Pulmonology Billing Services in California | 99% First-Pass Claim Rates
Our pulmonology billing company in California helps pulmonary practices stay compliant with state rules. Here is how we protect your revenue with CA compliance:
- Manage prior authorizations for sleep studies, CPAP, and home oxygen therapy
- Process California Workers’ Comp and Medi-Cal pulmonology claims under state rules
- Recover denied pulmonary claims and maintain a 99% first-pass clean claim rate
- Navigate California managed care plans like Health Net, Molina, and Anthem Blue Cross
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
Our Success in Numbers
What Are the Biggest Pulmonology Billing Problems in California?
Pulmonary practices in California lose revenue to a mix of specialty coding traps and state payer rules. The most costly problems pulmonologists face include:
Below-Market Reimbursement
Medi-Cal pays doctors only about 87.5% of Medicare rates for many services, and pulmonary procedures often fall even below that. With margins that thin, a single denied or underpaid claim wipes out the profit on several correctly paid ones.
PFT and E/M Bundling Denials
Same-day PFTs and office visits are routinely denied for modifier 25 and bundling errors, one of the most overlooked revenue leaks. Because each denial is small, pulmonary practices fail to notice how much they add up over a year of visits.
Sleep Study Site-of-Service Denials
California payers apply different rules to in-lab polysomnography (95810) versus home sleep testing (95806), and billing the wrong site of service triggers a denial. Practices lose revenue when a study is performed one way but coded another.
Conditional Prompt-Pay Protection
California's Knox-Keene rules require plans to pay clean claims within 30 days for commercial claims and 45 days for Medi-Cal claims. The catch is that only clean claims start that clock, so one error hands the payer a free extension.
Which Pulmonary Billing Services Does Transcure Provide to Practices in California?
Transcure’s pulmonology billing services in California help pulmonologists handle complex PFT and bronchoscopy coding and stay compliant with Medi-Cal and DHCS rules.
Medi-Cal TAR Management
PRIA handles eligibility checks and Treatment Authorization Requests for pulmonary services requiring Medi-Cal approval, with automated tracking to prevent authorization delays.
PFT and Bronchoscopy Coding
Transcure codes PFTs, bronchoscopy, lavage, and biopsies with precise CPT and ICD-10, checking modifiers and bundling before claims reach California payers.
California Managed Care Billing
We manage claim submission, follow-up, and payment tracking across California Medi-Cal managed care plans, so your team avoids juggling multiple payer processes.
Sleep and DME Billing
Our team bills for sleep studies, CPAP, and home oxygen, and runs eligibility and authorization checks to keep clinical and equipment claims coordinated throughout the process.
Pulmonary Denial and A/R
DEXA pinpoints the coding, authorization, or documentation issue behind each denial, and ARIA tracks aging PFT, bronchoscopy, and sleep claims through to payment.
California Payment Disputes
Transcure manages disputes over eligible underpaid commercial claims and prepares cases for California dispute resolution, handling all documentation throughout the process.
Which Cities in California Does Transcure Serve for Pulmonology Billing?
Los Angeles, California
San Diego, California
San Jose, California
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San Fransisco, California
Fresno, California
Sacramento, California
Long Beach, California
Bakersfield, California
Oakland, California
How Does Transcure Recover Revenue From Denied Pulmonology Claims in California?
25% of healthcare providers reported that their claim denial rates increased over the past 12 months, according to Experian Health’s survey. For your California pulmonology practice, that means more PFT, bronchoscopy, sleep, and respiratory claims needing more attention.
Once a claim is denied, getting that revenue back takes more than sending it through the system again. Your team has to determine why it failed, correct the issue, gather any missing information, and continue following up with the payer until the claim is paid.
Transcure takes this headache away with an AI-powered RCM built for California billing requirements. Our AI denial management agent, DEXA, helps identify the issues behind denied claims, while our certified billing team handles the necessary corrections and resubmissions.
Which California Counties Does Transcure Cover for Pulmonology Billing Services?
Los Angeles County
San Diego County
Orange County
Riverside County
San Bernardino County
Santa Clara County
Pulmonology Billing Services Across Other States in the US
Even though California is a key part of our coverage, Transcure’s pulmonology billing services extend beyond the state. We also support pulmonary practices across several other states in the U.S.
Which Pulmonary Procedures Do Transcure’s California Billing Services Handle?
Transcure provides specialized medical billing services to CA-based pulmonary practices for diagnostic, therapeutic, and critical respiratory procedures. Our team manages the coding, documentation, and authorization associated with each service, including:
Bronchoscopy Billing
Our bronchoscopy billing service covers lavage, brushing, biopsy, and related services through a focused coding workflow. Transcure verifies CPT selection, bundling, modifiers, and documentation before claims are submitted.
