Nephrology Billing Services in New York For Revenue Growth
With our nephrology billing services in New York, your practice can:
- Accurate billing for in-center and home dialysis, including hemodialysis and peritoneal dialysis services
- Specialized handling of Monthly Capitation Payment (MCP) codes for ESRD patients
- Full compliance with Medicare ESRD PPS, New York Medicaid, LCD, and NCCI guidelines
- Manage CKD, ESRD, and Renal Failure Billing with Precise Documentation
- Submit clean claims within New York’s timely-filing and prompt-payment standards
What Common Nephrology Billing Challenges Do Practices Face in New York?
Nephrology practices in New York face multiple specialized billing challenges, including:
- State-Level Medicaid & Managed Care Complexity: New York Medicaid has its own billing formats, physician carve-out rules, and authorization requirements that differ from other states.
- Surprise Billing & Transparency Requirements: New York’s laws protect patients from unexpected out-of-network charges and mandate clear patient billing and dispute resolution processes.
- Frequent Denials from Coding & Documentation Errors: Nephrology claims are often denied due to incomplete documentation of dialysis treatments, CKD progress, or incorrect CPT/ICD-10 usage.
- Medicare ESRD & Payer Rules: Claims for dialysis, MCP payments, and bundled services must follow strict Medicare guidelines and payer-specific rules to avoid audits and payment delays.
How Transcure Helps Practices With Their Nephrology Billing Services in New York?
Transcure delivers specialized nephrology billing services to help New York practices overcome regulatory risk. We support New York nephrology groups through the following services:
Insurance Eligibility Verification
We verify Medicaid, Medicare, and commercial coverage for renal and dialysis care to reduce eligibility-related denials.
Prior Authorization & Authorization Tracking
Our New York nephrology billing team manages authorizations for hemodialysis, peritoneal dialysis, vascular access procedures, imaging, and other nephrology services.
Nephrology Coding & Charge Capture
Using certified coders and AI agents, we ensure accurate CPT, HCPCS, and ICD-10 coding for services such as dialysis (90935–90937) and CKD management.
Denial Management & Appeals
Transcure’s nephrology billing services providers identify denial trends and aggressively appeal underpaid or rejected nephrology claims.
Audit & Documentation Support
Our team equips practices with thorough medical necessity documentation to withstand payer utilization reviews and audits.
New York Billing Law Compliance
Transcure’s processes comply with New York Medicaid policies, Medicare standards, state surprise billing laws, prompt payment rules, and security requirements.
Our Success in Numbers
Which New York Cities Does Transcure Support With Nephrology Billing Services?
New York City
Buffalo
Rochester
View All Cities
Yonkers
Syracuse
Albany
New Rochelle
Mount Vernon
Schenectady
How Much Can New York Practices Save with Transcure’s Nephrology Billing Services?
The average Medical Billing Specialist in New York earns approximately $46,675 annually, according to ZipRecruiter. By outsourcing your nephrology billing to Transcure, your practice only pays 5% of the revenue collected. With this pricing model, your practice can eliminate fixed salaries, recruitment expenses, and administrative overhead.
For a nephrology practice generating $500,000 annually, outsourcing billing to Transcure would cost $25,000. This amount is far less compared to $46,675 for an in-house biller, saving approximately $21,675 per year.
In Which Counties Does Transcure Provide Nephrology Billing Services in New York?
Kings County (Brooklyn)
Queens County
New York County (Manhattan)
Suffolk County
Bronx County
Nassau County
Westchester County
Erie County
Monroe County
What Nephrology Procedures Does Transcure Handle with Their New York Billing Services?
Transcure provides nephrology billing support for high-cost renal procedures governed by strict New York payer rules. Our New York nephrology billing experts manage every procedure, including but not limited to:
Hemodialysis Billing
We handle accurate coding and claim submission for hemodialysis sessions, including time-based reporting, frequency limits, and ESRD documentation required by New York payers.
