Hire Ventus,Your AI Dermatology Revenue Cycle Team.

Dermatology Revenue Cycle Management (RCM) is the end-to-end financial process dermatology groups use to get paid for care: prior authorization for biologics and advanced therapies, coding for E/M-plus-procedure visits, MOHS and dermatopathology claim submission, answering payer requests for records, payment posting, and follow-up. Dermatology is unusually exposed at three points: biologic prior auths that stall, payer scrutiny of modifier 25 that turns into records requests, and claims that bounce on laterality, referring provider, or diagnosis specificity. Dermatology RCM automation puts AI agents on exactly those three.

Ventus is the payer intelligence layer built for dermatology and MOHS groups. It works inside your existing EHR (ModMed/EMA, Nextech, NextGen, or AdvancedMD), logs into payer and PBM portals, clears prior authorizations on biologics, answers payer requests for additional information the day they arrive, and scrubs and submits clean claims — communicating with your team in Slack or Teams the whole way.

Ventus reads the schedule and the biologic orders behind it — Dupixent, Skyrizi, Cosentyx, Rinvoq, Otezla and others — assembles what each payer’s policy asks for (diagnosis, step-therapy history, IGA/BSA or PASI scores, TB screening, chart notes and photos), submits through the payer or PBM portal, and follows every request to a decision. Approvals are written back to the EHR with the auth number and expiry, peer-to-peer requests are scheduled with your provider, and renewals are filed before the current authorization lapses.

Ventus reads the request as it posts — a “claim lacks information” remark, an attachment-required code, or a records letter — identifies exactly what was asked for (the progress note behind a modifier-25 visit, the pathology report on a biopsy, photos or a letter of medical necessity for an excision or Mohs case), pulls it from the EHR, packages it to the payer’s specification, and sends it back the same day via portal attachment, corrected claim, or fax. It logs the confirmation and tracks the claim to adjudication, so a 30-day window is answered on day one instead of day 29.

Dermatology bills an E/M with a same-day procedure more than any other specialty, and payer E/M engines target modifier 25 for records requests and stripped-modifier denials. Ventus works both ends: before submission it keeps modifier 25 only when a separately identifiable E/M is documented and links the note; after submission it answers records requests with the progress note, procedure note, photos, and attestation the payer asks for. The result is fewer requests in the first place and fast, complete answers to the ones that still come.

As encounters close, Ventus builds each claim from the note and the verified coverage, then scrubs it against that payer’s rules: modifier 25 support, laterality (LT/RT) derived from both the billing card and the note, referring provider NPI for Medicare, telehealth place of service with modifier 95, diagnosis pointers, and unspecified diagnoses crosswalked to specific codes. Biopsy, pathology result, and diagnosis are linked before release. It submits through your clearinghouse, reads the acknowledgments, writes the claim status back to the EHR, and routes any rejection for a same-day fix.

Yes. Ventus handles MOHS and dermatopathology claims alongside medical and cosmetic dermatology: prior authorization and medical-necessity documentation where payers require it, linkage of biopsy to path result to diagnosis before submission, and answering the records requests these claims attract — operative notes, Mohs maps, and pathology reports.

Ventus works directly inside your existing EHR and practice management system including ModMed (EMA), Nextech, NextGen, and AdvancedMD. It logs in just like a team member would: reads the schedule and notes, pulls records and photos, builds and submits claims, writes auth numbers and claim statuses back, and posts payments. No API integration required.

Ventus logs into 40+ payer and PBM portals including Aetna, Cigna, UnitedHealthcare, Anthem, BlueCross BlueShield, Humana, and Medicare, plus clearinghouses such as Availity and Waystar. It submits prior auths, uploads requested records, and gathers claim statuses directly from the source.

Ventus confirms clearinghouse and payer acceptance the same day and follows the claim until it pays. Because claims go out authorized, documented, and clean, most simply adjudicate. For the few that stall or come back with a request, Ventus answers the request or supplies the missing information, and surfaces true exceptions to your team with full context.

Yes, Ventus is fully HIPAA compliant and SOC 2 Type II certified. We maintain enterprise-grade security with bank-level encryption, role-based access controls, and continuous compliance audits.

Ventus can be live in about 7 days. Our team maps your payer mix and EHR, configures the AI agents in your environment — usually starting with biologic prior auth and payer records requests — and gets you running with minimal disruption to your operations.

Dermatology groups using Ventus see prior authorizations cleared before the visit instead of after it, payer records requests answered in a day instead of weeks, and claims that go out with modifier 25, laterality, and referring-provider details right the first time — which lifts first-pass acceptance and shrinks the rework queue. Ventus runs 24/7 inside the EHR your team already uses.