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.
15 minutes. Custom financial scorecard for your practice.
At a glance
Is This Right for You?
This is for ENT practice owners who:
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.
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
Allergy Billing Compliance
- •Allergy testing CPT code selection accuracy
- •Immunotherapy billing documentation review
- •Serum preparation and administration coding
In-Office Procedure Revenue
- •Charge capture for in-office procedures
- •Pre-authorization verification for high-cost procedures
- •Facility vs non-facility reimbursement optimization
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
| Finding | Typical 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 restructuring | Department 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
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