Rheumatology medical billing and coding services
Infusion billing, buy-and-bill drugs and J-code accuracy. Medxcode codes, bills and appeals rheumatology claims with specialty-trained staff — 99% first-pass acceptance and an average of 42 days in A/R.
-41%
Drug claim denials
99%
First-pass acceptance
50
States covered
Where rheumatology revenue actually leaks
Rheumatology claims fail for reasons that have nothing to do with clinical quality. The denials cluster around a handful of documentation, coding and authorization patterns — and once you know which ones, they stop being inevitable. These are the three we correct first in almost every rheumatology engagement.
- 01
Infusion time units and hydration sequencing
- 02
J-code units and NDC reporting for biologics
- 03
Prior authorization for high-cost therapies
Codes our rheumatology coders live in
Your account is staffed by coders who work rheumatology every day, not generalists rotating through specialties. That means the code families below are familiar territory, along with the payer-specific edits that surround them.
96365–96375, J1745, J3262, 20610
How we run a rheumatology account
Packages
Rheumatology billing packages
Same packages, staffed with rheumatology coders. Managed service fees start at 3.99% of monthly collections, month-to-month with no setup fee.
Starter
3.99%
of monthly collections
Solo providers under 500 claims per month
- Eligibility verification and charge entry
- Claim scrubbing and electronic submission
- Payment posting and patient statements
- Rejection correction and refiling
- Monthly performance report
- Month-to-month. No setup fee. No long-term lock-in.
Growth
3.99%
of monthly collections
Practices billing 500–2,000 claims per month
- Everything in Starter
- Dedicated billing team and named lead
- Full denial management and appeals
- Aged A/R recovery included
- Coding review by certified coders
- Weekly KPI dashboard and monthly review call
Enterprise
Custom scope
proposal based on volume and scope
Multi-site groups above 2,000 claims per month
- Everything in Growth
- Multi-location and multi-TIN billing
- Credentialing and compliance audits bundled
- EHR / clearinghouse integration support
- Custom analytics and payer scorecards
- Quarterly executive business review
Calculator
Estimate recoverable rheumatology revenue
Medical billing revenue calculator
Estimate the collections you would recover by moving to a 99% first-pass, 24-hour submission billing workflow.
Total claims submitted each month across all providers.
Average allowed amount per claim.
Share of claims denied or rejected on first submission.
Projected additional annual collections
$182,892
Estimated annual revenue recovered by moving to a 99% clean-claim workflow
- Monthly billed charges
- $432,000
- Revenue lost to denials today
- $21,168 / month
- Projected monthly recovery
- $15,241
Estimates use benchmark recovery rates from comparable US practices. Your written analysis replaces these estimates with numbers from your own payer mix.
Services
Specialties