Are The Complexities of a Primary Care Medical Billing and Coding Holding You Back?
Primary care physicians are a part of a constantly evolving landscape that is bound by strict regulatory guidelines. Given the variety of services they provide for both the family and internal care domain, their medical billing and coding requirements often become complex. Since primary care encompasses patients of all ages and a variety of disorders the administrative load on primary care physicians is high making consistent high quality care delivery a significant challenge.
To add to the complexity, primary care physicians must also come to grips with Place of Service (POS), telemedicine, Managed Care Organizations (MCO) and Senior Care Options (SCO) related coding and billing requirements. Ensuring a clean claims rate devoid of errors for primary care physicians requires a dedicated partner.
Are You Facing These Challenges With Your Primary Care Practice?
Constant Change
Medical billing codes and regulations are updated frequently considering the patient centric care is a mandate now. Staying on top of this evolution requires ongoing education and vigilance to ensure accurate coding and claim submission.
Time Constraints
Primary care physicians often see a high volume of patients, leaving them with limited time for detailed documentation. Accurate documentation is crucial for proper coding and reimbursement so that this time crunch should not create difficulties.
E/M Coding Complexity
Evaluation and Management (E/M) coding determines reimbursement for office visits. However, these codes can be subjective and require careful consideration of factors like visit time, review of systems, medical decision-making complexities, and the examination’s extent.
Multiple Payers, Multiple Rules
Primary care physicians may treat patients with insurance from various providers, each with its own coding and billing requirements. This can lead to confusion and errors.
Denials and Appeals
Even with careful coding, insurance companies can deny claims. Appealing denials requires additional time and resources, further straining practices.
Focus on Value-based Care
The healthcare landscape is shifting towards value-based care, emphasizing preventative care and quality outcomes. However, current coding systems may not adequately reflect the complexity of managing chronic conditions, a core aspect of primary care.
Managing Increasing Number of Claims
Primary care physicians manage a high volume of patients, leading to a constant influx of claims. This can overwhelm internal staff and lead to backlogs and delays in reimbursement.
Errors in Coding
Mistakes in coding can lead to claim denials, reduced reimbursements, and delayed payments. Our expertise ensures accurate coding and maximizes your revenue potential.
Inefficient AR follow-up and Denial Management
Shortcomings in medical billing and coding processes can leave you collecting pennies on the dollar. Prompt follow-up and denial management can quickly increase your administrative burden.
Services Designed Specifically for Primary Care, the Widest Scope in Healthcare
With our expertise in your corner, you can finally focus on what matters most: delivering top-notch care to your patients. With 314e at the helm, expect a radical transformation of your revenue cycle strength with the following dedicated services.
E/M Coding (99201-99429)
We ensure accurate coding for all levels of primary care visits, capturing the complexity of each encounter.
ICD-10 Coding
Our team of certified coders equipped with industry’s top resources precisely translates diagnoses from many acute and chronic conditions commonly seen in primary care.
Preventive Care Coding (99381-99429)
Our streamlined coding for immunizations, screenings, and preventive counseling keeps you compliant and maximizes reimbursement.
Chronic Care Management Coding (99421-99433)
Our expert coding services for complex care plans and time-intensive chronic disease management ensure proper recognition of your efforts.
Capitated Contract Management
Our team has extensive experience analyzing and negotiating capitated contracts to ensure your practice receives fair compensation.
Leverage the 314e Advantage
Our team of certified medical billing rockstars is fluent in all the latest ways you get paid, including traditional models and innovative ones like ACOs. No matter your practice size, from a solo doc in the countryside to a bustling multi-doctor group, we’ll be your billing partner. We’ll help you identify areas for improvement, like mastering those tricky modifiers, and share best practices to keep your revenue cycle humming.
Streamlined Billing for Changing Regulations
We keep up-to-date on evolving billing requirements, ensuring you get reimbursed accurately for your services, regardless of the 'journey' your practice takes.
Expert Management of Location Codes
Our team handles complex location codes, including those for telemedicine and US-based services, saving you time and ensuring correct billing based on patient location.
Capitation Management
We understand negotiated rates and capitation models, ensuring your practice receives proper compensation.
Deep Knowledge of Primary Care CPT Codes
Our team has extensive expertise in primary care-specific Current Procedural Terminology (CPT) codes, maximizing your billing accuracy.