ENT Revenue Cycle

Multi-procedure sinus surgery. Are you billing all of it?

Multi-procedure sinus cases billed as singles, allergy immunotherapy missing serum codes, and audiology revenue that gets written off because nobody checked insurance. A free 15-minute assessment is usually enough to see which is your bleeder.

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15 minutes. Custom financial scorecard for your practice.

At a glance

Starts withFree 15-minute assessment
FormatEducational diagnostic, no cost
You getA scorecard of your top revenue leaks and where to focus
Next step/free-assessment

Is This Right for You?

This is for ENT practice owners who:

Sinus surgery coding is complex and your biller is not an ENT specialist. You suspect under-coding on multi-procedure cases
Allergy testing billing has specific documentation requirements that your nurses are not consistently meeting
In-office procedure reimbursement varies wildly by payer and you have no system to pre-verify what each case will pay
Hearing aid evaluations have both a medical and a retail component and the billing is often confused
Bilateral procedure modifiers are being applied inconsistently on sinus and ear surgeries

Want ongoing financial oversight? Our Fractional CFO service for ENT practices may be a better fit.

What We Analyze

Where ENT Practices Lose Revenue

We trace every dollar from claim submission to bank deposit in your ENT practice.

01

Surgical Coding Accuracy

  • Sinus surgery coding review (multiple procedure rules, bilateral modifiers)
  • Balloon sinuplasty billing and documentation audit
  • Tonsillectomy and adenoidectomy coding verification
  • Complex ear surgery modifier usage
02

Allergy Billing Compliance

  • Allergy testing CPT code selection accuracy
  • Immunotherapy billing documentation review
  • Serum preparation and administration coding
03

In-Office Procedure Revenue

  • Charge capture for in-office procedures
  • Pre-authorization verification for high-cost procedures
  • Facility vs non-facility reimbursement optimization
04

Audiology & Hearing Aid Billing

  • Medical vs retail hearing aid billing separation
  • Audiometric testing charge capture
  • Insurance coverage verification for hearing aids
  • ABN documentation for non-covered services

Results

What ENT Practices Recover

FindingTypical Outcome
Surgical coding corrections$131,000 in recovered revenue annually
Allergy program expansion$83,000 in additional annual revenue from adding one allergy nurse
Audiology restructuringDepartment moved from -$82K to +$34K through staffing adjustment and hearing aid pricing strategy

Case Study

Real results from a practice like yours

4-physician ENT group with audiology department, allergy clinic, and in-office procedure capability. Revenue was $5.1M but margins had declined from 28% to 19% over three years. The partners blamed declining reimbursements but had not analyzed where margin was actually being lost.

What we found:

  • The audiology department was losing $82K per year when fully loaded costs (audiologist salary, equipment, space, support staff) were properly allocated. Hearing aid margins had compressed from 45% to 18% due to OTC competition
  • Sinus surgery cases were being under-coded. 34% of multi-procedure cases were billed as single-procedure, losing an estimated $131K annually
  • The allergy program was the practice's most profitable service line at 64% margin but was being understaffed and turning away 8 to 10 patients per week
  • In-office balloon sinuplasty was billed at non-facility rates only 60% of the time. The remaining 40% were incorrectly coded at lower facility rates, losing $47K per year

The results

$131,000 in recovered revenue annually

Surgical coding corrections

$83,000 in additional annual revenue from adding one allergy nurse

Allergy program expansion

Department moved from -$82K to +$34K through staffing adjustment and hearing aid pricing strategy

Audiology restructuring

Our most profitable service was understaffed and our least profitable was overstaffed. We had the data all along — we just were not looking at it the right way.

Managing Partner, Southeast

Common Questions About Revenue Cycle Analysis for ENT Practices

Find out where your ENT practice revenue goes.

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