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The complexities of allergy immunotherapy billing

Allergy immunotherapy (aka allergy shots) is the recurrent administration of specific allergens to individuals with immunoglobulin E(IgE)-mediated condition. The goal is to reduce or stop the allergy by diminishing the strength of the IgE response. These treatments, being patient specific, can have serum mixed for up to one year of usage.

Put simply, Immunotherapy involves injection of the exact things to which you are allergic, named allergens. For example, if your skin test indicated that you are allergic to trees, small amounts of tree pollen extract will be utilized in your allergy vaccine.

Allergy testing and immunotherapy have had a significance in reestablishing and preserving balance in the patient’s biochemical system while dealing with a variety of medical emergencies. That’s why the field of immunotherapy has been demonstrating such an impressive growth. While this growth has no doubt improved medical practice volumes, it has not curtailed billing complexities that may have adversely affected reimbursements. This is where knowledgeable billing services can help a medical provider take command of their reimbursements and allow them to concentrate on their core medical practice.

As an example, the process may involve the desensitizing procedure in order to create a maintenance dosage of antigen for each patient. Once again, billing know-how is essential in determining if the insurance company will reimburse for the pre-mixed allergens or batch billing at the time of mixing. Billing for administering the antigens, either single or multiple shots, and desensitization also demand an understanding of this specialty.

At Medwave, we recognize the challenges and concerns in immunotherapy billing, including the disparities in the build-up and maintenance dosages.

One other concern: If a medical practice accepts Medicare, there is a totally distinct set of rules regulating serum billing and mistakes in the billing process can result not only in claims denials but end up with fines.

Why use Medwave as an allergy immunotherapy billing partner?

  1. Better claim processing
    Every insurance claim should be paid quickly and accurately in order to boost a medical office’s cash flow. Time is precious. By and large healthcare staff don’t have the luxury of assessing and following-up on each and every claim. Let’s face it, healthcare professionals and their support staff are often yanked in a variety of directions and wear many hats. Claims need to be presented as-soon-as-possible and accurately the first time. Otherwise, unpaid claims can instantly rob an office of resources that could be employed elsewhere. Loads of phone calls to insurance providers only squanders more time and increases internal resource frustration. By outsourcing your allergy testing billing, (typically) you save a bunch of money as you won’t have to invest in office infrastructure, medical billing software and the salaries of added staff.  Always keep in mind, qualified billing companies have a cost-effective way of getting claims accepted by insurance providers. Overall, the well-timed submission of claims boosts your revenue.
  2. Higher reimbursements
    By handing your complex billing processes over to qualified and experienced billing experts, healthcare providers achieve record numbers in reimbursement. Expert billing professionals remain up-to-date on today’s medical billing codes and are able to code claims more precisely. They review claims to make sure they are accurately coded and track them so they can be halted, before they ever have the chance to be denied. By attacking your denial rates and improving your clean claims, outsourcing your medical billing earns your practice quicker and higher reimbursements on average.
  3. Reduces staff errors
    Even the smallest blunder can make an insurance company refuse a medical claim. Obliging someone on your staff to fix the mistake, resubmit the request and wait for the corrected application to be accepted and administered can be very time-consuming. Working with a specialty firm such as Medwave vastly cuts down on staff blunders, given that they have more experience working in medical billing and have gone through lengthy training. Generally speaking, this support is superior to most in-house team(s) performance.
  4. Allow medical providers to focus on patient care
    Medical billing can be hectic from time to time and trigger a considerable amount of stress. Imagine if you or your medical staff are not the ones performing all the billing responsibilities—wouldn’t you be overjoyed? And on top of that, you and your staff can truly focus on taking care of your patients. Truth is, this is more helpful and advantageous to practices that are new or can’t afford to hire a medical staff to perform hectic billing tasks. Aside from that, hiring a firm like Medwave gives physicians much needed relief from performing time-consuming billing. Additionally, it makes good business sense to invest time and effort on your core competencies, such as patient care. It’s really quite easy — engage Medwave and let us be your billing staff. You won’t have to be concerned about taxes, vacation/sick leave, payroll or personnel management if you work with us. Even if you decide to keep some (or all) of your existing billing staff, but redistribute their responsibilities, you can be assured in seeing your billing is being managed professionally and being dealt with each day.
  5. Transparency
    Others in the medical industry think that outsourcing your billing represents you giving up control and the power of your practice, but this is completely untrue. When you outsource your billing to Medwave, you really gain greater control as well as transparency. You will be able to review your performance data or examine the process at any time of your choosing. This gives you up-to-the-minute assessments of how your practice’s billing is being handled, at any point.


Whether or not your practice should outsource billing services is a question that quite a few medical practices before you have asked. Some say, under your own nose is where medical billing should reside, but that’s not automatically the case. Many medical providers manage their billing processes in-house only to have denials slip through their fingers, payments going unpaid, and an ever more annoying administrative responsibility facing them.

Our certified team is on hand to deliver total management of immunotherapy medical billing, from claims submissions to payment posting to coding with steadfast support along your entire path.

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