Claim review for specialty practices
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Medical Billing Specialties

A cardiology claim, a timed therapy unit, and an ambulance trip do not fail for the same reason. Vector Medical Billing, in Jamaica, New York, assigns the coder to the specialty and runs the claim cycle inside the EHR you already use.

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Specialty coding review at Vector Medical Billing

Why specialty-matched billing matters

Generic queues miss specialty edits. The denial lands after the claim left, not before.

Chiropractic lives on 98940–98943 with the AT modifier Medicare requires. Mental health lives on timed psychotherapy codes and payer-specific prior auth. Cardiology fails on bundling and global periods. One generalist desk cannot hold all of those edits at once.

Vector Medical Billing assigns the coder to the specialty on the account. The monthly percentage of net collections covers the claim cycle. Credentialing, a coding audit, MIPS, and out-of-network disputes stay separate engagements.

What the free audit shows

  • Which specialty denials are already in the open A/R
  • Whether the written rate fits office, complex, or facility work
  • What stays on the monthly fee versus a separate quote

One process. Built around the specialty.

Same revenue cycle steps. Different edits, code sets, and payer rules per specialty.

1
Specialty assignment

The account lands with a coder who already bills that specialty’s CPT, HCPCS, or CDT set.

2
Claim scrub

Modifiers, bundling, time units, and global periods checked before clearinghouse submission.

3
Denial and A/R

Denials and A/R stay on specialty reason codes.

4
Monthly report

RCM reporting shows days in A/R, first-pass, denials, and net collections.

Office specialties

These claims start as an office visit, then add the test, the drug, or the procedure the note supports.

Office

Family Medicine

Office E/M, preventive visits, and a problem visit on the same day when the note supports both. Family medicine.

Read family medicine billing
Office

Internal Medicine

Chronic-care visits and the diagnosis list that supports the level billed. Internal medicine.

Read internal medicine billing
Office

Primary Care

A problem visit and an annual wellness visit are different claims. They are not billed as one code. Primary care.

Read primary care billing
Office

Pediatrics

Well-child visits, vaccine administration, and a sick visit when both are documented. Pediatrics.

Read pediatrics billing
Office

Geriatrics

Chronic care management and the annual wellness visit, kept apart from a problem-oriented visit when the rules allow it. Geriatrics.

Read geriatrics billing
Office

Cardiology

Diagnostic tests, device checks, and interventional claims. Cardiology is in the.

Read cardiology billing
Office

Dermatology

Biopsies, destructions, and the pathology charge for the specimen, not only the office visit. Dermatology.

Read dermatology billing
Office

Endocrinology

The visit plus the labs ordered under the treating provider. Endocrinology.

Read endocrinology billing
Office

Gastroenterology

The office visit is separate from the endoscopy professional claim. Gastroenterology.

Read gastroenterology billing
Office

Nephrology

Dialysis-related claims and monthly capitation codes are not an office visit. Nephrology.

Read nephrology billing
Office

Neurology

EMG and EEG, and the visit the test does not replace. Neurology.

Read neurology billing
Office

Pulmonology

Pulmonary function tests and the interpretation, plus sleep studies when the practice performs them. Pulmonology.

Read pulmonology billing
Office

Rheumatology

Infusion administration and the drug, coded apart from the visit. Rheumatology.

Read rheumatology billing
Office

Allergy and Immunology

Testing panels, the extract, and the injection administration. Allergy.

Read allergy billing
Office

Infectious Disease

Consult visits, including inpatient consults when the physician is not the admitting doctor. Infectious disease.

Read infectious disease billing
Office

Hematology

Infusion and drug lines alongside the visit. Hematology.

Read hematology billing
Office

Hepatology

The visit and a procedure or infusion stay on separate lines when both happen. Hepatology.

Read hepatology billing
Office

Urology

Office procedures and the surgical claim when the case leaves the office. Urology.

Read urology billing
Office

Podiatry

Routine foot care is often not a covered medical service. Lesion and nail codes need the qualifying diagnosis. Podiatry.

Read podiatry billing
Office

Ophthalmology

The eye exam and the surgical claim do not share one code. Ophthalmology.

Read ophthalmology billing
Office

Optometry

A routine vision benefit and a medical eye exam are different payers and different claims. Optometry.

Read optometry billing
Office

Otolaryngology (ENT)

Office endoscopy versus an operating-room claim, plus audiology when the practice owns it. ENT.

Read ENT billing
Office

Pain Management

Injections, fluoroscopy, and the drug, after the authorization the plan requires. Pain.

Read pain billing
Office

Sleep Medicine

The sleep study, the professional interpretation, and the later visit for the result. Sleep.

Read sleep billing
Office

Sports Medicine

The visit, the injection, and the imaging read as separate lines. Sports medicine.

Read sports billing
Office

Wound Care

Debridement by depth and the product used, not a generic office visit. Wound care.

Read wound billing

Surgery

A surgical claim follows the global package. Visits inside that package are not extra evaluation and management.

Surgery

General Surgery

Pre-op and post-op visits inside the global period are part of the surgical package. General surgery is in the.

Read surgery billing
Surgery

Orthopedics

Fracture care versus a splint, matched to the operative note. Orthopedics is in the.

Read orthopedic billing
Surgery

Neurosurgery

The surgical claim, implants, and an assistant when the operative report supports that role. Neurosurgery is in the.

Read neurosurgery billing
Surgery

Plastic Surgery

A reconstructive diagnosis is what the plan pays. A cosmetic request is a different claim. Plastic surgery is in the.

Read plastic surgery billing
Surgery

OB/GYN

Global maternity versus a delivery-only claim, and a surgical package for gynecologic cases. OB/GYN is in the.

