Family Medicine Billing Services
Family Medicine Billing Built Around the Full Picture of Care
The Family Medicine Billing solution designed around the whole story of patient care.
Family Medicine is in the middle of the patient’s care experience from general checkups and preventive care to acute visits, chronic disease management, care coordination, procedures and follow up. That width presents a billing environment where minor coding, documentation, eligibility and/or payer issues are fast turning into revenue issues.
A dedicated Family Practice Medical Billing Support approach is applied to each step of the revenue cycle with Proactive Medical Billing & Coding LLC, assisting practices in the capture of the services provided, submission of cleaner claims, payment obstacles, and a healthier A/R.
You’re concerned with the patient. The emphasis is placed on ensuring that the funds are used to support the care.
Family Medicine Doesn't Follow a Single Billing Pattern. Neither Do We.
One day the patient may come in for a preventive examination and the next for many chronic conditions, and the same week for an acute problem, in a Family Medicine practice.
There may be coding, documentation, payor and reimbursement aspects to consider for each encounter. Which is why Proactive MBC doesn’t take a cookie-cutter style approach to Family Medicine billing.
We Build Around Your Practice
Where Family Medicine Revenue Can Get Lost
- We Look Beyond the Claim
- Not all claims are denied; not all revenue leakage is associated with denial.
- Sometimes it begins with a missed charge.
- Sometimes with incomplete documentation.
- With an eligibility problem at times.
- In some cases, there is a mismatch in the codes.
- At times, with an underpayment no one complained about.
- Then sometimes, the claim wasn't submitted correctly to begin with.
Proactive MBC tackles revenue cycle on many fronts
Missed Revenue
Look for services that were rendered that weren't billed correctly.
Coding Inconsistencies
Review CPT, ICD-10-CM, modifiers, E/M levels, and documentation alignment.
Payer Requirements
Explain the requirements for payer specific billing and reimbursement.
Claim Rejections
Address preventable errors before they become prolonged payment delays.
Denials & Underpayments
Explore the reasons for Revenue not being received or received short of the expectation, and take action to rectify this situation.
Aging A/R
Focus on good balances and act early because claims are easier to come by the earlier you are able to recover collectible revenues.
The Proactive Family
Medicine Revenue Cycle
The actual steps from the Patient Encounter to the Final Payment.
Each dollar starts with the care provided. We work from the clinical encounter forward to help make sure the services provided by your providers are translated to billable charges.
Family Medicine often has layered diagnoses, multiple services, a preventive element and varying levels of E/M complexity. Our coding process is based on being accurate and not over coding, under coding or creating unnecessary claim risk related to the care documented.
As a physician, you should check the Payer Before the Claim before signing or reimbursing any claims. Coverage and Payer rules may determine reimbursability of a service. Where appropriate, eligibility benefits, authorization requirements, patient responsibility, and payer-specific requirements are integrated into the billing process.
A problem is not a problem just because it might have been picked up before it was submitted. Avoiding claim denial, our team checks key billing components and assists in eliminating unnecessary claim denials.
Submission is not the end of the line! Proactive MBC manages activity, tracks claims that are stalled or rejected, pursues payment from payers and ensures that outstanding claims make it to completion.
If the Payer says no, we don’t consider the denial to be the end of the story. We explore why it is, find out what to do next, correct or resubmit if necessary, and appeal or reconsider if warranted.
The A/R management process cannot just be reported, it must be actively managed. We coordinate exceptional balances based on age, payer, status and opportunity and allow our team to prioritize where it will have the most financial impact.
Your billing report should tell you more than what you collected. Proactive MBC offers insight into collections, aging A/R, denial trends, payments, claim performance and more revenue-cycle metrics to help you get a handle on what’s going on inside your practice.
Family Medicine Billing Services That Work Beyond the Claim.
One Specialty. A single strategy for coordinating revenues.
Proactive MBC collects all the elements of the Family Medicine Revenue Cycle rather than separate tasks.
Eligibility & Benefits Verification
Confirm coverage, benefits, patient responsibility, and relevant payer requirements before services are billed.
Charge Capture
Help ensure documented, billable services are properly represented in the billing workflow.