Dialysis Catheter Placement Billing
Transcure handles nephrology billing for tunneled and non-tunneled dialysis catheter placements, exchanges, and removals with accurate coding and modifier usage
Peritoneal Dialysis Billing
Our New York nephrology billing services manage continuous and intermittent peritoneal dialysis billing, including training sessions and modifier application to prevent underpayments.
Renal Biopsy Billing
Transcure’s nephrology billing services bill percutaneous and image-guided renal biopsies, applying correct CPT codes, modifiers, and pathology coordination required for reimbursement.
CKD Management Billing
With the help of our New York nephrology billing team, we handle CKD stage-specific evaluation and management services for proper diagnosis linkage and frequency compliance.
Renal Imaging Billing
Our billing experts cover ultrasound-guided renal studies, Doppler evaluations, and diagnostic imaging with proper technical component separation.
Why Should You Outsource New York Nephrology Billing Services to Transcure?
With countless nephrology billing companies in New York, Transcure helps your practice gain
Dedicated New York Nephrology Billing Manager
Your practice is assigned a billing manager experienced in NY Medicaid rules, no-fault claims, and nephrology-specific documentation requirements.
Transparent Performance Reporting
Nephrology practices receive monthly reports, including AR aging and payer performance metrics, along with procedure-level revenue insights
Supports 40+ Nephrology EHRs
Our billing team is well-versed with 40+ nephrology EHRs, including Athenahealth, AdvancedMD, EPIC, NextGen, and CareCloud.
Hospital and Facility Billing Accuracy
We manage inpatient and outpatient nephrology billing to capture emergency dialysis and hospital-based services without missed charges.
The Case Study of Idaho Kidney Institute Nephrology Billing Success with Transcure
Idaho Kidney Institute faced a $300,000 billing backlog with claims stuck over 60 days. Within 90 days, Transcure reduced the backlog by 66%, bringing unpaid claims down to $100,000. This improvement significantly strengthened IKI’s cash flow and overall financial stability.
What Nephrology EHR Systems Are Supported by Transcure?
We work confidently across leading nephrology EHRs to optimize documentation flow.
How Practices Benefit from Our New York Nephrology Medical Billing Services?
Explore our partners’ success stories to see how our nephrology billing services in New York drive stronger cash flow and long-term financial growth.
Jackie Judd
Practice Manager
Wilson Creek Internal Medicine
As a practice manager, I was looking to streamline the medical billing process. I tried other companies, but they were all complicated and took too much of my time. Fortunately, I found Transcure. They excel in tailoring solutions to fit my requirements.
Amber Vaughan
Office Manager
Idaho Kidney & Hypertension Institute
We are a large practice with 15 providers. Transcure has been working with us for the last 5 years. This billing company has been a great asset to us. I work with Transcure and they provide everything I ask for. The team is friendly and very pleasant to work with.
Ashlee Rose
Practice Manager
Harding Memorial Healthcare
We’ve been working with Transcure for 8 years now and I just wanted to say how happy we are with their services. They always get back to us quickly and are very easy to work with. They get my bills paid in record time and help us to generate millions in revenue.
Frequently Asked Questions (FAQs)
What is the surprise medical bill law in NY?
The New York Surprise Medical Bill law is a legal protection for patients in NY against surprise out-of-network medical bills. This law makes sure the patient is only billed according to in-network treatment rates. In case of any dispute, IDR comes into play, and patients are protected from the high costs.
What are the most common CPT codes used in nephrology billing?
Nephrology billing frequently uses CPT codes for evaluation and management (E/M) visits, dialysis procedures, kidney biopsies, and transplant services. Common codes include 90935, 90937, 90945, 90947, 36415, 50300, 50320, and 99213 to 99215 for outpatient visits.
Are your services HIPAA-compliant?
Yes. All our nephrology billing services in New York are fully HIPAA-compliant, ensuring strict protection of patient data. We also follow ISO27001 certified quality and security standards.
How much do nephrology billing companies in New York charge?
Most charge 4%–8% of monthly collections, depending on volume and services. Transcure charges a flat 5%, with no hidden fees.