Family Medicine Billing Expertise
Primary care billing requires deep understanding of preventive services, chronic care management, and the complex coding requirements that make family medicine unique among medical specialties.
Common Family Medicine Billing Pitfalls
Wellness Visit Coding Confusion
Mixing preventive and problem-focused visits in the same encounter often triggers denials. Medicare and commercial payers have strict guidelines about when to bill 99395-99397 versus 99213-99215, and incorrect modifier usage leads to automatic rejections.
Chronic Care Management Documentation
CCM billing (99490-99491) requires precise time tracking and specific care plan documentation. Many practices lose thousands monthly by failing to document the required 20+ minutes of non-face-to-face time or missing mandatory patient consent forms.
Vaccination Administration Oversights
Immunization billing involves multiple codes—vaccine products, administration fees, and age-specific modifiers. Missing the counseling component or incorrect VFC documentation can result in significant revenue loss, especially during flu season.
Multiple Condition Complexity
Family medicine encounters often address multiple unrelated conditions. Incorrect use of evaluation codes, missing comorbidity documentation, or improper problem-focused history elements frequently lead to downcoding and reduced reimbursement.
Our Family Medicine Billing Approach
- We maintain current knowledge of evolving primary care billing regulations, including Medicare's annual updates to preventive services coverage and commercial payers' varying wellness visit policies.
- Our certified coders specialize in family medicine's unique coding challenges, from routine physicals to complex multi-problem visits, ensuring proper documentation supports every billed service.
- We implement systematic workflows for CCM billing, including patient enrollment tracking, care plan documentation, and precise time logging to maximize this valuable revenue stream.
- Our quality assurance process specifically targets family medicine denial patterns, catching documentation gaps before claims submission rather than after payer rejection.
Family Medicine Results We Deliver
Optimize Your Family Medicine Revenue
Let our family medicine billing specialists handle your complex primary care revenue cycle while you focus on patient care.