Billing companies that work ENT claims every day. Describe your practice once and compare their proposals.
A few questions about the practice, then billing companies that fit send proposals. You are not committing to anything.
Hand off all of it or just the parts that are breaking. Say which in the form so the proposals match.
Charges entered, claims checked against payer edits, and sent daily so clean claims go out the first time.
Every denial worked, appealed, or corrected, with the root cause tracked so the same denial stops repeating.
Old balances called on and worked by payer and by age until they are paid, adjusted, or written off on purpose.
Certified coders assign CPT, ICD-10, and modifiers from your notes, or audit the codes your providers pick.
New providers enrolled with payers, CAQH kept current, and revalidations handled before they lapse.
Statements, online payment, payment plans, and the phone calls that come with them, handled in your name.
Eligibility checks, prior authorizations, and old AR cleanup go through the same request. If you only need one piece, say so.
There is no right answer for every practice. The usual tradeoffs:
An ENT visit rarely stays one line on the claim. A patient comes in with a stuffy nose, the physician does a nasal endoscopy, the audiologist runs a tympanogram down the hall, and someone removes wax from the other ear. That is an evaluation, a scope, a hearing test and a cerumen code on one date, and the payer's edit logic wants a reason for each. Modifier 25 on the visit and the right linkage on the procedure decide whether you are paid for the conversation or the work. Get it wrong and the visit gets bundled into the scope.
Then there are the global periods. Office procedures usually carry a short global window and surgeries a much longer one, and the post-op checks inside them are not billable unless something unrelated comes up. Medical necessity is where the real fights happen. Septoplasty and turbinate reduction get read as cosmetic until the chart shows obstruction, failed medical therapy and exam findings. Write those down every time. Balloon sinus procedures, tonsillectomy in adults, tubes, and hypoglossal nerve stimulators for sleep apnea each have their own prior authorization checklist, and the checklist changes by plan. Bilateral work takes modifier 50 for some payers and RT and LT for others, and nobody agrees on which. Audiology often sits under a different benefit than the physician, and hearing aids are frequently excluded outright.
In-house staff usually miss the quiet money. Allergy testing and immunotherapy vial prep have their own codes and unit rules, in-office CT is billed with a separate technical component, and ambulatory surgery center cases need a clean split between facility and professional claims. A good ENT biller reads the operative note before coding it, tracks every denial by payer and procedure, and calls on aged balances rather than waiting for a letter. Outsourcing makes the most sense when your only coder is also the front desk, or when a surgeon has joined and the surgical volume has outrun the person doing prior auths. In the quote form, put your payer mix, if you own a CT or an audiology booth, and how many cases you do in a surgery center.
Three steps. Most practices hear from the first billing company within a business day.
Specialty, providers, claim volume, your software, and what you want handled.
Your request goes to billing companies that work your specialty and take on practices your size.
Compare fees, scope, reporting, and contract terms side by side. Pick one, or none.
What practice managers usually ask before they fill out the form.
Describe the practice once and compare proposals from billing companies that fit. No obligation.
Request proposals