Medical Billing for Every Department and Every Type of Clinic
Primary care, urgent care, nephrology, cardiology, OB/GYN, pediatrics, behavioral health, labs, imaging, surgery centers, and specialty groups all have different codes, payer rules, authorizations, and denial patterns. MedRegion builds department-specific billing workflows so every visit, procedure, test, and follow-up is coded, submitted, appealed, and collected correctly.
Built Around How Each One Actually Gets Paid
A primary care clinic loses revenue differently than a nephrology group. Urgent care needs speed, OB/GYN needs package accuracy, cardiology needs documentation and modifier precision, while behavioral health needs authorization and parity-aware follow-up. We create a custom billing lane for every department.
Primary Care & Internal Medicine
High-volume E&M, preventive visits, AWV, CCM, TCM, vaccine administration, lab coordination, and chronic disease billing.
- E&M leveling and modifier checks
- Annual wellness visit capture
- CCM, RPM, and care management billing
Urgent Care
Fast-paced billing for walk-ins, occupational health, minor procedures, X-rays, flu tests, injections, and payer-specific urgent care rules.
- Same-day charge entry
- S9083 and POS handling
- Occupational medicine and work injury claims
Nephrology
ESRD, dialysis, CKD, transplant follow-up, monthly capitation, home dialysis, and complex Medicare and Medicaid coordination.
- ESRD MCP billing
- Dialysis visit reconciliation
- Dual-eligible payer coordination
Cardiology
Echo, stress testing, EKG, cath lab, EP studies, device monitoring, RPM, and cardiovascular procedure documentation review.
- Modifier and global period checks
- Diagnostics and procedure billing
- Prior authorization follow-up
OB/GYN & Women's Health
Global maternity packages, antepartum and postpartum care, gynecology procedures, screenings, fertility, and ultrasound billing.
- Global OB package accuracy
- Split billing where required
- Preventive versus diagnostic coding
Pediatrics
Well-child visits, vaccine administration, Medicaid, CHIP, developmental screening, sick visits, and pediatric preventive care.
- EPSDT and CHIP workflows
- Immunization code pairing
- Age-specific coding checks
Behavioral Health
Psychiatry, therapy, counseling, substance use treatment, IOP, MAT, ABA, and authorization-heavy payer workflows.
- Session and time-based billing
- Auth and medical necessity tracking
- Parity-aware denial appeals
Orthopedics & Pain Management
Fracture care, injections, procedures, spine, sports medicine, DME coordination, global surgical periods, and imaging linkage.
- Procedure and modifier review
- Global package management
- Implant and DME documentation
Labs, Pathology & Diagnostics
Clinical lab, pathology, molecular diagnostics, toxicology, imaging, radiology, and payer policy-driven testing workflows.
- Medical necessity checks
- CLIA and LCD/NCD alignment
- Professional and technical components
Emergency Medicine
ED E&M, trauma, critical care, observation, facility coordination, no-fault, and complex payer dispute handling.
- ED level validation
- Critical care documentation
- No Surprises Act awareness
Surgery & ASC Billing
General surgery, ambulatory surgery centers, anesthesia, assistant surgeon billing, implants, global periods, and post-op care.
- ASC and professional claim split
- Global period monitoring
- Authorization and operative note review
Telehealth & Virtual Care
Telehealth, remote patient monitoring, chronic care management, principal care management, and virtual-first clinic billing.
- POS and modifier accuracy
- Audio-only versus video billing
- RPM and CCM recurring claims
What We Customize for Each Department
Coding Rules
Specialty-specific CPT, ICD-10, HCPCS, modifiers, bundling edits, global periods, and documentation requirements.
Payer Rules
Cigna, Aetna, UHC, BCBS, Humana, Medicare, Medicaid, and MCO rules mapped to your specialty and state.
Collection Strategy
Follow-up queues built by denial type, payer, aging bucket, authorization risk, and claim value.
Name the department, we'll find the leak
A free review of that department's claims, denials, aging and payer mix, with the collection opportunity quantified.