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Specialized Clinical Revenue Architecture

Sub-Specialty Medical Billing & Coding
Across 16+ Clinical Disciplines

Generic billing protocols miss up to 14.8% of collectible revenue. MiraiCure deploys dedicated, specialty-credentialed RCM pods trained in your specific clinical documentation nuances, payer coverage policies, and regional fee schedules.

Request a Specialty Audit Explore Clinical Disciplines
HIPAA Compliant · 100% Encrypted EHR Remote Access · Dedicated Pod Leads
16+ Clinical Disciplines
150+ Certified RCM Professionals
96.5% First-Pass Clean Claim Rate
30-45 Days Average Days in A/R
Specialty Matrix

Tailored Revenue Architecture for Every Clinical Setting

Filter our specialty portfolio to view our clinical coding protocols, modifier mastery, and payer scrub engines customized for your specific medical setting.

UB-04 / PDPM

Skilled Nursing Facilities (SNF / PDPM)

Focus: Patient-Driven Payment Model (PDPM) scoring accuracy and MDS schedule alignment.
Impact: Eliminates nursing category down-coding and ensures 100% compliant UB-04 institutional claims.
Audit SNF Billing →
MEDICAID / LTC

Long-Term Care (LTC) & Medicaid

Focus: Medicaid room & board reconciliation, patient liability offsets, and state bed-hold tracking.
Impact: Accelerates slow-paying state Medicaid cycles and closes recurring month-end balance gaps.
Audit LTC Billing →
MS-DRG / APR-DRG

Inpatient Acute Hospitals

Focus: MS-DRG and APR-DRG chart validation, observation-to-inpatient status compliance, and chargemaster audits.
Impact: Eliminates post-discharge clinical denial clawbacks and protects high-acuity facility margins.
Audit Inpatient RCM →
CMS RAC APPEALS

Inpatient Denial Rescue & Audit Defense

Focus: Overturning medical necessity denials, ADR responses, and CMS/RAC audit appeals.
Impact: Systematic multi-level appeal packages recovering zero-balance write-offs.
Audit Denial Defense →
E/M + ADD-ON 90833

Psychiatry & Clinical Psychology

Focus: Precise evaluation & management (E/M) pairing with time-based psychotherapy add-on codes.
Impact: Audited documentation review preventing bundling rejections and payer under-coding audits.
Audit Psychiatry Billing →
ASAM / PER-DIEM

Substance Use Disorder (SUD) & Addiction Recovery

Focus: Bundled daily billing for Residential Treatment, Partial Hospitalization (PHP), and Intensive Outpatient (IOP).
Impact: Minimizes per-diem payment delays and closes length-of-stay authorization drop-offs.
Audit Addiction RCM →
MHPAEA DEFENSE

Mental Health Parity Act Defense

Focus: Challenging arbitrary payer caps and discriminatory Non-Quantitative Treatment Limitations (NQTLs).
Impact: Proven administrative appeal pathways forcing commercial payer compliance.
Audit Parity Claims →
CONCURRENT UR

Utilization Review & Prior Authorization

Focus: Dedicated pre-service authorization pods managing concurrent review cycles.
Impact: Near-zero retroactive authorization denials and continuous coverage security.
Audit UR Workflows →
ASC IMPLANT CARVE-OUT

Ambulatory Surgery Centers (ASC)

Focus: Dual facility and professional billing, high-cost surgical implant invoice tracking, and carve-out recapture.
Impact: Recovers unbilled hardware costs and defends against incorrect commercial payer bundling.
Audit ASC Billing →
MODIFIER 26 / TC

Cardiology & Interventional Cath Lab

Focus: Professional vs. technical component (26/TC) splits for diagnostics, echocardiography, and stent interventions.
Impact: Accurate reimbursement across both practice and diagnostic testing facility sites.
Audit Cardiology RCM →
GLOBAL SURGICAL 90D

Orthopedics & Spine Surgery

Focus: 90-day global surgery period modifier compliance, spinal instrumentation add-ons, and fracture care.
Impact: Prevents routine post-op visit denials and captures all billable surgical hardware adjuncts.
Audit Orthopedic Billing →
MODIFIER PT / 33

Gastroenterology & Endoscopy

Focus: Screening-turned-diagnostic colonoscopy conversions (PT/33 modifiers) and multiple polypectomy rules.
Impact: Compliant patient copay waiver application and maximum allowable procedure capture.
Audit GI Billing →
HCPCS E-CODES / CMN

DME & HME Specialized Providers

Focus: Certificate of Medical Necessity (CMN) verification, Detailed Written Orders (DWO), and capped rentals.
Impact: Automated lifecycle tracking across all 4 Medicare DME MAC jurisdictions.
Audit DME Billing →
CMS 8-MIN RULE / KX

Physical & Occupational Therapy

Focus: Strict CMS 8-minute rule calculations, KX modifier threshold monitoring, and plan-of-care recertifications.
Impact: Zero cap-limit payment interruptions and audit-proof therapy documentation.
Audit Therapy RCM →
MDM LEVELING / CCM

Internal Medicine & Family Practice

Focus: Medical Decision Making (MDM) E/M leveling, Chronic Care Management (CCM), and Transitional Care (TCM).
Impact: Maximizes preventative revenue streams while shielding clinics from over-coding audits.
Audit Internal Med →
POS 20 / S-CODES

Urgent Care & Walk-In Clinics

Focus: Rapid 12-hour charge turnaround, episodic minor procedure bundling, and global S-code contract billing.
Impact: Immediate cash velocity for high-volume walk-in patient rosters.
Audit Urgent Care →
EXPANDED CLINICAL NETWORK

Additional Active Coverage Units

MiraiCure also deploys dedicated billing pods for Dermatology & Mohs, Ophthalmology & Retina, Neurology Telemetry, and Pathology Networks.

Inquire About Your Specialty →
AAPC & AHIMA Standards

The Clinical Integrity Framework

Medical sub-specialties lose an average of 14.8% in collectible revenue annually due to mismatched modifiers, bundling assumptions, and outdated fee schedules. MiraiCure eliminates revenue leakage at the source.

Pre-Submission NCCI & Modifier Rules

Every claim runs through 1,500+ National Correct Coding Initiative (NCCI) edit tables to validate Modifiers 25, 59, and anatomical splits before file creation.

Clinical Denial Overturn Capability (92.6% Win Rate)

When complex claims are denied, our appeals specialists draft clinical dispute briefs citing local coverage determinations (LCD), national coverage determinations (NCD), and statutory CMS guidelines.

Zero-Migration EHR Integration

We work directly inside your existing software (Epic, Cerner, AthenaHealth, PointClickCare, eClinicalWorks, NextGen, Kareo, AdvancedMD, etc.) via encrypted, HIPAA-compliant remote protocols.

Complimentary Clinical RCM Audit

Request an In-Depth Specialty Billing Analysis

Identify uncollected revenue, modifier errors, and coding gaps. 100% confidential. Delivered within 48 hours.

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Pre-Clearinghouse NCCI Audit: Comprehensive chart scrub across 1,500+ edit tables to uncover missing modifiers and unbilled add-on codes.
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Denial Pattern Diagnostics: Root-cause analysis of your top CARC/RARC denial reason codes and aging accounts receivable backlog.
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Zero Software Changes: Completely non-disruptive review conducted via encrypted remote access inside your existing EHR/PM system.

Request an In-Depth Specialty Billing Analysis

Identify uncollected revenue, modifier errors, and coding gaps. 100% confidential. Delivered within 48 hours.

100% Confidential · Governed by HIPAA Business Associate Agreement (BAA) · No Software Changes Required