PCP Clients Served
First-Pass Rate
Revenue Recovered
Claim Turnaround
Primary care practices generate revenue across a wider range of CPT codes than most specialties. Annual wellness visits, chronic care management, transitional care, and standard E/M visits all follow different documentation and billing rules. One missed code or incorrect modifier can cost a practice thousands per month.
We build billing systems for primary care that capture every billable service without creating extra work for providers. Our coders review documentation daily, flag missed charges, and submit clean claims within 24 hours of the encounter.
Every Primary Care billing team deals with payer delays, coding nuance, and collection leakage. We tighten those weak points before they turn into write-offs.
Primary care physicians see patients for everything from sore throats to complex chronic disease management. Selecting the correct E/M level (99202-99215) for each visit type requires coding expertise that front-desk staff typically lack.
CCM codes (99490, 99491) reimburse $40 to $90 per patient per month, but most practices leave this revenue on the table because they lack systems to track the required 20 minutes of non-face-to-face care.
When a wellness visit (99395-99397) turns into a problem-oriented visit, modifier 25 must be appended correctly. Incorrect usage triggers audits. Missed usage leaves revenue uncollected.
MIPS and value-based payment programs require specific documentation and reporting that affects reimbursement rates. Missing quality measures can reduce Medicare payments by up to 9%.
Support spans the full revenue cycle, from front-end verification to denial recovery and reporting.
E/M coding optimization with daily chart review
Chronic care management (CCM) billing and time tracking
Annual wellness visit and preventive care billing
MIPS quality measure reporting and compliance
Modifier 25 audit and training for dual-purpose visits
Revenue cycle analytics with provider-level benchmarking
We support independent practices, multisite groups, and growing provider organizations with flexible workflows.
Independent physician groups
Multi-location practices
Private equity backed platforms
Hospital-owned outpatient groups
Primary care practices generate revenue across a wider range of CPT codes than most specialties. Annual wellness visits, chronic care management, transitional care, and standard E/M visits all follow different documentation and billing rules. One missed code or incorrect modifier can cost a practice thousands per month.
We build billing systems for primary care that capture every billable service without creating extra work for providers. Our coders review documentation daily, flag missed charges, and submit clean claims within 24 hours of the encounter.
Answers to the questions practice owners and managers ask most often before switching billing partners.
Studies show primary care practices lose 10% to 15% of potential revenue to missed charges, primarily from unbilled CCM services, uncaptured preventive care codes, and systematic E/M downcoding. A 5-physician practice can recover $150,000 to $300,000 annually by fixing these gaps.
CCM billing (CPT 99490) allows practices to bill Medicare $42 per patient per month for at least 20 minutes of non-face-to-face chronic care coordination. Patients must have two or more chronic conditions and provide written consent. Most practices with 200+ Medicare patients can generate $100,000 or more annually from CCM alone.
When a patient presents for a wellness exam but also raises a new medical concern, we ensure both the preventive code and the E/M code are billed correctly with modifier 25. We audit these dual-purpose visits monthly to confirm proper documentation supports both charges.
Yes. We track quality measures throughout the year, flag documentation gaps that could affect scores, and submit MIPS data before the reporting deadline. Our clients consistently avoid the negative payment adjustment and many qualify for positive bonuses.
We assign E/M levels based on the 2021 medical decision-making (MDM) guidelines, reviewing documentation for the number of problems addressed, data reviewed, and risk of management. This ensures accurate coding without relying on outdated bullet-counting methods.
We submit clean claims within 24 hours of receiving completed documentation. For practices using EHR systems with direct feed, turnaround is often same-day. Faster submission means faster payment.
The difference is operational discipline. We focus on clean submissions, fast follow-up, and transparency.
Get a revenue review and a clear action plan tailored to your practice, payers, and claim mix.