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SPECIALTY BILLING EXCELLENCE

RCM Built for the Specialties Where Generic Billing Fails

Generic billing companies handle your claims the same way they handle every other practice. Our certified coders live inside your specialty, understanding the CPT nuances, payer behaviors, and documentation requirements that determine whether you get paid.

Find Your Specialty →
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HIPAA CERTIFIED

HBMA MEMBER

 SOC2 AUDIT UNDERWAY (EXPECTED Q3 2024)

90+ AAPC-CERTIFIED CODERS

  • HIPAA CERTIFIED BROKERAGE
  • PROUD MEMBER OF HBMA
  • SOC2 TYPE II AUDIT (Q3 2024)
  • 90+ AAPC-CERTIFIED CODERS

CRITICAL GAPS EXPLAINED

Generic RCM Breaks Down Exactly Where Your Revenue Is Most at Risk

A generalist billing company can submit a claim. What they can’t do is recognize that your orthopedic surgeon performed a bilateral procedure requiring payer-specific modifier selection, or that the add-on CPT code your pain management provider just performed wasn’t covered under the original prior authorization. That gap — between claim submission and claim accuracy — is where revenue disappears.

Specialty billing isn’t a niche skill. It’s a different discipline entirely.

✕

GENERIC RCM

Generalist coders across all specialties
Modifier errors on complex procedures
Prior auth gaps on add-on CPT codes
Denial management after the fact
No documentation review capability

CLIENTELE RCM

Certified coders per specialty (5-12 yrs exp)

Modifier review before every submission

Auth-tracking embedded in workflow

Denial prevention as a feedback loop

Specialty-configured workflow per practice

SPECIALIZED DIRECTORIES

Find Your Specialty

Each specialty below has its own billing complexity. Click through to see exactly how Clientele RCM handles yours.

Orthopedics

SURGICAL & MUSCULOSKELETAL PRACTICES

Specialty RCM centered on critical bone alignment
modifiers, surgical margins, and strict pre-authorization
parameters.

KEY BILLING CHALLENGES:

• Global period modifier errors (-24, -25, -57, -78)

• Bilateral procedure coding (-50 vs -RT/-LT by payer)

• Prior authorization failures on expanded surgical scope

Explore Orthopedic RCM →

Pain Management

INTERVENTIONAL & CHRONIC PAIN PRACTICES

Specialty RCM built to reconcile drug screening, sedation, fluoroscopy guidance, and complex block codes clearly.

KEY BILLING CHALLENGES:

• Add-on CPT codes billed without updated prior authorization

• Bundling denials for procedure combinations in same session

• Fluoroscopy guidance coding disputes (77002/77003)

Explore Pain Management RCM →

Anesthesia

ANESTHESIOLOGISTS & CRNA GROUPS

Direct crosswalk integrations, dedicated supervision modifiers, and exact minute-to-unit calculations.

KEY BILLING CHALLENGES:

• CRNA modifier mismatch with documented supervision model (AA, QX, QY, QZ) • Time-unit calculation errors (15 min = 1 unit) • ASA crosswalk inaccuracies causing systematic underpayment
Explore Anesthesia Billing →

Comprehensive Therapy

PT / OT / ST SPECIALTY RCM

Compliant Medicare 8-minute calculations, cap-tracking modifiers, and accurate RPM/RTM billing capabilities.

KEY BILLING CHALLENGES:

• 8-minute rule compliance for Medicare timed services
• KX modifier omissions triggering therapy-cap denials
• RTM billing alongside traditional therapy — most billers can’t do both
Explore Therapy Billing →

Chiropractic & Rehabilitation

CHIROPRACTIC & REHAB HUB

Active spinal codes management, maintenance thresholds audits, and ABN forms validation workflows.

KEY BILLING CHALLENGES:

• Maintenance vs. active-care billing distinctions
• Medicare frequency limits and AT-workflow management
• Spinal manipulation code selection and modifier accuracy
Explore Chiropractic & Rehab RCM →

ADDITIONAL SUPPORT

Have specialties not represented on our diagnostic menu list?
Inquire With Our Coders →

Multi-Specialty Practices

When your practice spans two or more specialties, billing complexity multiplies. We manage it all under one engagement.

