This is not a service line we added. It is what the firm was built around, and it is most of what we do all day. Here is exactly how we work it (so you can judge us on method, not adjectives).
IONM is billed as a base study plus a monitoring code, and the monitoring code depends on where the professional was and how many rooms they covered. Those distinctions are where most of the lost revenue in this specialty lives.
Code descriptions are summarized in plain language for orientation and are not a substitute for the current CPT and HCPCS code sets or your payers' policies. Definitions and payment rules change annually.
Six documents have to agree with each other before anything is transmitted. When they don't, we go get the missing piece; we don't send it and hope. It is slower on day one and dramatically faster to payment.
Under the No Surprises Act, out-of-network monitoring at an in-network facility can no longer be balance billed. What replaced it is a structured federal process with real deadlines. It takes staff time and discipline, which is precisely why so much of it goes unworked, and why it is still worth money to the practices that do work it.
Timeframes and eligibility under the federal dispute process are set by regulation and have been subject to ongoing rulemaking and litigation. We track current requirements per claim and per plan; nothing on this page should be relied on as legal advice.
Ambulatory EEG is billed on a different logic from IONM: recording duration, whether the study was video, and whether it was reviewed intermittently or continuously all change the code. The technical and professional components are frequently performed by different entities, which means two claims that have to reconcile with each other.
Duration tiers billed correctly. Recording time drives the code. Rounding it the wrong way is either lost revenue or a refund request.
Technical and professional split reconciled. Both halves tracked together so one doesn't sit unpaid behind the other.
Prior authorization handled up front. Many plans require it for extended studies. We confirm before the electrodes go on.
Medical necessity documented to plan policy. Seizure history, prior workup, and the clinical question the study answers.
If your service line isn't listed, ask. The honest answer is sometimes no. And we'd rather tell you that than learn on your revenue.
You send us a sample of denials and aged claims. We come back with what went wrong, what's recoverable, and what isn't.
A clear scope, a clear rate, and a business associate agreement. No long lock-ins, no surprise line items.
System access, clearinghouse setup, credentialing check, and a walkthrough of how your documentation reaches us.
New claims go out clean while we work the backlog in parallel. First full report at the end of month one.
No cost and no commitment. If your current biller is doing fine, we'll say so.
Specialist revenue cycle management for intraoperative neuromonitoring, ambulatory EEG, and out-of-network surgical claims.