Professional Medical Billing & Coding Services | LifeCareBilling

Professional Medical Billing & Coding Services

Maximize reimbursements with precise, compliant, and specialty-specific coding.

At LifeCareBilling, we provide full-service medical billing and coding solutions designed to improve revenue integrity, reduce claim denials, and ensure full compliance with evolving payer requirements. Our AAPC-certified coders work hand-in-hand with our billing team to ensure accurate CPT, ICD-10, and HCPCS code assignment, proper modifier usage, and clean linkage between diagnoses and procedures—essential for both first-pass claim approval and audit protection.

We serve a wide range of specialties—including physical therapy, mental health, home health, primary care, and multi-specialty clinics—with coding workflows tailored to their documentation style and payer mix.

Certified Medical Coding with Payer-Specific Expertise

Precision-driven coding that meets payer standards, prevents denials, and drives maximum reimbursement

At LifeCareBilling, our AAPC-certified medical coders specialize in transforming clinical documentation into fully compliant, payer-ready claims. Every code we assign—CPT, ICD-10, or HCPCS—is backed by clear documentation, payer justification, and real-time policy validation. We go beyond surface-level accuracy, aligning each encounter with CMS, NCCI, and payer-specific rules, ensuring that your claims not only pass audits but get paid faster.

CMS Guidelines & Real-Time Regulatory Updates

In today’s evolving billing environment, outdated coding leads directly to denied or delayed payments. Our coders stay ahead through continuous monitoring of Centers for Medicare & Medicaid Services (CMS) updates, including:

• Quarterly CPT® and HCPCS Level II code revisions
• Annual ICD-10-CM diagnosis updates and crosswalks
• E/M (Evaluation & Management) documentation and time-based coding reforms
• Global periods, bundled service edits, and telehealth coverage updates

By applying the latest CMS guidance before claims are even generated, we eliminate denials tied to obsolete codes and maintain full compliance with payer policy changes.

NCCI Edits, LCD/NCD Policies & Payer-Specific Logic

Our coders apply NCCI (National Correct Coding Initiative) edits and payer-specific billing logic to prevent errors before submission. We tailor every code set to the payer’s adjudication rules, including:

• Medicare Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)
• Commercial insurance billing logic for carriers like Aetna, Cigna, UHC, and BCBS
• State Medicaid service caps, frequency limits, and plan-specific documentation rules

This precision ensures each claim complies with its payer’s medical necessity and procedural linkage, drastically reducing COB conflicts, unbundling denials, and policy-based rejections.

Modifier Logic & Correct Usage Validation

Modifiers can make or break reimbursement. Misused modifiers trigger audits; missing ones cause denials. LifeCareBilling’s coders are experts in applying correct modifier logic such as:

• -25 for distinct E/M services on the same day
• -59 or -XU to unbundle procedures when clinically justified
• GP, GO, GN for therapy plan-of-care indicators
• KX for confirming medical necessity beyond standard limits

Each modifier is reviewed against payer LCDs, encounter notes, and documentation context, ensuring your claims are compliant, defensible, and fully reimbursable.

Specialty-Focused Coding Excellence

We understand that each medical specialty has unique rules, time units, and documentation requirements. Our coders are specialty-trained to handle complex nuances across:

• Therapy Clinics (PT, OT, ST): Accurate unit counting, enforcement of the 8-minute rule, and modifier stacking compliance.
• Behavioral & Mental Health: Proper coding for psychotherapy (90832–90837), group sessions, and telehealth visits, with attention to provider-type requirements (LCSW, LMHC, PhD).
• Home Health Agencies: Integration with OASIS data, visit reconciliation, LUPA threshold tracking, and episode-based coding accuracy.
• Primary Care/Internal Medicine: Optimized E/M level selection, preventive visit coding (99381–99397), and care coordination services (CCM, TCM).
• Multi-Specialty Groups: Streamlined code allocation, documentation crossover management, and payer bundling edits for multi-provider workflows.

Every coding decision is data-backed and cross-validated against documentation, ensuring full transparency and consistency across the billing lifecycle.

