Endocrinology Billing Services Designed for Endocrinology, Thyroid and Hormone Practices
Endocrine patients come back monthly and each time there is a claim to be entered just right. Solution360 provides endocrinology billing services for practices all over the US, whether you need to submit a thyroid lab or a blood glucose monitor claim. We submit insurance forms so your team doesn't have to.
Why Endocrinology Billing Requires Specialized Expertise?
By design, endocrinology is a primary care specialty, with many claims coming in every few weeks for years from a single patient. A patient’s visit might be a blood draw, a download from a device and a check-in on their care plan and each aspect comes with its own code. A lot of pumps, sensors and medications require prior authorization from the insurer and without that knowledge, a wrong click spams a thousand wrong clicks.
- Multiple Claims Per Patient: Follow-up care can result in repeated mistakes on a monthly basis.
- Mixed Services in One Visit: Labs, device reviews and office time must be coded simultaneously.
- Authorization prior to treatment Pumps, sensors and hormone drugs typically require payer approval before use.
Services We Handle
- Verifying your insurance coverage and benefits.
- Getting approvals for devices and medicines.
- Fixing denied claims and filing appeals.
- Coding of visits and tests CPT, ICD-10 and HCPCS.
- Entering charges and reviewing superbills.
- Filing and submitting claims online.
- Posting payments and matching remittances.l
- Getting approvals for devices and medicines.
- Collection of aging insurance receivables (A/R).
- Billing for chronic care and remote monitoring programs.
- Sending patient statements and answering billing questions.
- Provider credentialing and payer enrollment.
- Billing audits & compliance reviews.
- Monthly reports and payer mix reviews.
Why Clinics Trust Us
Specialized Endocrinology Billing
Prior Authorization Management
Accurate Laboratory Billing
Claim Scrubbing & Error Prevention
Faster Claims & Improved Cash Flow
Seamless EHR Integration
Transparent Monthly Reporting
Patient Data Privacy & Security
A/R Recovery & Payment Audits
Our Performance Metrics
Providers
Procedures We Support
From routine office visits to lab work, to our maintenance care programs. For each one, we take the code that matches and find it in the payer rules. We also include children’s endocrinology and video visits.
- New and Returning Patient Office Visits Thyroid Function Testing, Such as TSH (84443)
- Testing Hormone Levels
- Continuous Glucose Monitor Setup (95250) Data Review (95251)
- Insulin Pump Training and Care
- Chronic Care Management (CCM)
- Remote Patient Monitoring (RPM)
- Diabetes Self-Management Training (DSMT)
- Medical Nutrition Therapy (MNT)
- Thyroid Ultrasound and Fine Needle Aspiration
- Bone Density (DEXA) Scans
- Visits for Hormone Therapy
- Pediatric Endocrinology Appointments
- Telehealth Endocrinology Visits
Common Occupational Therapy Billing Challenges
- The billed E&M level doesn't agree with the information in the documentation.
- The code isn't the one that needs to be delivered for the test being carried out.
- Sensor billing mix-up: Confusion when it comes to installation and reviewing the data from glucose monitors.
- Chronic care program documentation deficiencies: Chronic care program patient consent and time logs.
- Coverage decisions: Tells the patient which insurance policies will pay for the new treatment.
- Medical necessity denial: Diagnosis on claim doesn't support service.
- Bundled code conflicts Two codes are billed that the payer expects to be one.
- If claims get rejected, you don't appeal because the office just can't keep up.
Our Billing Process
Step 1
Practice Assessment
We review your billing workflow to identify inefficiencies, errors, and revenue gaps.
Step 2
System Integration
We connect with your EHR and practice management systems for seamless data exchange.
Step 3
Coding & Claim Management
We ensure accurate coding, clean claim submission, and timely claim follow-up.
Step 4
Payment Tracking
We track every claim through payment, resolution, or necessary follow-up.
Step 5
Issue Resolution
We quickly address denials, payer issues, and outstanding balances.
Step 6
Optimization & Reporting
We monitor performance and provide clear reports to continuously improve your revenue cycle.
Frequently Asked Questions
Why do weight-loss and GLP-1 drug claims get denied so often?
Some plans won't cover weight loss use or will require you to be diagnosed with diabetes first. Coverage varies by plan.
Who bills for tests sent to an outside lab?
Those tests are paid for by the outside lab. Your practice charges for the tests it performs.
What happens if a patient's insurance changes mid-treatment?
Re-verify coverage and make updates to authorizations so subsequent visits get routed to the appropriate payer.
Do you handle Medicare and Medicaid as well as private plans?
Yes, all three. They have different rules and forms for filing.
Can a patient be billed if the claim for a CGM is denied?
It varies based on the payer agreement and the notice. We review both prior to submitting a patient bill.
Let Us Take a Look at Your Endocrinology Claims
Just give us a handful of recent claims, and our billers will highlight what cost you money-the approvals and denials. There is no cost for this review, and it's not based on a contract-just where your billing is.
Get your Free Billing Review