Neurology Billing Services in Utah

Utah's neurology practices face unique billing challenges shaped by SelectHealth (Intermountain)'s commercial rules, Utah Medicaid requirements, and Noridian Medicare policies. Our AAPC-certified coders specialize in both UT payer rules and neurology coding complexity.

AAPC Certified
UT Payer Expert
Neurology Specialists
2.49% Rate
8,000+UT Physicians
2.49%Starting Rate
3Medicaid MCOs
98%+Clean Claim Rate

Why Utah Neurology Practices Need Specialized Billing

Utah's healthcare market includes 8,000+ physicians, and neurology practices here face a payer market dominated by SelectHealth (Intermountain) on the commercial side and Utah Medicaid on the public payer side. Medicare claims are processed through Noridian, which applies its own Local Coverage Determinations that directly affect neurology procedure coverage and medical necessity requirements. Generic billing teams without UT specific knowledge leave revenue on the table.

Neurology billing itself is complex. Neurology diagnostic testing codes have professional and technical components, time-based elements, and study-specific documentation requirements. EMG/NCS (95907-95913, 95885-95886) requires documenting specific nerves tested. EEG (95816-95822) has awake, sleep, and long-term monitoring variants. When you combine this coding complexity with Utah's specific payer rules, authorization requirements, and 3 Utah Medicaid managed care plans that each have their own billing rules, you need a team that understands both dimensions. Go Medical Billing provides that expertise at 2.49% of collections, serving neurology practices from Salt Lake City to St. George and across Utah.

Top CPT Codes for Neurology in Utah

Our UT coders handle these neurology codes daily, applying Noridian Medicare rules and SelectHealth (Intermountain) commercial policies to each claim.

Code
Description
95816
EEG
95907
NCS
95886
EMG
96365
Infusion

Utah Payer Challenges for Neurology

Every UT payer has specific rules for neurology claims. Here's how we navigate them.

SelectHealth (Intermountain) Neurology Claims

SelectHealth (Intermountain) processes the largest share of Utah commercial neurology claims. We know their UT specific fee schedules, prior authorization requirements for neurology procedures, and their appeal timelines when claims are denied. Nerve conduction and needle EMG have separate code families that must be coordinated.

Utah Medicaid Neurology Billing

Utah Medicaid routes neurology patients through 3 managed care plans: Healthy U, Molina, SelectHealth Community Care. Each MCO has its own neurology authorization and billing rules that we manage.

Medicare (Noridian) Neurology Coverage

Noridian processes Medicare neurology claims in Utah with its own Local Coverage Determinations. We navigate Noridian's policies around eeg variant selection to prevent medical necessity denials.

Denial Prevention for Utah Neurology

Common neurology denials in Utah include nerve conduction and needle emg have separate code families that must be coordinated and routine, extended, ambulatory, and video eeg each have different codes and documentation. Our team catches these issues before submission and appeals aggressively with UT payer-specific documentation when denials occur.

Get Expert Neurology Billing in Utah

Free billing assessment for your UT neurology practice. See where revenue is leaking.

98%+ clean claim rate
2.49% starting rate
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What We Handle for Utah Neurology Practices

EEG coding (routine, extended, video, ambulatory)
EMG and nerve conduction study billing
Sleep study billing (PSG and HST)
Neurology infusion therapy coding
Botox injection billing (migraine, spasticity)
Prior auth for advanced neuro testing

Utah Neurology Billing Cost Comparison

Hiring an in-house biller with neurology expertise in Utah costs $36K-$50K annually in salary alone. Add benefits, software, clearinghouse fees, and office space, and the true cost is even higher. At 2.49% of collections, Go Medical Billing provides an entire team of AAPC-certified neurology coders and UT payer specialists for a fraction of that cost.

$36K-$50K

In-House Biller Salary

+ benefits, software, space

2.49%

Go Medical Billing Rate

Full team, all services included

60-80%

Typical Cost Reduction

With better results

Frequently Asked Questions

All major UT payers: SelectHealth (Intermountain), Regence, UHC, Molina, Utah Medicaid (including Healthy U, Molina, SelectHealth Community Care), and Medicare through Noridian. If a payer accepts neurology patients in Utah, we submit and follow-up on claims with them.
The most frequent neurology denials we see from UT payers include nerve conduction and needle emg have separate code families that must be coordinated, routine, extended, ambulatory, and video eeg each have different codes and documentation, neurology infusions (biologics, ivig) require sequential administration coding. Our team catches these before submission by applying both neurology coding expertise and UT payer-specific rules to every claim.
Utah Medicaid routes neurology patients through 3 managed care plans: Healthy U, Molina, SelectHealth Community Care. Each MCO has its own neurology authorization requirements, fee schedules, and billing rules. We credential and bill with all of them so your neurology practice gets paid correctly.
Most UT neurology practices are fully transitioned within two to three weeks. We connect to your EHR, learn your neurology workflows, and start submitting claims to SelectHealth (Intermountain), Utah Medicaid, Medicare, and all your UT payers with no downtime.

Fix Your Utah Neurology Billing

Call 888-701-6090 for a free billing assessment specific to your UT neurology practice. We'll show you where revenue is leaking and how to fix it.