Nephrology
Healthcare IT and billing built for a nephrology practice
Dialysis MCP billing, CKD staging and multi-site rounding workflows for nephrology practices.
Why nephrology is different
Nephrology billing centers on the monthly capitation payment for dialysis patients, where reimbursement depends on documented face-to-face visit counts within the month and on patient age and modality.
Healthcare SBC tracks visits across every dialysis facility, applies the correct MCP tier, and supports CKD staging, vascular access tracking and transplant coordination alongside office-based care.
Common challenges
Where nephrology practices lose revenue
The billing and workflow problems specific to this specialty, and the ones generic systems handle badly.
MCP visit count tracking
Monthly capitation tiers depend on documented face-to-face visits, which are easy to lose across multiple facilities.
Multi-facility rounding
Nephrologists round across several dialysis centers and hospitals, fragmenting documentation and charge capture.
CKD staging documentation
Accurate staging drives both clinical management and risk-adjustment revenue.
Vascular access management
Access placement, maturation and complications require longitudinal tracking across providers.
How we address it
Built for nephrology workflows
- Dialysis rounding with automatic MCP visit counting and tier assignment
- Mobile charge capture across facilities and hospitals
- CKD staging with eGFR trending and progression alerts
- Vascular access tracking from placement through surveillance
- Transplant referral and evaluation coordination workflows
Commonly billed codes in nephrology
A sample of the codes our nephrology coders work with daily.
- 90960ESRD services, 4 or more visits per month, age 20+
- 90961ESRD services, 2-3 visits per month, age 20+
- 90962ESRD services, 1 visit per month, age 20+
- 90935Hemodialysis, single evaluation
- 99214Established patient office visit, moderate complexity
Codes shown for reference only. Verify against current code sets and payer policy.
Other medical specialties
Cardiology
Procedural and diagnostic billing precision for cardiology, from office E/M through cath lab and device monitoring.
Dermatology
High-volume visit throughput, lesion documentation and pathology tracking for medical and cosmetic dermatology.
Obstetrics & Gynecology
Global obstetric packages, prenatal tracking and gynecologic procedure billing on one platform.
FAQ
Nephrology, frequently asked questions questions
- How is monthly capitation payment billed?
- The platform counts documented face-to-face dialysis visits within each calendar month per patient and assigns the correct MCP code tier by visit count, age and modality, preventing the downcoding that occurs when visits at different facilities aren't consolidated.
- Can nephrologists chart while rounding?
- Yes. Mobile rounding lists by facility let physicians document and capture charges at the chairside, so nothing depends on reconstructing the day's visits later.
- Do you support CKD risk-adjustment coding?
- Yes. CKD staging is documented with supporting eGFR data and reviewed by risk-adjustment coders to ensure accurate annual recapture under value-based and Medicare Advantage contracts.
We're here to help
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