HIPAA & HITECH Compliant RCM
MediNexus
B I L L I N G
Clinical Discipline Specialization

Specialty-Driven Billing & Coding Expertise

One size does not fit all in healthcare reimbursement. Our certified billing teams are structured into specialized clinical divisions to tackle your discipline's unique modifiers, carve-outs, and payer rules.

Behavioral & Mental Health
+22% Revenue Lift

Behavioral & Mental Health

Specialized billing for psychotherapy, psychiatric evaluations, substance abuse, and telehealth sessions.

Common Industry Hurdle

Frequent payer carve-outs, session frequency caps, and complex pre-authorization requirements.

The MediNexus Protocol

Dedicated mental health billing team tracking policy carve-outs, ensuring 99.1% clean session submissions.

Specialty Billing Scope
Time-based psychotherapy add-on codes (+90833, +90836, +90838)
Strict telehealth parity rule navigation
Prior auth for intensive outpatient (IOP) and partial hospitalization (PHP)
Cardiology & Vascular
21-Day Avg DSO

Cardiology & Vascular

High-complexity procedural coding for echocardiograms, catheterizations, and electrophysiology.

Common Industry Hurdle

Heavy documentation burden, modifier -26 and -TC split rules, and severe pre-authorization scrutiny.

The MediNexus Protocol

Subspecialty certified coders matching anatomical specificity to LCD criteria for zero unbundling penalties.

Specialty Billing Scope
Nuclear stress testing and PET scan reimbursement
Multiple procedure discounting rules
Device tracking and technical vs. professional component split
Orthopedics & Physical Therapy
98.9% Clean Claims

Orthopedics & Physical Therapy

Comprehensive surgical bundling, fracture care global periods, and physical therapy cap compliance.

Common Industry Hurdle

Post-op global period exclusions, complex surgical assistant billing, and Medicare PT KX modifier thresholds.

The MediNexus Protocol

Rigorous operative report scrubbing and proactive therapy KX modifier threshold tracking.

Specialty Billing Scope
90-day global surgery package compliance
Modifier -59 and -X{EPSU} distinct procedural service optimization
DMEPOS and orthotic fitting billing
Ambulatory Surgery Centers (ASC)
99.4% Payment Accuracy

Ambulatory Surgery Centers (ASC)

Specialized facility fees, implant carve-outs, and multi-specialty surgical billing.

Common Industry Hurdle

Strict payer-specific approved procedure lists, invoice requirements for high-cost implants, and rapid filing deadlines.

The MediNexus Protocol

End-to-end ASC billing workflows ensuring maximum allowable reimbursement for both facility and implants.

Specialty Billing Scope
ASC covered procedure list compliance
High-cost implant and biologics invoice attachment
Facility fee vs. physician fee synchronization
Pediatrics & Family Medicine
-78% Denial Drop

Pediatrics & Family Medicine

High-volume preventive medicine, vaccine administration, and chronic care management billing.

Common Industry Hurdle

High claim volume, frequent payer downcoding of combined preventive/problem encounters, and parent copay collection.

The MediNexus Protocol

Bulletproof documentation templates for modifier -25 and automated parent patient portal billing reminders.

Specialty Billing Scope
Vaccine counseling and VFC program billing
Same-day sick and well-child visit modifier -25 usage
Developmental screening (96110) reimbursement
Neurology & Pain Management
< 2% Denial Rate

Neurology & Pain Management

Interventional fluoroscopic guidance, EMG/NCV nerve testing, and spinal injection reimbursement.

Common Industry Hurdle

Aggressive payer audits on high-frequency interventional procedures and medical necessity requirements.

The MediNexus Protocol

Continuous LCD tracking and verified medical necessity documentation prior to procedure submission.

Specialty Billing Scope
Fluoroscopic and ultrasound guidance (+77002, +76942)
Strict LCD diagnostic frequency limitations
Facet joint and epidural steroid injection rules