General FAQs
A specialty billing company manages your entire revenue cycle—from coding and charge entry to AR follow-up, denials, and reporting.
PulmoCare RCM specifically focuses on:
- Pulmonary hospital rounds
- ICU and Critical Care billing
- Rehab facility visits
- Ventilator management
- Inpatient E/M services
- Split/shared billing
- High-acuity documentation review
We ensure every service is captured, coded correctly, and reimbursed fully.
These specialties involve:
- Time-based critical care codes (99291 / 99292)
- Frequent hospital and ICU encounters
- Procedures bundled with E/M
- Strict documentation requirements
- Multiple places of service
- High denial risk
Pulmonary, ICU, and hospitalist providers face heavy payer scrutiny, making expert billing essential.
Yes. We support Pulmonary and Critical Care providers in all 50 states and integrate
seamlessly with major EHRs, PM systems, and hospital networks.
Critical Care Billing FAQs
Critical care billing must meet CMS requirements:
- Direct patient care for organ failure / life-threatening conditions
- Total time documented
- Exclusions for separately billable procedures
- No overlapping time between providers
- Medical necessity documented clearly
We review physician notes and time statements before submission to ensure
compliance.
Essentials include:
- Total minutes spent
- Description of organ system failure
- Interventions performed
- Provider’s active involvement
- Decision-making complexity
- Exclusion of procedure time
- Patient risk level
We also help providers improve documentation to avoid denials.
Top causes:
- Missing time statements
- Incorrect bundled service billing
- Lack of medical necessity
- Overlapping time between clinicians
- Inadequate documentation
PulmoCare RCM uses a multi-level audit to eliminate these issues before
claims are submitted.
Pulmonary Billing FAQs
We handle billing for:
- Hospital visits
- Outpatient & inpatient consults
- PFT (Pulmonary Function Testing)
- Ventilator management
- Bronchoscopy
- Rehab visits
- Chronic care management
- Sleep study-related services
- Respiratory failure management
Our coders are trained specifically in pulmonary coding guidelines.
Yes. We ensure correct coding for:
- Daily ventilator management
- Weaning
- Non-invasive ventilation
- Respiratory support documentation
This avoids common undervaluation and bundling errors.
Absolutely. Pulmonary physicians frequently treat patients in:
- Rehab centers
- LTACs
- SNFs
- Transitional care units
We apply correct POS codes and facility-specific billing rules.
Hospitalist Billing FAQs
Yes. We manage:
- Admissions
- Daily rounding
- Discharge services
- Prolonged care
- Consultations
- Critical care when applicable
- Split/shared inpatient E/M services
We ensure accurate E/M level selection, preventing downcoding and revenue loss.
We follow CMS guidelines ensuring:
- Proper attribution to NPs / PAs or physicians
- Accurate documentation
- Compliance with split/shared rules
- Proper modifier usage
This ensures compliance and maximizes reimbursement.
Top causes:
- Missing time statements
- Incorrect bundled service billing
- Lack of medical necessity
- Overlapping time between clinicians
- Inadequate documentation
PulmoCare RCM uses a multi-level audit to eliminate these issues before
claims are submitted.
Billing Process FAQs
Our full-service RCM includes:
- Eligibility checks
- Charge entry
- Coding & audits
- Claim submission
- AR follow-up
- Denial management
- Appeals & corrections
- Payment posting
- Reporting & analytics
- Compliance and HIPAA safeguards
We manage the entire revenue cycle for consistent cash flow.
Yes. We offer flexible partial outsourcing options such as:
- Charge entry only
- Payment posting only
- Coding audit only
Perfect for practices with partial in-house billing teams.
We use:
- Daily follow-ups
- Root cause analysis
- Coder review of denied claims
- Strong appeals
- Analytics to prevent future denials
Our process reduces denials by 40–60% in most practices.
Technology & Integration FAQs
Yes. We offer AI-enabled tools such as:
- Claim error prediction
- Real-time eligibility
- Automated claim status tracking
- Coding assistance
- Denial forecasting
- AI-powered documentation checks
These tools reduce manual effort and prevent claim rejections.
Credentialing FAQs
Yes. We manage:
- Payer enrollment
- CAQH profile setup
- Medicare / Medicaid enrollment
- Commercial contracting
- Revalidation monitoring
Credentialing delays are one of the biggest revenue bottlenecks—our service prevents that.
Typically:
- Commercial insurance: 45–90 days
- Medicare: 30–60 days
- Medicaid: 60–120 days
Timelines vary by payer and state.
Financial & Revenue FAQs
Yes—most practices see 20–40% revenue growth within months due to:
- Accurate coding
- Reduced denials
- Complete charge capture
- Faster reimbursements
- Fewer underpayments
- Compliance-driven billing
Our specialty expertise directly boosts cash flow.
We reduce denials through:
- Pre-claim audits
- Correct coding
- Thorough documentation checks
- Automated eligibility verification
- Root cause analysis
- Strong appeals
Our clean claim rate often exceeds 95%.
Yes, including:
- Monthly performance reports
- Reimbursement trends
- AR aging analysis
- Denial analytics
- Coding accuracy reports
- Custom dashboards
You always know the financial health of your practice.
Compliance FAQs
Yes. We maintain:
- Encrypted data transfer
- Secure servers
- Role-based access
- PHI protection policies
- HIPAA-certified staff
- Regular security audits
Your data is safe at every step.
Absolutely. We stay updated with:
- CMS regulations
- CPT & ICD-10 changes
- Payer policies
- Medicaid / major commercial rules
- Critical care documentation standards
Compliance is built into our billing workflow.
Partnership FAQs
Onboarding timeline:
- Small practice: 7–10 days
- Medium practice: 2–3 weeks
- Large groups or hospitals: 3–6 weeks
We handle everything from integrations to workflow setup.
Yes. Each client receives:
- Dedicated billing manager
- Dedicated AR team
- Specialty-trained coders
- Support specialists
This ensures consistent quality and communication.
Via:
- EHR integration
- Secure portal access
- Encrypted data transfers
All methods are HIPAA compliant.
Yes. We can perform a no-cost audit to identify:
- Coding opportunities
- Underpayments
- Denial patterns
- Missing charges
- Revenue leaks
This helps practices understand potential improvements.
Schedule a Demo / Contact Us
Let us show you how our Pulmonary & Critical Care Billing expertise can transform your revenue performance.
Pulmocare RCM is a specialty-focused Pulmonary & Critical Care Revenue Cycle Management company serving healthcare providers across the United States. With 27 years of experience, we help hospital-based physicians, ICU teams, and rehabilitation providers reduce denials, ensure compliance, and maximize reimbursement.
