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Specialty billing

Family Practice Medical Billing Across Every Age Group

Preventive and problem visits, chronic care management and the modifier discipline primary care depends on.

Family physician consulting with a patient in a primary care clinic
2021 the year E/M leveling moved to medical decision making or time, and many practices never adjusted

The challenge

What makes family practice billing different

Family practice bills a wider range of services than almost any other specialty, and it does so at a lower value per encounter. A single morning can include a Medicare annual wellness visit, a pediatric immunisation, a chronic disease follow-up and an acute injury. Each carries different documentation requirements and a different set of ways to lose the claim.

The biggest recoverable opportunity in most family practices is not a missing service line. It is systematic under-leveling: providers defaulting to a mid-level E/M code on visits where the documented medical decision making clearly supports more.

Why us

Why primary care practices work with us

Specialty billing is not a marketing label for us. Coders and A/R staff are assigned by specialty, so the person on your account reads notes like yours every day.

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  • E/M leveling reviewed against current guidelines rather than long-standing habit
  • Preventive and problem visits on the same day billed correctly instead of avoided
  • Chronic care and remote monitoring revenue captured where it is already being delivered
  • Annual wellness visits distinguished cleanly from routine physicals

Scope of work

What we handle for family practices

The work below is specific to this specialty, not a generic billing checklist with the name swapped out.

Annual wellness visits

Medicare AWV coded distinctly from a commercial preventive physical, with the required elements verified.

E/M leveling review

Visit levels assessed against documented medical decision making or total time under current rules.

Same-day preventive and problem

Both services captured with correct modifier use when a separate problem is addressed.

Chronic care management

CCM, principal care and remote monitoring programs billed against documented time and consent.

Immunisations across all ages

Vaccine products and administration coded together for pediatric through geriatric patients.

Transitional care management

Post-discharge management captured within the contact and visit timeframes it requires.

The Right Way difference

What we watch on primary care claims

These are the details that separate a paid claim from an appealed one in family practice. They are checked on every claim, not sampled.

  • 01 Whether documented medical decision making supports a higher level than the provider habitually selects
  • 02 The distinction between a Medicare annual wellness visit and a commercial preventive physical
  • 03 Consent, care plan and documented time requirements for chronic care management programs
  • 04 Modifier use when a preventive visit and a problem visit occur in the same encounter
  • 05 Transitional care management contact timing, which is easy to miss and unrecoverable once passed

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Years running revenue cycles for physician practices

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Providers billed for across every specialty we serve

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First-pass clean claim rate

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Median days in accounts receivable

Questions

Family Practice billing questions

What practices in this specialty ask us most often before making a change.

Ask us something else

A baseline audit answers it directly. We sample recent encounters, level them independently against the documentation, and show you the distribution alongside specialty benchmarks. It is usually the fastest revenue finding in primary care.

How it works

Getting started takes about a month

The same four steps whichever specialty you are in. No system migration and no gap in your cash flow.

  1. 01

    Revenue assessment

    We audit a sample of your claims, denials and aged A/R and show you what we found. Free, and yours to keep either way.

  2. 02

    Scope and agreement

    A written scope covering exactly which services we run, what it costs and what we are accountable for.

  3. 03

    Access and onboarding

    We set up inside your existing EHR and clearinghouse. Two to four weeks, run in parallel with your current process.

  4. 04

    Live and reporting

    We take over submission and follow-up, and you get monthly reporting you can actually act on.

Free consultation

Let us look at your family practice claims

Send us a sample and we will tell you specifically what is being coded, denied or under-paid — and what it is worth to fix. Free, and yours to keep.