Billing for infusion centers is not general billing with a different code set. Administration hierarchy — initial, sequential, concurrent — plus drug units by NDC, all driven by documented start and stop times.
Buy-and-bill exposure means a denial costs the acquisition price of the drug, not just the administration fee.
At a glance
What drives the coding
Administration hierarchy — initial, sequential, concurrent — plus drug units by NDC, all driven by documented start and stop times.
What drives the payer behavior
Buy-and-bill exposure means a denial costs the acquisition price of the drug, not just the administration fee.
Coding
Assigned by certified coders from your documentation.
Reporting
Denials segmented by reason, payer, and provider.
Where infusion centers claims actually fail
- Start and stop times not documented
- Administration hierarchy applied incorrectly
- Drug wastage not billed with the required modifier
How we work it
We code from what your record documents and query you when it does not support a code, which in infusion centers is where most of the avoidable exposure sits.
Denials are worked by cause rather than in queue order, so the same failure stops recurring instead of being re-worked every month.
We work the claims. You practice medicine.
Coding, claim submission, denial management, and A/R follow-up — with nothing left for your front desk to chase.
View pricingHow It Works
Review
We look at your current infusion centers denials and aging.
Scope
A written scope and price before any work starts.
Transition
Coding and submission move across without a gap.
Report
Denial causes reported monthly, segmented by payer.
Infusion Centers — Frequently Asked Questions
Do you have coders who know infusion centers?
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Yes. All coding is performed by certified coders, and specialty assignment is deliberate rather than incidental — administration hierarchy — initial, sequential, concurrent — plus drug units by NDC, all driven by documented start and stop times.
What makes infusion centers claims deny most often?
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Three causes account for most of it: start and stop times not documented; administration hierarchy applied incorrectly; drug wastage not billed with the required modifier. Each is a documentation or process failure rather than a coverage dispute, which is why we report denials grouped by cause instead of as a single rate.
How do payers behave differently for infusion centers?
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Buy-and-bill exposure means a denial costs the acquisition price of the drug, not just the administration fee. That shapes which denials are worth appealing and where the front-end effort should sit, so it drives how we staff the work rather than being background color.
Do you guarantee higher collections for a infusion centers practice?
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No. Payment is decided by the payer, and any firm promising a collection rate is describing something it does not control. We commit to the process and to six reported numbers you can check against your own system.
Who is responsible if a infusion centers code is wrong?
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Codes are assigned from the documentation the practice provides, and where the record does not support a code we raise a query rather than infer intent. The clinical record and the certification of medical necessity remain the practice's, and claims go out under the provider's own National Provider Identifier.
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