Top-Rated Nephrology Billing Services in California with Local Compliance
With our nephrology billing services in California, your practice can:
- Comply with California No Surprises Act and balance-billing protections
- Apply Hospital Fair Billing rules for dialysis and ESRD-related claims
- Accurately bill high-volume nephrology CPT codes, including 90935
- Prevent denials related to medical necessity for CKD treatments
- Maintain compliance with CA patient financial disclosure requirements
- Perform timely submission under California clean-claim standards to meet new 30-day payment timelines
What Common Nephrology Billing Challenges Do Practices Face in California?
Nephrology practices in California face multiple medical billing challenges, as follows:
- Strict Medi-Cal Billing Requirements: Billing nephrology services under Medi-Cal requires precise CPT/HCPCS selection and eligibility verification to prevent denials.
- Complex Dialysis Authorization Processes: Hemodialysis, peritoneal dialysis, and vascular access procedures often require prior authorizations and ongoing approvals.
- High Documentation Scrutiny: Chronic Kidney Disease and ESRD treatments are closely reviewed, requiring detailed clinical documentation to withstand audits and utilization reviews.
- Expedited Claim Payment Deadlines:California law (AB 3275) requires all clean claims, including Medi-Cal, to be paid or contested within 30 calendar days, risking interest penalties.
How Transcure Helps Practices With Their Nephrology Billing Services in California?
Transcure provides nephrology billing services to help practices overcome complex billing and compliance challenges. We offer the following services to California nephrology groups:
Insurance Eligibility Checks
With our ELIXA AI agent, we verify Medi-Cal, Medicare, and commercial coverage for dialysis, ESRD care, and renal procedures to reduce eligibility-related denials.
Prior Authorization and Treatment Validation
Our California nephrology billing team manages authorizations for hemodialysis, peritoneal dialysis, vascular access procedures, and renal imaging to prevent payment delays.
Nephrology Coding and Charge Capture
Using our CODIN AI agent and certified coders, we do accurate CPT and ICD-10 coding for high-frequency nephrology services, such as 90935 and 90937.
Denial Management and Appeals
Our nephrology billing experts in California, along with the DEXA agent, identify denial patterns related to medical necessity and aggressively appeal underpaid or rejected claims.
Audit and Documentation Support
Transcure’s nephrology billing services help practices prepare documentation for utilization reviews and audits involving CKD and ESRD services.
California Billing Laws Compliance
Our processes comply with California balance-billing restrictions, Hospital Fair Billing requirements, and patient financial disclosure laws to reduce regulatory risk.
Which California Cities Does Transcure Support with their Nephrology Billing Services?
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
Our Success in Numbers
How Much Can California Practices Save with Transcure’s Nephrology Billing Services?
According to Salary.com, the average medical billing specialist in California earns about $53,143 annually, depending on experience and location within the state. 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 costs, benefits, and administrative overhead.
For a nephrology practice generating $500,000 annually, outsourcing billing to Transcure would cost $25,000. This amount is far less than the typical $48,000 to $54,000 salary for an in-house biller, saving approximately $28,143 per year in direct staffing costs alone.
Counties Served by Transcure Medical Billing Services in California
Los Angeles County
San Diego County
Orange County
Riverside County
San Bernardino County
Santa Clara County
What Nephrology Procedures Does Transcure Handle with Their California Billing Services?
Transcure provides nephrology billing support for high-cost renal procedures governed by strict California payer and Medi-Cal rules. Our California 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 California payers.
Peritoneal Dialysis Billing
Our California nephrology billing services manage continuous and intermittent peritoneal dialysis billing, including training sessions and modifier application to prevent underpayments.
Vascular Access Creation Billing
We support billing for AV fistula and graft creation, revisions, declotting procedures, and access evaluations for compliance with California medical-necessity and bundling rules.
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 California nephrology billing team, we handle CKD stage-specific evaluation and management services for proper diagnosis linkage and frequency compliance.
Renal Imaging Billing
Our nephrology billing services in California cover ultrasound-guided renal studies, Doppler evaluations, and diagnostic imaging with proper technical component separation.
Why Should You Outsource California Nephrology Billing Services to Transcure?
With countless nephrology billing companies in California, Transcure helps your practice gain:
Dedicated California Nephrology Billing Manager
You’ll be assigned a billing manager experienced in Medi-Cal rules, ESRD guidelines, and California-specific nephrology documentation requirements.
Nephrology Coding for All Service Levels
Transcure’s certified coders ensure accurate CPT, HCPCS, ICD-10, and modifier usage for dialysis, CKD management, and vascular access procedures.
Audit-Ready Documentation Support
Our nephrology billing team in California helps maintain medical-necessity and treatment documentation required for CKD and dialysis utilization reviews.
Transparent Financial Reporting
We provide clear Account Receivable reports, denial trends, and revenue insights fit for your California nephrology practices.
How Transcure's Expertise Rescued Idaho Kidney Institute from a Billing Backlog?
Struggling with denied claims and aging receivables? Idaho Kidney Institute faced the same crisis, having $300,000 trapped in over 60-day accounts receivable. In just 90 days, Transcure reduced that backlog to $100,000 through targeted denial management, precise insurance verification, and aggressive appeals. Every recovered dollar strengthened cash flow and allowed clinicians to refocus on patient care instead of billing chaos.
This isn’t a one-off success. It’s a proven, repeatable revenue cycle strategy. If your practice is losing revenue to denials, eligibility errors, or underpaid claims, it’s time to act. Partner with Transcure and turn aging AR into predictable revenue, starting in the next 90 days.
What Nephrology EHR Systems Are Supported by Transcure?
We work confidently across leading nephrology EHRs to optimize documentation flow.
How Practices Benefit from Our California Nephrology Medical Billing Services?
Explore our partners’ success stories to see how our nephrology billing services in California 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 payer policies should nephrology practices watch for?
Nephrology practices should track Medicare ESRD rules, Medicaid coverage variations, commercial payer dialysis policies, prior authorization requirements, bundled payment guidelines, and any local coverage determinations (LCDs).
What is AB 3275, and how does it impact nephrology billing?
AB 3275 mandates clean claims be paid, denied, or contested within 30 calendar days, increasing pressure for accurate submissions.
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.
How does Medi-Cal affect dialysis and ESRD billing in California?
Medi-Cal enforces strict coding, frequency limits, and eligibility checks for dialysis, ESRD MCP services, and vascular access procedures.