Unit count rejections
Tests denied for units not matching the record. We reconcile units against the antigen list.
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Allergy & Immunology medical billing services
Allergy practices bill testing, immunotherapy and a steady stream of injections under rules that trip up generalist billers: unit counts for tests, antigen preparation versus administration, and the 95165 dosing rules that payers interpret differently.
What makes allergy & immunology billing different
General billers treat every specialty the same. These are the rules, code families and payer habits that decide whether allergy & immunology claims pay the first time.
- Allergy testing codes (95004, 95024, 95027) are billed per test, and the unit count must match the documented number of antigens.
- Immunotherapy preparation (95165) is billed in doses, with Medicare and commercial payers defining a dose differently.
- Injection administration (95115, 95117) is separate from antigen preparation and billed per visit, not per injection count beyond the two-tier split.
- Biologics for asthma and urticaria require prior authorization, buy-and-bill or specialty pharmacy decisions and J-code accuracy.
Denials we see most in allergy & immunology
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
95165 dosing disputes
Preparation denied or reduced for exceeding the payer's dose definition. We apply Medicare and commercial definitions correctly.
Biologic authorization gaps
Biologic claims denied for missing authorization or wrong J-code. We manage authorizations and verify J-codes and units.
How Core MB bills for allergy & immunology
A dedicated team that already knows your payers' rules, plus the reporting to prove it is working. Credentialing for new allergy & immunology providers runs in the same system, tracked live in your client portal.
- Unit reconciliation on every testing claim.
- Payer-specific 95165 dose rules applied at the scrubber.
- Prior authorization and buy-and-bill support for biologics.
Everything in the service
The full revenue cycle as standard for allergy & immunology practices, priced on what we collect for you. Take all of it, or start with one piece such as AR recovery or credentialing.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Allergy & Immunology billing questions
Why are allergy testing claims denied?
Almost always unit counts: the number of tests billed must match the antigens documented. We reconcile before the claim is sent.
How is immunotherapy preparation billed?
In doses under 95165, and the definition of a dose differs between Medicare and commercial payers. Billing the wrong definition causes reductions.
Do you handle biologic injections?
Yes, including prior authorizations, J-code and unit verification and the buy-and-bill process where the practice supplies the drug.
How do we get started with Core MB for allergy & immunology billing?
Send us your specialty, provider count and monthly claim volume through the quote form and we will come back with a written proposal. Transitions run alongside your current billing so nothing is dropped, and credentialing for new allergy & immunology providers can start at the same time.
Find out what your allergy & immunology billing is leaving on the table
Send us a snapshot of your current billing and we will come back with a quote and a realistic view of recoverable revenue.