support
For teams addressing a backlog or a specific billing problem Discuss an aged A/R review, a defined recovery project or a specialty coding audit. Set the accounts, deliverables, exclusions and fee arrangement before work begins.
Prior authorization, credentialing, coding directly from documentation and patient-balance services are separately scoped. Confirm cancellation terms and any handover responsibilities in your agreement.
Your specialty billing questions, answered.
Get clarity on scope, systems and expectations before you make a decision.
Discuss your specialtyWhat makes specialty billing different?
The billing fundamentals are shared, but the checks change with the care delivered. Specialty claims may involve procedure bundles, drug units, time-based services, global surgical periods, detailed coverage criteria or separate facility and professional claims. The workflow needs to account for those differences.
Can you work with our in-house billing team?
Yes. Discuss the functions you want Dastify Solutions to handle and those your staff will retain. A focused engagement can address a specific backlog or workflow. Defined ownership, escalation paths and reporting help avoid duplicated work or missed follow-up.
Will we need to change our EHR?
Usually not. We first review your existing EHR, practice management system, clearinghouse and payer access. The proposal should identify any access limitations, workflow changes or additional costs before you commit.
How quickly can we go live and see progress?
Timing depends on access, system setup, specialty complexity, documentation readiness and the size of any backlog. We agree on the transition plan after discovery. Submission activity and unresolved issues can be monitored early; collection and denial trends take longer to assess as payers process claims.
Can you help with claims already over 90 days old?
Yes. Older claims are reviewed for status, documentation, timely-filing and appeal limits, and a viable path to payment. Recovery work prioritizes actionable balances. Age alone does not establish that a claim is collectible, and recovery is not guaranteed.
How are coding and compliance questions handled?
Review starts with the documented service and the rules applicable to that claim. Medicare NCDs, relevant MAC LCDs and billing articles, NCCI edits and other payer policies have different roles. Documentation questions go back to the practice; coding must reflect the services actually provided.
How is specialty billing priced?
Ongoing billing is generally quoted as a percentage of collections, with the rate and collection basis defined in the proposal. Specialty complexity, volume, payer mix, systems and service scope matter. Focused projects need their own scope and fee arrangement; confirm optional services, third-party charges and termination terms in writing.
Let's talk about your specialty.
Tell us what you bill, which systems you use and where work is getting stuck. We can discuss specialty fit, the right scope of support and the next steps for your practice.
Please do not include patient names, records or other protected health information in your inquiry.
