Pulmonology Medical Billing Services
Pulmonary practices bill a mix of office visits, pulmonary function testing, and durable medical equipment that depends on documentation and, in many cases, prior authorization.
Reading time about 4 minutes · Reviewed by the Guardian billing team
Testing and therapy claims
Pulmonary function tests, oximetry, and sleep-related services all carry technical requirements, and some payers expect specific indications before they will pay. Oxygen and equipment claims often need documentation and recertification timing to line up.
We review those requirements per payer and track the recurring items — recertifications, equipment periods, and authorization windows — so nothing expires quietly.
- Pulmonary function testing and interpretation billing
- Oxygen documentation and recertification timing
- Sleep study and related service coordination
- Prior authorization for advanced testing
Chronic conditions, long relationships
Pulmonary patients tend to stay with a practice for years, which means a single unresolved payer rule can cost money every month.
Reporting by condition family rather than by claim helps surface those long-running issues.
Measures worth reviewing
Numbers only help if they are defined the same way each month. These are the four we would look at first for a pulmonology practice.
- Testing denial rate by payer
- Oxygen recertification timeliness
- Authorization compliance on advanced studies
- Denials by condition family
Frequently asked questions
We can support it, including the documentation, recertification, and timing requirements involved.
Build a plan for your practice
Request an introductory review to identify what information is needed, what the current workflow does well, and what may be worth investigating first.