UR RCMCONSULTANCY
Clinical Domain Precision

Specialized Billing Protocols for Every Healthcare Discipline

Revenue cycle management is not one-size-fits-all. Payer guidelines, global surgery periods, behavioral health carve-outs, and modifier rules require domain-specific billing expertise.

Primary Care & Family Medicine

General Medicine

High-volume encounter workflows requiring efficient E/M coding, preventive wellness checks, chronic care management, and rapid claim turnaround.

Key Workflow Nuances:

Pre-scrubbing for modifier accuracy, LCD medical necessity cross-checks, and proactive prior authorizations.

UR RCM Specialty Team

Internal Medicine

General Medicine

Complex multi-condition patient encounters, prolonged care services, diagnostic testing, and coordinated care billing across specialty referrals.

Key Workflow Nuances:

Pre-scrubbing for modifier accuracy, LCD medical necessity cross-checks, and proactive prior authorizations.

UR RCM Specialty Team

Mental & Behavioral Health

Behavioral Care

Individual psychotherapy, psychiatric evaluations, telehealth sessions, group therapy, and varying payer-specific behavioral health authorizations.

Key Workflow Nuances:

Pre-scrubbing for modifier accuracy, LCD medical necessity cross-checks, and proactive prior authorizations.

UR RCM Specialty Team

Cardiology

Cardiovascular

Diagnostic echocardiography, stress testing, cardiac catheterization, telemetry monitoring, and combined professional/technical component split billing.

Key Workflow Nuances:

Pre-scrubbing for modifier accuracy, LCD medical necessity cross-checks, and proactive prior authorizations.

UR RCM Specialty Team

Orthopedics & Sports Medicine

Surgical & Musculoskeletal

Surgical global periods, fracture care, joint injections, durable medical equipment (DME), and physical therapy crossover claims.

Key Workflow Nuances:

Pre-scrubbing for modifier accuracy, LCD medical necessity cross-checks, and proactive prior authorizations.

UR RCM Specialty Team

Dermatology & Dermatopathology

Specialty Care

Biopsies, lesion removals, Mohs micrographic surgery, cosmetic vs. medical service separation, and pathology lab technical components.

Key Workflow Nuances:

Pre-scrubbing for modifier accuracy, LCD medical necessity cross-checks, and proactive prior authorizations.

UR RCM Specialty Team

Pediatrics

Specialty Care

Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services, complex state immunization registries, and commercial/Medicaid plans.

Key Workflow Nuances:

Pre-scrubbing for modifier accuracy, LCD medical necessity cross-checks, and proactive prior authorizations.

UR RCM Specialty Team

Radiology & Imaging Centers

Diagnostic Services

High-volume diagnostic imaging reads, professional component billing for independent reading groups, and technical facility claims.

Key Workflow Nuances:

Pre-scrubbing for modifier accuracy, LCD medical necessity cross-checks, and proactive prior authorizations.

UR RCM Specialty Team

Physical & Occupational Therapy

Rehabilitation

Timed 15-minute therapy units (8-minute rule), plan of care re-evaluations, therapy cap thresholds, and specialized functional limitation reporting.

Key Workflow Nuances:

Pre-scrubbing for modifier accuracy, LCD medical necessity cross-checks, and proactive prior authorizations.

UR RCM Specialty Team

Clinical Laboratories & Pathology

Diagnostic Services

Clinical CLIA lab panels, molecular diagnostics, toxicology screens, and pathology specimen interpretations with complex payer medical policies.

Key Workflow Nuances:

Pre-scrubbing for modifier accuracy, LCD medical necessity cross-checks, and proactive prior authorizations.

UR RCM Specialty Team

General & Ambulatory Surgery

Surgical & Musculoskeletal

Multiple procedure payment reductions, co-surgeon and assistant surgeon billing, operative note coding, and ASC facility fee coordination.

Key Workflow Nuances:

Pre-scrubbing for modifier accuracy, LCD medical necessity cross-checks, and proactive prior authorizations.

UR RCM Specialty Team

Multi-Specialty & Urgent Care Clinics

Specialty Care

Fast-paced, walk-in environments requiring real-time patient eligibility, point-of-service collections, and diverse multi-provider billing.

Key Workflow Nuances:

Pre-scrubbing for modifier accuracy, LCD medical necessity cross-checks, and proactive prior authorizations.

UR RCM Specialty Team

Operate a Multi-Specialty Clinic or Ambulatory Center?

We configure partitioned billing queues across providers, facilities, and unique NPI billing relationships.