Family Practice

Family medicine has never been more important to the American healthcare system, as seen by the latest statistics showing 208 million visits to family doctors annually. There is no other medical specialty that has as large of a patient base as family physicians, who provide a full spectrum of acute, chronic, and preventive care services. With its vast reach, family medicine requires careful billing and coding to ensure that medical bills are paid as much as possible. If this isn’t done, it will negatively affect physician income, patient outcomes, and the healthcare system as a whole.

Thankfully, family physicians can rely on skilled and knowledgeable billers and coders who are certified by the American Academy of Professional Coders (AAPC), knowledgeable with ICD-9, CPT, and HCPCS coding according to CMS and AMA rules, and compliant with HIPAA privacy regulations. Most of the top family physicians, clinics, diagnostic centers, and hospitals have preferred our billers and coders because they fit the bill.

Were you aware?

Family practitioners who see Medicare patients should be aware of this fact in order to prevent denials. Consultation CPT codes 90241 to 99248 are accepted by commercial payers but are not by Medicare.
In order to be compensated, family practitioners who provide office visits must apply modifier 57 for the surgical choice made that same day.
If correctly applied, E&M Modifiers 24, 25, and 57 reimburse family practitioners 100% of any additional services they give to patients in addition to an office visit. Family practitioners might therefore gain from maximum reimbursements by utilizing these modifications to their fullest potential.

The Family Medicine Medical Reimbursement Cycle Should Ideally Be Phased

Our Family Medicine reimbursement specialists are renowned for their skillful phasing of the reimbursement process into manageable steps as they navigate the intricate processes involved in billing and coding.

Primary Phase:

Enrolling patients, confirming insurance, and obtaining authorization are done.

Secondary Phase

Billing Advanced medical billing software, such as NextGen Healthcare, Epic, Cerner, AthenaOne, NueMD, TherapyNotes, DrChrono, eClinicalWorks, Allscripts, Athenahealth, Practice Fusion, TherapyNotes, etc., is used to convert the variety of services provided by family physicians into accurate bills.

Tertiary phase

Experts in family medicine billing and coding translate appropriately billed services such as acute, chronic, and preventive medical care; diagnosis and treatment of internal illness; preventive care, including routine checkups, health-risk assessments, immunizations, and screening tests; and personalized counseling on maintaining a healthy lifestyle. They also translate these codes into complying codes (as per AMA and CMS guidelines) for optimal reimbursement of family physicians’ medical bills that are free from errors and denials.

Additionally, appropriate modifiers have been applied diligently to reduce the unfavorable return of claims from insurance companies. As a result, family medicine invoices have been successfully processed by top commercial insurance companies like Unitedhealth, Wellpoint, Aetna, Humana, HCSC, Blue Cross Group, and government-sponsored Medicare and Medicaid.

PBC Goal

Our Family Medicine Coding and Billing Specialists hold themselves to a high standard of professional efficiency, with the sole goal of obtaining maximum end-to-end reimbursement for Family Medicine services claims. Our professionals constantly improve their skills to match “best practices in medical coding and billing” for Family Medicine services, since they must satisfy the expectations of Family Medicine Practitioners in the face of a strict coding and billing system.

Physicians practicing family medicine who chose to outsource their medical bills to us for our effective billing and coding services have benefited from increased income, an increase in patients and referrals, and a benchmarking of their medical productivity.