Generalist RCM is why you have a denial problem. The ASP-RCM answer: specialty-staffed pods.
Every specialty has its own coding rules, payer behavior, and documentation traps. ASP-RCM staffs teams by specialty, not by client size. Your senior ASP-RCM partner has 15+ years in your world, not someone else’s.
Where we’ve done the most damage to denials.
Four specialty teams that handle the largest portion of our portfolio. Each has its own playbook, payer-rule library, and senior partner.
ABA Therapy Billing
Authorization-driven, units-heavy, and audit-targeted. From a single BCBA-led clinic to multi-state ABA networks: same dedicated pod, same senior accountability, denial rate consistently under 3%.
- Concurrent authorization tracking across plans
- 97155, 97153, 97156 modifier & unit precision
- Treatment-plan documentation review
- Single-case agreements & out-of-network billing
- 22-clinic ABA network case study available
Hospital & Health System Billing
UB-04, DRG, observation vs inpatient, transfer DRG: the full hospital RCM stack, run by senior partners who’ve managed billing departments at 4-hospital systems.
- Inpatient, outpatient, ED, observation, surgical
- DRG validation & transfer DRG capture
- 340B compliance & audit defense
- Provider-based billing & split-billing rules
- 4-hospital system case study available
Mental Health & Behavioral
Outpatient psych, IOP, PHP, residential, telehealth: we handle the full continuum. Authorization workflows, level-of-care transitions, and parity-act underpayment recovery.
- Outpatient, IOP, PHP, residential, inpatient psych
- Level-of-care transition documentation
- Parity Act underpayment recovery
- Telehealth billing across 50 states
- 14-location outpatient psych case study available
Physician Group Billing
Multi-specialty groups, IPAs, and ACOs. E/M leveling, surgical bundling, modifier discipline, and HCC capture, with provider-level documentation feedback baked in.
- E/M leveling (99202-99215) at audit-defendable accuracy
- Surgical CPT bundling & modifier 24/25/57/59
- HCC risk-adjustment coding for MA contracts
- Provider-level documentation coaching
- 62-provider multi-specialty case study available
34 more specialty playbooks in production.
Don’t see yours? Ask. We’ve probably got a senior lead with 15+ years in it.
FQHC / Community Health
PPS rate billing, sliding-fee, scrubbing for HRSA & UDS reporting compliance.
SNF / LTC
PDPM coding, MDS validation, dual-eligible billing, Medicaid pending workflows.
DME / HME
CMN tracking, recertification deadlines, PA-driven billing for CGM, CPAP, mobility.
Urgent Care
S9083, observation rules, occupational health splits, walk-in eligibility velocity.
Home Health & Hospice
OASIS-D timing, PDGM episode billing, hospice cap management, GIP/IRC distinctions.
Anesthesia
Time-unit billing, base-unit accuracy, modifier QK/QY/QX/QZ, CRNA supervision rules.
Radiology
Professional/technical splits, modifier 26/TC, RVU optimization, advanced imaging PA.
Pathology
88305 series accuracy, technical/professional, molecular pathology PA workflows.
Lab & Diagnostics
14-day rule, PAMA reporting, NCD/LCD review, molecular genomics billing.
Cardiology
Cath lab bundling, EP procedures, modifier 51/59, device monitoring follow-up.
Orthopedics
Global period management, hardware coding, DME splits, workers’ comp workflows.
Gastroenterology
Screening vs diagnostic colon, modifier PT/33, anesthesia pairing, ASC splits.
OB/GYN
Global OB packaging, antepartum-only, delivery types, fetal monitoring rules.
Pediatrics
VFC vaccine billing, well-child documentation, EPSDT, school-based health.
Dermatology
Mohs surgery, biopsy bundling, cosmetic vs medical, telederm workflows.
Urology
Cystoscopy, robotic surgical, in-office procedures, UroLift & advanced therapies.
Neurology
EEG/EMG units, infusion therapy, MS specialty drug billing, telehealth coverage.
Oncology & Hematology
Drug-acquisition margin, infusion timing, OCM/EOM contracts, biosimilar substitution.
Pain Management
Injection bundling, modifier 50/RT/LT, PDMP compliance, Medicare LCD navigation.
Physical Therapy
8-minute rule, CQ/CO modifiers, plan of care recertification, MIPS reporting.
Optometry / Ophthalmology
Vision vs medical, refraction billing, post-op modifier 24, intravitreal injections.
Dental / Oral Surgery
Medical-to-dental cross-coding, sleep apnea appliance, sedation, OMS workflows.
Allergy & Immunology
95004 testing units, vial preparation 95165, immunotherapy administration coding.
Plastic / Reconstructive
Medical-necessity documentation, cosmetic carve-outs, breast reconstruction WHCRA.
Podiatry
Routine foot care exclusions, Q7/Q8/Q9 modifiers, diabetic care coverage rules.
Chiropractic
AT modifier discipline, active treatment vs maintenance, CMT level coding.
Ambulance / EMS
BLS/ALS levels, mileage capture, point-of-pickup rules, signature requirement.
ASC / Surgery Centers
Implant billing, multiple-procedure reduction, packaging vs separate, modifier 50.
Nephrology / Dialysis
MCP billing, ESRD bundled rate, home-dialysis training, transplant follow-up.
Infusion / Specialty
Drug acquisition margin, J-code precision, NDC mapping, prior-auth for biologics.
Wound Care
Hyperbaric oxygen, Q4-series skin substitute billing, debridement depth coding.
Telehealth / Virtual Care
POS-02/10, modifier 95/93, state licensure compliance, asynchronous billing.
Don’t see yours?
We’ve probably got a senior partner with 15 years in it. Ask.
Occupational Therapy
Timed-code units, KX/59 modifiers, therapy threshold tracking, plan-of-care compliance.
Speech & Audiology
Evaluation vs treatment coding, audiology CPT, early-intervention and school-based billing.
Pharmacy
NCPDP vs medical benefit, 340B split-billing, J-code precision, specialty drug prior auth.
Hospice
Hospice cap management, GIP/IRC distinctions, NOE timing, level-of-care revenue codes.
SNF / Skilled Nursing
PDPM coding, MDS validation, dual-eligible billing, Medicaid-pending workflows.
Multispecialty Groups
Cross-specialty rules engines, shared scrubbing, per-department denial analytics.
Want a senior partner who actually knows your specialty?
30 minutes. They walk your last 90 days of denials, through the specific lens of your specialty’s payer rules and audit risks.