Read OB/GYN billing

Hospital and facility specialties

These are not clinic superbills. The claim follows the site of service and the physician’s role.

Facility

Emergency Medicine

The emergency-department professional claim, critical care time when it is documented, and procedures done in the department. Emergency medicine is in the.

Read emergency medicine billing
Facility

Anesthesiology

Base units plus time, and the modifier for the anesthesia role. Anesthesiology is in the.

Read anesthesiology billing
Facility

Radiology

A professional read is not the facility’s technical charge. The two components are billed apart. Radiology is in the.

Read radiology billing
Facility

Teleradiology

The same professional interpretation, billed by the physician who read the study. Teleradiology is in the.

Read teleradiology billing
Facility

Pathology

The specimen and the professional interpretation. A panel is not an office visit. Pathology is in the.

Read pathology billing
Facility

Oncology

The drug, the administration, and the visit. Each line has its own units. Oncology is in the.

Read oncology billing
Facility

Radiation Oncology

Planning, treatment delivery, and weekly management are separate from a clinic visit. Radiation oncology is in the.

Read radiation oncology billing
Facility

Hospitalist

Inpatient visits by day, the admission, and the discharge. Not a clinic superbill. Hospitalist billing is in the.

Read hospitalist billing

Behavioral health

These claims are timed or program-based. A standard office visit code usually does not fit.

Behavioral health

Mental Health

Timed psychotherapy and the psychiatric evaluation. Behavioral health is in the.

Read mental health billing
Behavioral health

Psychiatry

An evaluation and management visit with a psychotherapy add-on when both are documented, plus medication management. Psychiatry is in the.

Read psychiatry billing
Behavioral health

Behavioral Health

Timed services, often paid under a program benefit rather than a medical-visit benefit. Behavioral health is in the.

Read behavioral health billing
Behavioral health

Substance Use Disorder

Intake, group, and individual codes for the program the payer enrolled. Substance use disorder is in the.

Read substance use disorder billing
Behavioral health

ABA Therapy

Timed behavior-analysis codes and the supervising analyst. Units are time, not a visit level. ABA therapy is in the.

Read ABA therapy billing
Behavioral health

Peer Support

The peer service the state plan covers, billed under that program, not as psychotherapy. Peer support is in the.

Read peer support billing

Rehab, dental, and supplies

The code set changes here. Therapy uses timed units. Dental uses CDT. Supplies and transport are not visits.

Rehab and supplies

Physical Therapy

Timed units under the 8-minute rule. Untimed codes are not stacked the same way. Physical therapy is in the.

Read physical therapy billing
Rehab and supplies

Occupational Therapy

The same timed-unit rules, with the plan of care the payer asks for. Occupational therapy is in the.

Read occupational therapy billing
Rehab and supplies

Chiropractic

Spinal manipulation codes, including the Medicare limit, and an exam that is outside that cap. Chiropractic is in the.

Read chiropractic billing
Rehab and supplies

Dental

CDT codes, not CPT. A medical plan pays only when the service meets a medical benefit. Dental is in the.

Read dental billing
Rehab and supplies

Orthodontics

Banding and the periodic orthodontic visit on the dental benefit, not a medical claim. Orthodontics is in the.

Read orthodontic billing
Rehab and supplies

Medical Nutrition Therapy

Medical nutrition therapy codes and the hours the diagnosis allows. Medical nutrition therapy is in the.

Read medical nutrition therapy billing
Rehab and supplies

Diagnostic Labs

The ordering provider, the panel, and the lab’s CLIA claim. Diagnostic labs are in the.

Read diagnostic lab billing
Rehab and supplies

Pharmacy

Dispensing on the pharmacy benefit, separate from the medical claim. Pharmacy is in the.

Read pharmacy billing
Rehab and supplies

DME

A purchase or capped rental, the modifier, and the order that replaced the certificate of medical necessity. DME is in the.

Read DME billing
Rehab and supplies

Ambulance

Loaded mileage, origin, and destination. Not an office-visit claim. Ambulance is in the.

Read ambulance billing

Tell us the specialty and the EHR

The free audit starts with specialty, claim volume, payer mix, and the system you already use. You get a written rate before anything moves.

Request a specialty billing audit from Vector Medical Billing
55
Specialties Listed
50
US States
Written
Monthly rate
98%
Net Collection Rate

Specialty billing questions

Straight answers tied to the groups above.

Do you bill every specialty the same way?

No. Coders and billers are assigned by specialty. A cardiology claim, a timed therapy unit, and an ambulance trip use different code sets, payer edits, and denial patterns.

What specialties does Vector Medical Billing cover?

Office specialties, surgery, hospital and facility roles, behavioral health, rehab and therapy, dental and orthodontics, diagnostic labs, pharmacy, DME, and ambulance — all listed on this page for practices in all 50 states. If yours is missing, send it on the free audit form.

Is specialty billing included in the monthly fee?

The monthly percentage of net collections covers the claim cycle for the specialty on the account. Credentialing, coding audits, MIPS, HIPAA security risk analysis, transcription, underpayment recovery, and out-of-network disputes are separate engagements.

Do we have to change our EHR?

No. Billers log into the practice management system you already use — see EHR integration. Compatibility is confirmed before you commit.

Why do some specialties take more scrub time?

Cardiology, surgery, OB/GYN, behavioral health, rehab, dental, labs, pharmacy, DME, ambulance, and facility work take longer because of bundling, global periods, and timed or program codes. The written rate still follows volume and payer mix.

Where is Vector Medical Billing located?

15717 85th St, Jamaica, NY 11414-2620. Billing work is remote for practices in all 50 states.