Chart-Based Coding: SOAP, EHR, or Paper Documentation

LifeCareBilling supports multiple documentation sources to fit your workflow:

• SOAP notes (Subjective, Objective, Assessment, Plan)
• EHR/EMR exports from WebPT, Kareo, SimplePractice, TheraNest, Athena, and more
• Scanned clinical documentation or hybrid charting systems

Our process ensures every service is:

• Accurately coded using CPT, ICD-10, and HCPCS Level II standards
• Fully justified through clear provider documentation
• Ready for payer audits and internal compliance checks

This chart-to-code approach minimizes administrative lag, boosts efficiency, and guarantees traceable, defensible claims.

How LifeCareBilling Should Differentiate

What makes our billing & coding services stand apart from the competition

At LifeCareBilling, we don’t just process claims—we deliver a strategic, compliance-first medical billing & coding partnership. While many RCM vendors offer general billing support, our approach is built on accuracy, specialty-specific insight, and total transparency.

Here's exactly how LifeCareBilling stands out in a crowded marketplace:

Flat Monthly Pricing – Not a % of Your Collections

Industry problem: Most billing companies charge 5–9% of collections, which grows as your revenue grows—eating into your profitability. Our difference: We offer predictable, flat monthly fees with no percentage-based surprises. You know exactly what you’re paying—whether you bill $25K or $250K per month.

Positioning line:

“Transparent pricing that scales with your trust—not your revenue.”

Specialty-Focused Coders & Billing Experts

Industry problem: Competitors use offshore teams or generalized coders with limited understanding of nuanced payer rules or specialty documentation. Our difference: All coding is performed by U.S.-based, AAPC-certified professionals who specialize in your practice type—be it therapy, behavioral health, home health, or internal medicine.

Positioning line:

“You get a coder who speaks your specialty—not a call center in another time zone.”

Payer-Specific Coding Precision — Beyond Generic Templates

Industry problem: Most billing companies rely on templates that overlook payer variations or modifier rules. Our difference: We apply real-time CMS updates, payer edits, and modifier rules (e.g., -25, -59, KX, GP, GO) tailored to Medicare, Medicaid, and commercial plans—reducing denials before they happen.

Positioning line:

“Your codes are backed by CMS logic, NCCI edits, and payer-specific compliance—not guesswork.”

Specialty-Specific Workflow Customization

Industry problem: Generic workflows fail to capture the complexity of services like PT units, telehealth, or home health episodes. Our difference: We build custom billing and coding logic for each client’s discipline:

• PT/OT/ST: Modifier 59/XU, 8-minute rule
• Mental Health: 90837, telehealth modifier 95, LCSW coding
• Home Health: OASIS-driven billing, LUPA thresholds
• Internal Medicine: E/M leveling under 2021+ AMA rules

Positioning line:

“We don’t force your practice into a box—we build around your specialty.”

Compliance-Driven, Audit-Ready Claims

Industry problem: Coding errors can lead to RAC/MAC audits or payment recoupments. Our difference: We cross-validate every claim against documentation, payer rules, and CMS policy—ensuring each service is medically necessary, justified, and defensible.

Positioning line:

“We don’t just get you paid—we help you stay compliant.”

Real-Time Reporting with Full Visibility

Industry problem: Many billing providers offer reports only on request—or not at all. Our difference: You get access to a secure portal with:

• Clean claim rate
• Denials by reason or payer
• A/R aging buckets
• Monthly summaries and trends

Positioning line:

“You’ll know exactly what’s happening with your revenue—every step of the way.”

Fast Onboarding & Seamless EHR Integration

Industry problem: Switching billing vendors can delay cash flow. Our difference: We support direct integration with EHRs like SimplePractice, WebPT, Kareo, TheraNest, DrChrono, and others—with zero downtime and no disruption to your front office.

Positioning line:

“We don’t ask you to change systems—we meet you where you are.”

End-to-End Medical Billing & Coding — Not Just Pieces

Industry problem: Some vendors handle coding but not claims, or billing but not AR follow-up. Our difference: LifeCareBilling offers a complete RCM solution, including:

• Chart-to-code translation
• Claims submission & payer scrubbing
• Denial management & appeals
• Payment posting & reconciliation
• Patient billing & statements
• Real-time dashboards & KPI reviews

Positioning line:

“From SOAP notes to settled payments—we handle it all.”