Family Medicine Coding
CPT & HCPCS coding support, ICD-10-CM coding, E/M coding, modifier coding, and documentation coding support.
Claims Management
Electronic Claim Submission, Claim Review, Claim Rejection Management, Claim Status Monitoring & Payer Follow-up.
Payment Posting & Reconciliation
Correct posting of payers and patient payments and matching of discrepancies and outstanding balances.
Denial & Appeal Management
Determine the reasons for denials, address the billing problems, resubmit claims and follow the correct appeal process.
A/R Management
Aging of claims, payer response and recoverability.
Patient Balance Support
Clear and organized communication and handling of patient balances and billing.
Reporting & Revenue Visibility
Reporting with actionable insights to know what's happening in collections, A/R, denials and revenue cycle.
Built for the Realities of Family Medicine
The Services May Be Broad. We are very narrow in our attention to detail. There are many different types of encounters and services of which family medicine practices can earn revenue. Proactive MBC knows that getting the details right along that spectrum is essential.
Our Family Medicine Billing Expertise Includes:
- New and established patient E/M services.
- Preventive medicine examinations
- Annual Wellness Visits
- Chronic Care Management
- Transitional Care Management
- Care coordination services
- Preventive screenings
- Immunization-related billing
- Office-based procedures
- Multiple-diagnosis encounters
- Time-based services
- Where relevant, long term and complex services.
- If applicable, telehealth services will be used.
- Medicare and Medicare Advantage billing
- Managed Medicaid and Medicaid.
- Commercial payer billing
- Multi-payer revenue cycle management
Why Family Medicine Practices Choose Proactive MBC
Billing should feel like it’s a part of your practice, not another department you’re managing.
What a Stronger Revenue Cycle Can Change
When the Billing Process Works Better, the Practice Has Room to Work Better.
Capture More Completely
Minimise risk of legitimate services going unnoticed in the billing process.
Recover More Effectively
Provide denied, delayed and aged claims a clear roadmap towards resolution.
Understand Revenue Performance
Identify missing or blocked money and where your attention is required.
Submit With Greater Confidence
Prevent billing and coding issues from turning to claim issues.
Recover More Effectively
Provide a clear process for denied, delayed and aging cases.
Reduce Administrative Pressure
Give doctors and practice personnel more time to focus on patient care.
Your Family Medicine Practice Deserves More Than a Billing Vendor
It Deserves a Revenue Partner That Understands the Entire Journey. Dozens of decisions can impact a patient’s care from the moment they come in the door to when the last payment is posted. Proactive MBC links those decisions.
We combine coding, claims, payer follow-up, denial, A/R management, payment oversight and reporting into a cohesive family medicine medical billing strategy.
Frequently Asked Questions
Find answers to the most common questions healthcare providers ask about our medical billing, coding and revenue cycle management services.
Family Medicine billing can include charge capture, coding, eligibility verification, claim submission, payment posting, denial management, A/R follow-up, patient billing support, and revenue-cycle reporting.
Yes. Proactive MBC can support billing workflows across Medicare, Medicare Advantage, Medicaid/managed Medicaid, and commercial payers, subject to the practice’s payer relationships and applicable requirements.
Yes. We support billing and coding workflows for applicable preventive and wellness services, with attention to documentation and payer requirements.
Yes. We can support applicable care-management billing workflows and review documentation and billing requirements associated with eligible services.
We investigate the underlying denial reason, determine the appropriate corrective action, and where supported, correct, resubmit, or pursue an appeal/reconsideration. We also look for recurring denial patterns rather than treating each denial as an isolated event.
In many cases, yes. Our team is designed to work with the systems and workflows already used by your practice, subject to system capabilities and access.
Yes. Reporting can provide visibility into collections, A/R, claim activity, denials, payments, and other revenue-cycle indicators relevant to your practice.
Preparing Your Family Medicine Revenue Cycle To Be More Proactive?
Make Billing a Business Advantage, not just a Back-Office Task. Your doctors should be considering patients. You should have your staff consider the practice. Your revenue cycle should be functioning without fail: accurately, consistently, and proactively.