WHAT THIS COVERS:

Practices billing across orthopedics + pain management; therapy + RPM/RTM;
anesthesia + surgical specialties, or any combination requiring simultaneous management of different payer rule sets, auth workflows, and coding standards.

Talk to Us About Your Multi-Specialty Practice

HUMAN-GUIDED AUTOMATION ENGINE

The Team Behind the Specialty Knowledge

Every specialty sub-page on this site references AAPC-certified coders. That’s not a marketing claim — it’s a hiring requirement. Every coder and biller on our team holds AAPC certification, with a minimum of five years of specialty-specific experience. No generalist staffing. No training wheels.
“When a Pain Management claim requires a real-time judgment call on whether a 64415 add-on is covered under an existing auth, you need someone who has seen that scenario hundreds of times — not someone reading the payer policy for the first time.”

TEAM ACCOUNTABILITY CAPABILITIES:

90+ RCM professionals acting as an extension of your own internal staff of administrators.

Dedicated, continuous supervisor tracking in Newark, CT and Bangalore Delivery Centers.

Human-Guided Automation pairing Clientele AI checks with 100% certified clinical coders.

30+

AAPC-CERTIFIED CODERS

Multi-specialty active certification credentials verified quarterly.

5-12 Years

SPECIALTY EXPERIENCE

Minimum verified specialized CPT billing experience per staff coder assigned.

99%

CLEAN-CLAIM RATE

Represents average portfolio submittal accuracy vs. industry average 65-80%.

PERFORMANCE BENCHMARKS

Where Generic Billing Costs You The Most

Denial rates vary significantly by specialty. The more complex the coding, the wider the gap between an average biller and a specialty-certified one.

Orthopedics

Industry: 18% | Clientele: 10%

Pain Management

Industry: 22% | Clientele: 10%

Anesthesia

Industry: 20% | Clientele: 10%

Comprehensive Therapy (PT / OT / ST)

Industry: 16% | Clientele: 10%

Chiropractic & Rehabilitation

Industry: 15% | Clientele: 10%
📍 Industry average denial rate: 15-22%. Clientele RCM is 92% today, targeting <1% post-Clientele AI automation — compared to 15-22% across specialty categories.
Industry benchmarks based on CMS and MGMA published data. Clientele figures based on current portfolio performance.

EHR COMPATIBILITY

Integrated with the Systems Your Specialty Already Uses

No rip-and-replace. Clientele RCM connects directly with 11 leading EHR and practice
management platforms — across all specialties we serve.

eClinicalWorks

Meditech

Medisoft

Allscripts-Veradigm

Practice Fusion

Office Ally

AdvancedMD

Cerner

GE Centricity

ModMed

ChartPerfect

+

Don’t see your EHR? We’ve likely worked with it. Ask us.

CLIENT VALIDATION

From the Specialties We Serve

Verified clinical administrators describe standard performance differences post-transition.

★★★★★

“Before Clientele, global period billing disputes were eating into our surgical revenue every quarter. Their coders flagged the modifier issues within the first audit and the difference showed up in our collections within 60 days.”

REVENUE CYCLE MANAGER — MULTI-SPECIALTY ORTHOPEDIC CLINIC

MICHIGAN

★★★★★

“The add-on CPT authorization problem was costing us more than we realized. Clientele embedded an auth-tracking step that caught three unbilled procedures in the first week alone.”

BILLING DIRECTOR — MULTI-LOCATION PAIN MANAGEMENT PRACTICE

FLORIDA

★★★★★

“Managing RTM billing alongside our traditional therapy codes was something our previous biller refused to touch. Clientele handles both without any gap in compliance documentation.”

DIRECTOR OF REHABILITATION SERVICES — MULTI-SPECIALTY PRACTICE

NEW JERSEY
ALL THREE REPRESENT AGGREGATE PORTFOLIO CASE STUDY EVALUATIONS.

Your Specialty Deserves a Billing
Partner Who Knows It

No contracts that favor the vendor. No reporting that obscures the truth. Just a team that shows up, delivers, and proves it with numbers.

Find Your Specialty