Specialized Dialysis Billing Services for ESRD Facilities
Transcure’s dialysis billing services assign AAPC-certified coders backed by dedicated dialysis billing AI agents. Our dialysis billing team provides specialized services to eliminate revenue leaks across ESRD, hemodialysis, peritoneal dialysis, and renal care claims.
- CMS ESRD PPS & Medicare Compliance with accurate bundling, MSP coordination, and HIPAA-safe billing workflows
- AI-Powered Dialysis RCM (ELIXA, PRIA, CODIN, DEXA) covering eligibility, claim scrubbing, and collections
- Dialysis Denial Prevention using precise ICD-10, CPT, HCPCS coding and modifier accuracy
- Full Dialysis Modality Billing for hemodialysis, peritoneal dialysis, and home dialysis programs
- ESRD MCP & Revenue Optimization (CPT 90960–90962) with underpayment recovery and AR acceleration
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Our Success in Numbers
Trusted by
500+ Physicians
Catering to
40+ Specialties
1100+ Certified
Medical Billers & Coders
End-to-End
RPA Billing Solutions
Up to 98% First Pass
Clean Claim Rate
Why Dialysis Billing Is the Hardest Specialty in the Healthcare Revenue Cycle?
Dialysis billing follows complex rules, including ESRD PPS, monthly capitation payments, session-based billing, strict visit requirements, and payer coordination across multiple entities. Even minor coding errors or incorrect comorbidity reporting can change reimbursement outcomes or trigger denials. Managing MCP codes alongside dialysis sessions adds further complexity.
Transcure is built for this environment. Our AAPC-certified coders and AI-powered denial prevention tools ensure accurate ESRD PPS and MCP billing. The result is a 1% claim denial rate and a 99.99% clean claim rate.
Nephrology Practices That Have Put Trust in the Transcure Billing Team
Many nephrology practices have trusted the Transcure billing team for their revenue cycle management needs. Over the years, we have partnered with a wide range of providers, from small independent nephrologists to large multi-location renal care groups. Some of the prominent ones include:
What Dialysis Billing Services Transcure Delivers to Maximize ESRD Facility Revenue?
Transcure provides end-to-end dialysis billing services built for ESRD facilities, not retrofitted from physician billing workflows. Each service block addresses a specific revenue leak point in the dialysis billing cycle:
AI-Powered ESRD Eligibility Verification
We verify Medicare entitlement under 42 CFR § 406.13, secondary Medicaid coverage, commercial payer benefits, and the 30-month coordination period using our ELIXA AI agent.
Prior Authorization Management
Our PRIA AI agent manages prior authorizations for dialysis-related services, including vascular access procedures, fistulagrams, catheter exchanges, and transplant workup imaging.
AAPC-Certified Dialysis Coding
Our certified coders assign accurate codes for hemodialysis, peritoneal dialysis, home dialysis training, and ESRD MCP, while CODIN validates each code against documentation.
ESRD PPS Bundle Management
Transcure checks each dialysis service against CMS ESRD PPS rules to see if it is included in the bundle or billed separately, and automatically flags drugs, labs, supplies, and equipment.
Dialysis Claim Submission & Scrubbing
Our dialysis billing company submits clean dialysis claims after AI-driven scrubbing that validates ESRD PPS bundling rules, CPT/HCPCS accuracy, modifiers, and payer-specific requirements.
Real-Time Denial Detection & Appeal Generation
DEXA AI detects dialysis denial trends like underpayments, missing modifiers, and frequency errors, auto-generates appeal letters, and updates claim status in real time on your dashboard.
Accounts Receivable (AR) Management
We actively manage aging dialysis claims through our AI agent ARIA, use structured follow-ups, payer escalation workflows, and systematic recovery processes to keep AR days under 24.
Patient Billing & Collections
Our dialysis billers generate clear patient statements for remaining balances after payer adjudication, while our system supports payment plans, automated reminders, and compliant collection workflows.
Composite Rate & Revenue Cycle Reporting
Transcure delivers weekly RCM dashboards with composite rate performance, days-in-AR aging, denial categorization by payer, and net collection rate by service line.
Why Dialysis Facilities Outsource Dialysis Billing Services to Transcure?
Transcure delivers customized dialysis billing solutions that simplify coding, reduce errors, and improve reimbursements. Below are the key reasons practices rely on Transcure for dialysis medical billing services:
Dialysis-Specific Billing Expertise
We bill across in-center hemodialysis, home hemodialysis, peritoneal dialysis, vascular access centers, and hospital-based dialysis programs. Generalist billers cannot match the depth of ESRD PPS, QIP, and dual-eligibility expertise our team applies.
Transparent Percentage-Based Pricing
We charge 3-5% of monthly collections for dialysis billing services. No setup fees. No long-term contracts. Your facility pays only when Transcure collects.
Dedicated Dialysis Billing Account Manager
Every account gets a named manager available 24/7 to resolve denials, payer issues, and reporting questions. No ticket queues, no offshore handoffs.
40+ EHR Integrations
Transcure connects with every major EHR and dialysis-specific platform your dialysis facility uses, including eClinicalWorks, AdvancedMD, NextGen, athenahealth, Epic, CareCloud.
