Wound care and hyperbaric medicine are highly specialized areas of healthcare, often requiring advanced treatments, frequent visits, and a multidisciplinary approach to healing. While these services offer tremendous value to patients, they also come with a host of billing complexities that can negatively impact your practice’s bottom line.
At AMS Billing Solutions, we understand the nuances of wound care and hyperbaric billing. Below are five of the most common billing challenges faced by providers—and how to address them effectively.
1. Complex and Changing Coding Requirements
Wound care treatments often involve a variety of services, including debridement, skin substitutes, advanced dressings, and hyperbaric oxygen therapy (HBOT). Each procedure has strict coding guidelines, and documentation must match exactly to avoid denials.
Why it’s a challenge:
Many practices struggle to keep up with coding updates from CMS, payers, and Local Coverage Determinations (LCDs). Miscoding or under-documenting can lead to claim rejections or audits.
How to overcome it:
Work with a billing partner who stays on top of the latest coding changes. At AMS, our certified coders are wound care and HBOT experts who ensure accurate, compliant submissions every time.
2. Frequent Payer Denials for Hyperbaric Therapy
Hyperbaric Oxygen Therapy (HBOT) is often scrutinized by insurance companies due to its high cost. Coverage is typically limited to specific diagnoses, with strict documentation and medical necessity requirements.
Why it’s a challenge:
Even minor documentation errors or failure to meet payer-specific criteria can result in costly denials or delays in reimbursement.
How to overcome it:
Ensure comprehensive, compliant documentation is submitted with each HBOT claim—including start/stop times, treatment indication, and evidence of medical necessity. AMS provides detailed checklist templates and training to ensure your staff captures the necessary data.
3. High Patient Volume with Recurring Visits
Wound care patients often require frequent or ongoing treatment, sometimes visiting a center several times per week for months. This creates a high volume of claims and increases the chances of administrative errors.
Why it’s a challenge:
Recurring visits multiply the chances for small errors to add up, including duplicate claims, missed charges, and incorrect patient balances.
How to overcome it:
Implement billing automation and structured processes that ensure consistency from visit to visit. AMS utilizes advanced practice management systems to streamline claim entry, minimize duplicate errors, and ensure that every visit is captured and coded correctly.
4. Bundled Payments and Unclear Reimbursement Rules
Some procedures and services in wound care—especially those involving skin substitutes or surgical dressings—fall under complex payment models. CMS and private payers may bundle payments, making it hard to determine how much a practice is owed and for which services.
Why it’s a challenge:
Practices often face underpayment when they aren’t clear on what’s included in bundled services or miss opportunities to bill separately for qualifying items.
How to overcome it:
AMS conducts routine audits and payer contract reviews to ensure you are billing all eligible services appropriately. Our team also monitors bundling policies and educates your team so nothing is left on the table.
5. Underutilized Revenue Opportunities
Many wound care and hyperbaric providers don’t realize they’re missing out on reimbursable services—such as advanced imaging, consultations, nutritional assessments, or pain management procedures—that are related to ongoing wound care.
Why it’s a challenge:
A lack of billing strategy or awareness of reimbursable add-on services can mean lost revenue—even when those services are being provided.
How to overcome it:
With AMS, you’ll receive customized reports that highlight billing trends, missed opportunities, and areas for growth. We help identify underutilized codes, optimize claim sequencing, and ensure full reimbursement for services already being delivered.
Why Work with AMS Billing Solutions?
Wound care and hyperbaric practices need more than just a basic billing company. You need a partner who understands your specialty and proactively works to protect your revenue cycle.
AMS offers:
- Wound care and HBOT billing expertise
- Certified coders with specialty training
- Real-time denial management
- Transparent reporting and insights
- Full compliance with HIPAA and payer guidelines
We don’t just process claims—we help practices grow.
Ready to Reduce Denials and Maximize Revenue?
Let AMS Billing Solutions help you simplify your wound care and hyperbaric billing process. Contact us today for a free revenue assessment or to learn more about our tailored solutions for your practice.