Pulmonology Medical Billing That Captures Every Test You Perform
ClainetRCM delivers end-to-end revenue cycle management built for pulmonologists, respiratory clinics, and pulmonary function laboratories. Stop losing revenue to bundled testing and oxygen documentation gaps.
Certified coders check pulmonary function test components against bundling edits and confirm oxygen qualification is documented before the claim is submitted
Why Pulmonology Billing Demands a Specialist
Pulmonology combines high-volume office testing with procedural and critical care work. Pulmonary function components bundle in ways generic billers miss, and oxygen and equipment claims fail without precise qualifying documentation.
Pulmonary Function Test Bundling
Spirometry, diffusion capacity, and lung volume components have specific bundling relationships. Billing them separately when they are included triggers edits and refund demands.
Oxygen and Equipment Qualification
Home oxygen requires documented saturation values obtained under defined conditions. Without the qualifying test on file the entire equipment claim fails.
Bronchoscopy and Procedural Coding
Diagnostic bronchoscopy with biopsy, lavage, and navigation each carry distinct codes and bundling rules that decide whether the full procedure is paid.
Critical Care Time Documentation
Pulmonologists provide substantial critical care. Time-based codes are denied without a clear statement of total time and the conditions that justify it.
Complete Pulmonology RCM Solutions
From charge capture to final payment posting, ClainetRCM manages every step of your pulmonology revenue cycle so you can focus on patient outcomes.
Pulmonology Medical Billing
Complete billing management built specifically for pulmonologists, respiratory clinics, and pulmonary function labs.
- Charge entry and claim scrubbing
- Electronic and paper claim submission
- ERA/EOB posting and reconciliation
- Denial management and appeals
- Patient statement and balance collections
Pulmonology Medical Coding
Certified coders with deep pulmonology coding expertise capture every procedure at the correct, compliant level.
- Pulmonary function test and component coding
- Bronchoscopy and image-guided procedure coding
- Home oxygen and respiratory equipment documentation
- Critical care and prolonged service time coding
- Modifier 26 and TC splits with compliance audits
Healthcare Credentialing
Fast payer enrollment and re-credentialing so you never miss a payment because of a lapsed credential.
- Insurance enrollment and re-credentialing
- CAQH profile management
- Medicare and Medicaid enrollment
- Payer contracting and fee schedule review
- Ongoing status tracking and follow-up
Virtual Medical Assistant
Dedicated remote assistants to absorb your front-desk workload so your staff stays focused on patients.
- Prior authorizations and referrals
- Appointment scheduling and reminders
- Insurance eligibility verification
- Patient follow-up calls
- EHR data entry and documentation support
Accounts Receivable Management
Dedicated AR follow-up to recover outstanding claims and pull down aging balances across every payer.
- Aging AR review and prioritization
- Payer follow-up and escalation
- Patient balance collections
- Write-off and adjustment analysis
- Monthly AR performance reporting
Revenue Cycle Audit
A thorough audit of your pulmonology billing to surface revenue leakage and compliance risk before it escalates.
- Billing workflow assessment
- Coding accuracy and payer policy audit
- Denial pattern analysis
- Payer contract review
- Custom revenue improvement roadmap
Pulmonology Billing Challenges We Solve Every Day
Pulmonology practices face billing obstacles that generic billing companies consistently get wrong. We know them all, and we fix them.
Pulmonary Function Bundling Edits
Components billed separately that should roll into a comprehensive study are denied. We apply the correct bundling logic on every test.
Oxygen Claims Denied
Home oxygen denied because the qualifying saturation test was missing or obtained under the wrong conditions. We verify qualification before billing.
Medical Necessity Denials
Testing denied because the diagnosis does not support it under payer policy. We screen the indication before the claim is released.
Critical Care Time Gaps
Critical care denied because total time was never documented. We flag notes missing the time statement before they are billed.
Component Split Errors
Tests performed in a hospital and interpreted by the physician require correct component splitting. We map it to each site of service.
Prior Authorization Gaps
Advanced imaging, sleep testing, and biologics require authorization. Our team obtains and tracks approvals before services are delivered.
