RCM24Billing Free A/R Audit

Specialties

Primary care billing

For family medicine and internal medicine. Primary care runs on volume: many visits, modest claims, and revenue that depends on capturing the services the practice already provides.

Doctor talking with an adult patient across her desk

Where primary care loses money

  • Preventive and problem visits on the same day. A physical that also addresses a new or chronic problem can support two services, with modifier 25 and documentation that separates them. Patients also need to understand why part of the visit may carry a cost share.
  • Medicare wellness visits. The Annual Wellness Visit isn’t a physical, and Medicare doesn’t cover routine physicals. Mixing the two up is one of the most common primary care denials.
  • Chronic care and transitional care management. Both pay for work many practices already do, but each has consent, time and contact requirements that must be documented to bill it.
  • Risk adjustment. For Medicare Advantage patients, chronic conditions have to be documented and addressed every calendar year, or they drop out of the risk score.
  • Eligibility. With high visit volume, outdated insurance details cause more denials than any coding issue.

How we work it

Eligibility is checked before the visit, not after the denial. Coders review same-day preventive and problem visits so both are billed when the note supports it, and care management time is tracked so it’s claimed every month it qualifies. For risk-adjusted contracts we flag chronic conditions that haven’t been addressed this year, so the provider can review them at the next visit.

Common questions

Can we bill a physical and a sick visit on the same day?

Yes, when the problem-oriented part is significant and separately documented. Modifier 25 goes on the problem visit, and the note has to show the extra work rather than relying on the modifier alone.

Do you handle chronic care management billing?

Yes. We track consent, monthly time and the care plan requirements, so the service is billed each month it qualifies and not when the documentation is incomplete.

Other specialties we bill for

Start with the free audit

Send us ninety days of claims data and we’ll show you what was left uncollected. No charge, no obligation, and the findings are yours either way.

Request my free audit