- Business Hours: 08:00 to 05:00 | Monday to Friday
- Contact: +1 713-702-7332
- Email: info@ombcs.com
- 906 W. Medical Center Blvd, Webster TX 77598

# Nephrology Billing Services

### Our Specialties

## Nephrology Billing Services

Specialized billing solutions for nephrology practices and dialysis centers to optimize revenue, reduce denials, and streamline billing for complex renal procedures and ongoing dialysis services.

### Our Services

## Nephrology Billing Expertise

- Specialized dialysis facility billing (hemodialysis, peritoneal)
- ESRD and CKD diagnosis and procedure coding
- Medicare renal disease and dialysis claim handling
- AV fistula and graft procedure coding

- Renal transplant billing and follow-up care
- Home dialysis program billing optimization
- Compliance with CMS ESRD Quality Incentive Program
- Coordination of multiple payers for ESRD patients

### Coding Expertise

## Common Nephrology CPT Codes

Code | Description
--- | ---
90935 | Hemodialysis procedure with single evaluation by physician
90945 | Dialysis procedure other than hemodialysis with single evaluation
36818 | Arteriovenous anastomosis for dialysis access
90940 | Hemodialysis access flow study to determine blood flow
36901 | Diagnostic angiography of dialysis circuit, including imaging

### Our Process

## Nephrology Billing Process

Our comprehensive approach ensures maximum revenue and minimal administrative burden for your nephrology practice and dialysis centers.

### Patient Registration & Insurance Verification

We verify nephrology-specific insurance benefits and coverage for dialysis and other renal procedures before services are rendered, including:

- Medicare ESRD eligibility verification and coordination of benefits
- Primary and secondary insurance validation for dialysis patients
- Pre-authorization for vascular access procedures
- Coverage verification for home dialysis programs
- Transplant evaluation insurance verification and authorization

### Specialized Nephrology Coding

Our nephrology coding specialists ensure accurate code assignment for all renal services:

- Precise coding for dialysis services and monthly capitated payments
- Expert coding for vascular access procedures and interventions
- Accurate CKD staging and documentation support
- Proper modifiers for complex nephrology scenarios
- Compliant documentation for renal transplant workups and follow-up care

### Clean Claim Submission

We achieve a 98% clean claim rate for nephrology services through our thorough process:

- Dialysis-specific claim scrubbing to identify coding errors
- Verification of medical necessity documentation for procedures
- Coordination of Medicare and secondary payer submissions
- Proper sequencing of kidney disease diagnosis and procedure codes
- Electronic submission to all major payers within 24-48 hours

### Nephrology Denial Management

Our specialized approach to nephrology claim denials includes:

- Expertise in appealing Medicare ESRD payment denials
- Management of frequency limitation issues for dialysis services
- Documentation support for vascular access interventions
- Appeals for inpatient and outpatient dialysis coordination
- Monitoring and addressing nephrology-specific payer policy changes

### Nephrology Practice Analytics

Our nephrology-specific reporting and analytics help optimize your practice:

- Monthly capitated payment analysis and optimization
- Revenue analysis by service line (office visits, procedures, dialysis)
- Payer-specific performance metrics for renal services
- Denial trend analysis by procedure and service type
- Recommendations for revenue optimization by treatment modality

### frequently asked questions

## Nephrology Billing FAQs

Get answers to common questions about our nephrology medical billing services, coding challenges, and revenue optimization strategies.

##

Our team has extensive experience with Medicare's complex ESRD payment system. We manage the Monthly Capitation Payment (MCP) structure, ensure proper documentation for the number of visits per month, coordinate primary and secondary insurance billing, and navigate the 90-day global period for vascular access procedures. We also help ensure proper reporting for the ESRD Quality Incentive Program.

##

We specialize in home dialysis billing, including peritoneal dialysis and home hemodialysis. Our approach includes proper coding for training sessions, equipment and supply billing, monitoring documentation requirements, and coordinating the complex payment schedules. We help practices maximize appropriate reimbursement while maintaining compliance with Medicare and commercial payer guidelines.

##

Our vascular access procedure billing includes detailed documentation review to support medical necessity, proper coding for the specific access type (fistulas, grafts, catheters), coordination with surgical and interventional teams, and management of global period regulations. We track frequency limitations and ensure proper modifier usage for procedures performed within the global period.

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We manage the complex coordination of benefits requirements for ESRD patients, including determining primary payer status during Medicare's 30-month coordination period. Our team tracks the specific dates when Medicare becomes primary, ensures proper submission to all applicable payers in the correct order, and reconciles payments to maximize total reimbursement while maintaining compliance.

## Ready to optimize your nephrology revenue cycle?

Contact us today for a free consultation and learn how our specialized nephrology billing services can benefit your practice and dialysis centers.

Request a Free Consultation

### How can we help you?

I can help with nephrology billing questions, insurance information, or scheduling assistance.