Slow Reimbursements
Long AR days on testing-heavy claims strangle cash flow. We submit within 48 hours and escalate with payers until paid.
Undercoded Office Visits
Complex pulmonary patients support higher visit levels than are typically billed. Our audits recover that value compliantly.
Get Started in 5 Simple Steps
Onboarding with ClainetRCM is fast and seamless. Most pulmonology practices go live within one week with no disruption to daily operations.
Free Consultation
We analyze your current billing setup and identify pulmonology revenue gaps at zero cost.
Custom Onboarding
We integrate with your EHR and PM system and configure pulmonology billing workflows.
Team Assignment
A dedicated billing team with real pulmonology experience is assigned immediately.
Claims Submission
Clean, policy-compliant claims submitted within 48 hours with real-time tracking.
Revenue Growth
Watch collections climb with transparent monthly performance reporting.
What We Commit To on Every Pulmonology Claim
These are the standards we control and hold ourselves to, written into every engagement.
From charge capture to claim submission, on every working day
Business days to onboard your pulmonology practice end to end
Between full accounts receivable reviews, every single cycle
Starting rate on monthly collections. No setup fee, no contract
Pulmonology Billing for Every Practice Size
Whether you are a solo pulmonologist or a multi-site respiratory group, ClainetRCM delivers billing that scales with your practice.
Solo Pulmonologists
Independent pulmonary physicians who need accurate testing and procedural coding without in-house billing staff.
Pulmonary Clinics and Groups
Multi-provider respiratory practices and pulmonary function laboratories working to cut denial rates across all providers.
Hospitals and Health Systems
Hospital pulmonary and critical care departments requiring enterprise reporting and compliance oversight.
Frequently Asked Questions
We apply the bundling relationships between spirometry, diffusion capacity, and lung volume studies before the claim is created. Billing components separately when they are included in a comprehensive study produces both denials and refund demands, so we code from what was actually performed and let the bundling logic decide how it is reported.
Yes. Home oxygen depends on a qualifying saturation value obtained under specific conditions and documented in the chart. We verify that the qualifying test exists and meets the payer requirement before billing the equipment, because without it the entire claim and the recurring rental fail.
Yes. Critical care is time-based, so we confirm the note contains a clear statement of total critical care time and the conditions justifying it. We also check that bundled procedures are not billed separately. Missing time documentation is the leading reason these high-value claims are denied.
Our virtual assistants obtain and track authorizations for advanced imaging, sleep testing, and biologic therapies, including peer-to-peer review when a request is declined. We confirm approval is on file before the service is delivered rather than discovering the gap when the claim is denied.
ClainetRCM integrates with the platforms pulmonology practices already use, including Epic, Athenahealth, eClinicalWorks, NextGen, AdvancedMD, and Kareo. We adapt to your existing technology rather than forcing a migration, so onboarding does not disrupt your clinical workflow.
Pricing starts at 2.29% of monthly collections, so we are only paid when your practice is paid. There are no setup fees, no long-term contracts, and no hidden charges. Book a free consultation for a quote based on your volume and payer mix.
Ready to Grow Your Pulmonology Revenue?
Talk to a pulmonology billing specialist about your testing denials, your oxygen documentation, and your AR aging.
Request Your Free Audit TodayLet's Grow Your Pulmonology Practice
No obligation. Our pulmonology billing specialists will review your current setup and identify exactly where you are losing revenue.
Why Consult With ClainetRCM?
In a single free session, our pulmonology RCM experts will uncover hidden billing gaps and give you a clear roadmap to increase collections starting immediately.
Free Revenue Audit
We review your billing performance and identify gaps at zero cost to you.
Dedicated Pulmonology Billing Expert
You will speak directly with a specialist who understands pulmonology billing deeply.
100% Confidential
All information shared is protected by HIPAA and never shared with third parties.
Fast Onboarding
Practices go live within 7 to 14 business days of signing on.
No Long-Term Contracts
Pricing starts at 2.29% of collections. No setup fee, no lock-in.