Endocrinology Medical Billing & Credentialing Services

Optimized RCM for Hormone Specialists, Diabetes Clinics, and Endocrine Practices

Endocrinology billing is uniquely complex, involving chronic disease management, frequent lab integrations, long-term treatment plans, and evolving payer rules for diabetes, thyroid disorders, metabolic conditions, and hormonal therapies. With Oakview Medical Billing Solutions, you get a partner who understands the nuances of endocrine care and transforms your claims into clean, reimbursable submissions.

We offer full-spectrum revenue cycle management (RCM) and credentialing services tailored for endocrinologists, hormone therapy clinics, diabetic educators, and metabolic specialists—so you can focus on patient care while we ensure your cash flow remains uninterrupted.

Key Billing Challenges in Endocrinology

Endocrinology providers face several unique challenges:

• Complex E/M Coding for Chronic Care: Many patients require ongoing evaluation, which means navigating 99213–99215 codes with chronic care modifiers and time-based documentation.

• High-Volume Lab Testing: Endocrinologists frequently order and interpret tests (e.g., thyroid panels, A1C, cortisol levels), requiring accurate modifier use (e.g., 25, 59) and integration of lab billing workflows.

• Insulin Pump Management & Device Coding: Device-related services, such as insulin pump programming (code 95250/95251), must be billed with strict adherence to payer rules and proof of medical necessity.

• Hormonal Therapy & Injections: Proper coding for testosterone, thyroid hormone replacement, and adrenal support includes J-codes and related supervision requirements.

• Telehealth Management for Chronic Conditions: Requires knowledge of POS 10, Modifier 95, and care continuity documentation for remote endocrine follow-ups.

Endocrinology Credentialing Services

We help endocrinology providers get in-network and stay compliant with:

• Medicare / Medicaid Enrollment

• Commercial Panels (Aetna, BCBS, UHC, Cigna, Humana)

• Endocrine-Focused Insurance Panels

• Telehealth Platform Paneling

• Hospital & ASC Privileging

• CAQH Profile Setup

• NPI Registration (Individual & Group)

• Revalidation & Re-credentialing

Our credentialing team ensures you're listed with the correct specialty taxonomy (e.g., 207RE0101X for Endocrinology, Diabetes & Metabolism) and that all your contracts reflect your scope of services.

CPT Codes in Endocrinology Billing

Our Endocrinology RCM Services Include:

• Charge Entry & Coding Review

• Endocrine-Specific Claim Scrubbing

• Device & Injectable Code Auditing

• Real-Time Eligibility Verification

• Telehealth Coding Compliance

• ERA & EOB Payment Posting

• Appeals for Hormonal Therapy Denials

• Patient Statements & Collection Support

• Monthly Reporting & Financial Forecasts

Why Endocrinologists Choose Oakview

✔ Deep experience in endocrinology-specific billing workflows
✔ Proven success in securing hard-to-access payer contracts
✔ Personalized account management with transparent reporting
✔ Clean claim rate over 98% and first-pass resolution rate >92%
✔ Full compliance with HIPAA, CMS, and endocrine payer policies
✔ No long-term contracts — we earn your trust month-to-month

Ready to Level Up Your Endocrinology Billing?

At Oakview, we understand how critical it is for endocrinologists to get paid correctly and on time for complex, often chronic care. Let our RCM and credentialing team streamline your operations and help you scale faster—with fewer denials and faster reimbursements.