Subject: Pulmonology billing quote - scope, fees, and 12 questions

We are a pulmonology practice comparing billing companies. Before a demo, please answer the items below in writing. Practice-level information is enough; please do not include identifiable patient or claim details.

ABOUT US
- State(s), locations, number of providers:
- EHR and practice management system:
- Main payers:
- Monthly collections (rough):
- Start date we want:

WHAT WE NEED COVERED
For each line, tell us: Included / Extra fee / We handle it / You don't do it.
- Office visits and pulmonary function tests (PFTs):
- Hospital and ICU professional claims, including critical care:
- Bronchoscopy, EBUS, and pleural procedures:
- Sleep studies, home sleep tests, and CPAP follow-up (if we provide them):
- Pulmonary rehab (if we run it):
- Lung cancer screening counseling (if we provide it):
- Home oxygen orders and supplier coordination; equipment billing only if we operate a supplier:
- In-office biologics and injections:
- Remote monitoring (if we provide it):
- Prior authorizations:
- Patient statements and patient calls:
- Unpaid claims from before the start date:
- Credentialing and payer enrollment:

YOUR FEE
1. Your percentage or other pricing.
2. Exactly which money the percentage applies to (all collections, insurance only, or only what you collect).
3. Your monthly minimum, if any.
4. Setup, software, clearinghouse, statement, and other monthly charges.
5. A sample monthly invoice at our collection amount.
6. Contract length, renewal, cancellation notice, and any exit charge.

12 QUESTIONS
1. For diagnostic bronchodilator-response testing, we do spirometry, give a bronchodilator, and repeat the test. What do you bill?
2. When can we report an office visit alongside PFTs?
3. We read PFTs done on hospital equipment. What goes on our claim?
4. A Medicare patient got 80 minutes of critical care. What do you bill?
5. Our physician and NP in the same group share a Medicare critical-care visit in a facility on the same day. Who bills, and how?
6. A Medicare patient is on pulmonary rehab session 37. What changes on the claim?
7. How do you check G0296 (the lung cancer screening counseling visit) and first-LDCT requirements?
8. We order home oxygen for a Medicare patient. What form, if any, do you send?
9. Please send a synthetic or de-identified sample monthly report split by service line: office, PFT, sleep, hospital.
10. How do you get our hospital and ICU charges each day?
11. Who handles prior authorization for sleep studies and biologics, and is it in your fee?
12. If Medicare rates drop in 2027 and our collections fall, does your minimum fall too?

Please also send your business associate agreement and tell us how we get our data back if we leave.

Thank you.