Biologics and infusion claims
Biologic therapies require authorization, often with step-therapy documentation showing what was tried first. Infusion administration adds coding and monitoring requirements.
We track authorization status, step-therapy requirements, and administration codes together, so the drug and the service are billed consistently.
- Biologic prior authorization and step-therapy documentation
- Infusion administration and monitoring codes
- Buy-and-bill versus specialty pharmacy workflows
- Osteoporosis testing and treatment billing
Visits that are longer than they look
Rheumatology visits involve extensive history, joint examination, and medication review. When time and complexity are not documented, the visit is under-billed.
We review visit levels against notes and report the gap, so documentation improves rather than the coding being inflated.