Northgate bills and credentials private practices across specialties. The nine below have their own billing playbook and page; the rest run on the same model. What changes by specialty is the denial pattern, the payer rules and the credentialing path. What never changes: a named account lead, every claim visible, pricing on the website.
Not sure if we cover you? Use the form at the bottom. We answer within one business day.
What is different about billing each specialty, and the denial to watch for. Each full page covers codes, modifiers, payer rules, credentialing and pricing.
Therapy billing lives on time-based codes, telehealth modifiers and closed payer panels. Credentialing is among the slowest of any specialty because panels for LCSW, LPC and LMFT fill up. We prioritize the payers that are still open.
High visit volume, low claim value, and Medicare covering only spinal manipulation. The AT modifier and medical necessity documentation decide whether you get paid.
Prior authorization, proof of delivery, physician orders and rental cycles on every claim. More paperwork per dollar collected than most specialties, which is why DME carries a complexity factor on our pricing.
Dental and medical cross-coding for procedures that medical insurance covers, coordination of benefits between dental and medical plans, and frequency limits by payer.
Routine foot care exclusions, class findings, and Q modifiers decide coverage. Diabetic foot care and nail debridement are where documentation gets tested.
Time units plus base units, physical status modifiers, and medical direction rules for CRNAs. One wrong start time changes the whole claim.
8-minute rule, timed and untimed codes, the KX modifier past the threshold, and plan-of-care certifications that lapse. Visit caps by payer need tracking from day one.
OASIS, face-to-face documentation, 30-day payment periods under PDGM, and a notice of admission due within five days of the start of care. Timing errors cost whole periods.
Medical necessity for the transport, level of service, mileage, origin and destination modifiers, and PCS forms for repetitive patients. Documentation from the crew decides the claim.
Same model, same pricing. Want to know what we see in yours? Ask on the form below.
Specialty-specific systems included: SimplePractice and TherapyNotes for mental health, ChiroTouch for chiropractic, Brightree for DME, Dentrix and Open Dental for dental, WebPT for physical therapy, Axxess and Kinnser for home health, ESO and ImageTrend for EMS.
AdvancedMD
athenahealth
DrChrono
SimplePractice
TherapyNotes
ChiroTouch
Brightree
Dentrix
WebPT
Axxess
ESOTell us what you do and what you bill with, and a billing lead will reply within one business day with whether we cover it and what we see in it.
Nine with their own billing playbook and page: mental health, chiropractic, DME and HME, dental, podiatry, anesthesia, physical therapy, home health, and EMS and ambulance. Most other outpatient specialties are billed on the same model and pricing. The full list is on this page.
The brackets are the same for every specialty. DME and HME, EMS and ambulance, and home health carry a complexity factor because they generate many low-value claims per dollar collected. It is shown on the pricing page and in your agreement before you sign.
Yes, for every specialty. Out-of-network billing follows the same submission and appeal process with the patient's benefits verified before the visit.
Yes. Credentialing is a flat fee per provider, and the specialty page tells you which payers are typically open or closed for your specialty. Mental health is the slowest; most others follow the standard payer timelines. See our insurance credentialing services.
Use the form above. We reply within one business day with a yes or a no, and if it is a no we will say why.
Last updated 12 October 2026. Reviewed by Name, title pending, Northgate Billing.
The free audit is benchmarked to your specialty. Ten questions and one report, a written answer in 3 business days.
