Built for y|
Built for y
We know the payors, denial patterns, and collections complexity that define your world.
Explore specialties
Denial patterns differ by specialty. See how Amperos handles the unique insurance recovery challenges your RCM team faces.
Orthopedics
Key pain points
- Workers' comp payor complexity
- Surgical prior auth requirements
- Multi-procedure bundling rules
- Global period and split-care billing
Top denials resolved
- Medical necessity
- Prior authorization
- Bundling edits and modifier errors
DME / HME
Key pain points
- CMN documentation and renewals
- Rental vs. purchase reimbursement
- HCPCS coding specificity
- Payer-specific LCD requirements
Top denials resolved
- Invalid or expired CMN
- Medical necessity
- Prior authorization
Cardiology
Key pain points
- Diagnostic testing prior authorization
- TC / 26 component billing
- Cath lab documentation requirements
- E/M downcoding on complex visits
Top denials resolved
- Prior authorization
- Medical necessity
- Downcoding and modifier errors
Behavioral health
Key pain points
- Session authorization requirements
- Telehealth modifier and POS errors
- Session limit and frequency denials
- Carve-out plan billing complexity
Top denials resolved
- Authorization
- Insufficient documentation
- Coordination of benefits
Ophthalmology
Key pain points
- Medical vs. vision benefit routing
- Drug injection and ASC billing
- Diagnostic frequency limitations
- Exam level downcoding (MA plans)
Top denials resolved
- Benefit routing / wrong plan billed
- Prior authorization (retinal and IOL)
- Downcoding and E/M level reductions
Anesthesiology
Key pain points
- Time unit calculation rules
- Medical direction documentation
- Contracted rate discrepancies
- Concurrency and supervision denials
Top denials resolved
- Modifier errors
- Timely filing
- Underpayments
Dermatology
Key pain points
- Cosmetic vs. medical classification
- Mohs and pathology billing
- Biologic prior authorization requirements
- E/M leveling and Modifier 25 scrutiny
Top denials resolved
- Medical necessity
- Prior authorization for biologics
- Downcoding and global period violations
Urology
Key pain points
- Advanced diagnostic prior authorization
- Buy-and-bill drug administration
- In-office vs. ASC billing differences
- J-code and NDC coding specificity
Top denials resolved
- Medical necessity
- Prior authorization
- J-code / NDC mismatches
Dental
Key pain points
- Medical-dental crossover routing
- Aging claim follow-up
- Sleep apnea and TMJ classification
- CDT-to-CPT crosswalk errors
Top denials resolved
- Wrong benefit plan (dental vs. medical)
- Coordination of benefits
- Medical necessity (oral surgery)
Oncology
Key pain points
- Buy-and-bill drug claim denials
- Formulary and step therapy denials
- Off-label regimen justification
- Multi-cycle treatment billing errors
Top denials resolved
- Prior authorization (drug-specific)
- Medical necessity (treatment protocols)
- J-code / NDC mismatches
"Boulder Care is expanding rapidly to reach more patients who are in critical need. The reality is that we need to adapt our operations for scale in the modern age."
MitziYue
SVP of Finance, Boulder Care