Critical Care Billing
Our CA billing specialists manage pulmonary critical care claims, including time-based services and add-on codes. Documented critical-care time, CPT selection, and supporting services are reviewed before claim submission.
Spirometry and PFT Billing
PFT billing from Transcure covers spirometry, lung volumes, diffusion studies, and related testing services. Our team reviews CPT combinations, modifiers, medical necessity, and documentation for each claim.
Polysomnography (Sleep Study) Billing
We manage billing for polysomnography and home sleep testing, including diagnostic and titration studies. Our team handles CPT coding, authorization checks, and California payer requirements for each claim.
EBUS Billing
For EBUS claims, our team verifies lymph node station counts and transbronchial needle aspiration coding. CPT selection, documentation, and payer requirements are checked to support accurate reimbursement.
Thoracentesis & Pleural Procedure Billing
Transcure handles billing for thoracentesis and pleural catheter placement and removal. Imaging guidance, CPT selection, modifiers, and documentation are reviewed before claims are submitted to California payers.
Why Should You Outsource Pulmonology Billing Services in California to Transcure?
Outsourcing to Transcure gives your practice dedicated support across the pulmonary billing cycle. Our focus stays on getting claims billed correctly, followed through, and paid.
Dedicated Pulmonology Billing Manager
A dedicated California billing manager oversees your account and remains your primary point of contact. You have one person coordinating your billing team and communicating directly with your practice.
California Payer & Medi-Cal Expertise
Our team works with CA commercial plans and Medi-Cal billing requirements throughout the revenue cycle. Eligibility, claim submission, and payer-specific requirements are incorporated into the billing workflow.
AActive Denial Resolution
Denied claims are investigated rather than simply recorded as unpaid. Our team identifies the denial reason, makes necessary corrections, submits supporting information, and follows the claim through payer resolution.
Billing Capacity That Grows With You
As your California pulmonary practice adds providers, procedures, or claim volume, Transcure can expand its billing support to meet your needs. You avoid building an equally large in-house billing team as your revenue cycle grows.
Are Medi-Cal Claims Slowing Your Pulmonary Revenue?
If you serve Medi-Cal patients, keeping up with California’s changing enrollment and claim requirements can become another billing challenge for your practice. Since July 23, 2026, certain Medicare-enrolled ordering, referring, and prescribing providers must also be enrolled in Medi-Cal, or associated claims can be denied.
By outsourcing to Transcure, you can have Medi-Cal and commercial payer billing managed from claim submission and payer follow-up to denial handling and A/R recovery. Our team works within applicable California requirements to help you avoid preventable claim issues and protect the reimbursement your practice has earned.
Which Pulmonology EHR Systems Does Transcure Support?
Transcure supports leading EHR systems, making it easy to manage your billing within your existing platform.
What Practices Say About Our California Pulmonology Billing Services?
See how our pulmonology billing service has helped California practices improve collections, reduce denials, and increase overall revenue.
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 about Pulmonology Billing Services in CA
Get answers to the most common questions California pulmonology practices ask about our billing services, compliance, and state-specific regulations.
How does Transcure handle denial management for California pulmonology practices?
Transcure works denied claims through correction, resubmission, and payer follow-up while tracking recurring denial patterns. Across its billing operations, Transcure reports a 99% first-pass clean claims rate, helping reduce avoidable rework before claims reach the payer.
Can Transcure help pulmonary practices in California reduce billing delays?
Yes, Transcure reviews claims before submission, manages authorization and eligibility requirements, follows up on unpaid accounts, and addresses payer issues throughout the revenue cycle. This coordinated approach helps California pulmonary practices reduce avoidable billing delays.
Will outsourcing pulmonology billing increase my practice’s revenue?
Yes, our billing support is designed to increase the revenue your practice collects from services already being provided. Transcure has achieved up to 20% revenue improvement through cleaner claims, denial resolution, and active A/R follow-up, with results varying by practice.
How does Transcure charge for pulmonology billing services?
We charge 5% of monthly collections for full-cycle revenue cycle management. There are no upfront setup fees, so our billing fee is tied only to the revenue we collect for you, not to what you collect from patients upfront.
Does Transcure work with the EHR system a pulmonology practice already uses?
Yes, Transcure integrates with more than 40 EHR platforms, so your practice keeps its existing workflow instead of switching systems to work with us. Our team adapts to your setup rather than requiring you to adapt to ours.