Full Regulatory Compliance
Our team operates under HIPAA, ISO 27001, SOC 2, and CMS dialysis billing rules. Quarterly Stark Law and AKS audits protect your facility from referral compliance violations.
Underpayment Detection & Contract Analysis
We analyze payer contracts and reimbursement trends to identify underpaid dialysis claims from Medicare Advantage plans, Medicaid MCOs, and commercial insurers.
How Transcure Cut Idaho Kidney Institute's Dialysis Billing Backlog by 67% in 90 Days?
Idaho Kidney Institute faced a $300,000 backlog of unpaid claims stuck in the 60+ AR bucket, which was creating major cash flow pressure and operational strain. Transcure stepped in with expert medical billing support, resolved denied claims, insurance verification issues, coding gaps, and medical necessity challenges.
By improving revenue cycle management, Transcure helped accelerate reimbursements and reduce billing delays. Within 90 days, the backlog dropped to $100,000, and IKI saw a reduction in billing burden by 66%.
What Procedures Does Transcure Support with Their Dialysis Medical Billing Services?
Transcure provides dialysis billing support for high-cost renal procedures governed by strict Medicare ESRD PPS rules and payer compliance requirements. Our certified billing experts manage every procedure, including but not limited to.
Hemodialysis Billing
We handle accurate coding and claim submission for in-center hemodialysis sessions, and ensure proper ESRD documentation, time-based reporting, and bundled payment compliance.
Peritoneal Dialysis Billing
Our dialysis billing team manages continuous and automated peritoneal dialysis claims, including home dialysis documentation, training sessions, and correct modifier usage for reimbursement accuracy.
Home Dialysis Training Billing
Transcure supports billing for patient and caregiver training programs, providing proper coding for initial and refresher training sessions under Medicare ESRD guidelines.
Vascular Access Procedure Billing
We manage billing for AV fistula creation, graft placement, catheter insertion, and access maintenance procedures with correct CPT coding and modifier application.
Dialysis Catheter Management Billing
Our experts handle tunneled and non-tunneled catheter placement, exchange, and removal billing, ensuring compliance with surgical coding rules and payer-specific requirements.
ESRD Monthly Management Billing
We bill monthly ESRD physician supervision services, including care plan oversight, dialysis adequacy monitoring, and chronic kidney disease progression management under Medicare rules.
Nephrology Billing Services Serving Every State in the United States
Our Expertise in Dialysis CPT, ICD-10 & Revenue Codes
Years of experience in dialysis billing mean our coders apply the correct code on the first pass. Our coding expertise spans:
90935 to 90937
- Hemodialysis evaluation and management CPT codes
90945 to 90947
- Peritoneal dialysis CPT codes
90960 to 0962
- ESRD monthly capitation payment codes
90963 to 90966
- ESRD pediatric monthly capitation codes
90999
- Unlisted dialysis procedure codes
N18.6
- ICD 10 ESRD requiring chronic dialysis or transplant
Z99.2
- ICD-10 renal dialysis dependence code
Z49.31 to Z49.32
- Dialysis access and preparation codes
0820 to 0889
- Dialysis facility revenue reporting codes
Stop Losing Dialysis Revenue to Avoidable Denials
Get a free dialysis billing audit. Transcure’s team will review 30 days of your facility’s claims, identify the top denial categories costing you revenue, and deliver a recovery plan within 5 business days.
Dialysis EHR Systems Supported by Transcure
Transcure integrates with every major dialysis and renal care EHR platform. Our coders pull documentation directly from your existing system without disrupting clinical workflows.
Frequently Asked Questions About Dialysis Billing
Get answers to the most common questions nephrology practices ask about our dialysis billing services, ESRD compliance, and CMS reimbursement rules.
What is ESRD QIP, and how does it affect dialysis facility revenue?
The CMS End-Stage Renal Disease Quality Incentive Program (QIP) reduces Medicare payments by up to 2% in the following payment year for facilities that fail to meet quality measures. QIP measures include Kt/V dialysis adequacy, vascular access type, hypercalcemia, ICH-CAHPS patient experience scores, and clinical depression screening.
How much does Transcure charge for dialysis billing services?
Transcure charges between 3% and 5% of monthly collections for dialysis billing services. Your rate depends on facility size, claim volume, payer mix, and ESRD patient count. There are no setup fees or long-term contracts.
Can Transcure handle dialysis billing for hospital-affiliated programs?
Yes, we bill for hospital-based outpatient dialysis programs, hospital-owned freestanding facilities, and inpatient acute dialysis. Each setting has distinct revenue code, place-of-service, and modifier requirements that our coders apply correctly.
Do you guarantee performance improvements?
Yes, we aim to deliver up to a 99.99% clean claim rate with denial rates around 1% or lower through AI-driven billing workflows. Most facilities also see AR days reduced to about 24 days and overall AR improvement of nearly 30%.
Are your billers experienced with ESRD PPS reimbursement?
Yes. Transcure’s dialysis billing team has extensive experience with ESRD PPS reimbursement across independent dialysis centers, nephrology groups, and hospital-based ESRD programs. Our billers understand bundled payment rules, monthly capitation payment (MCP) billing, dialysis-related modifiers, injectable drug reimbursement, vascular access billing, and CMS ESRD compliance requirements.
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