Physician Billing & Primary Care Coding Experts for Family Medicine
Improve your Physician Billing, Primary Care Coding, and Revenue Performance by Partnering with Experts at MBS
MBS Select is a highly reputable medical billing company providing expert billing and coding services for Family Medicine & Primary Care practices. Our RCM services help maximize your physician billing revenue while freeing up your staff's time for other practice management responsibilities on the clinical side.
Primary Care Billing Expertise with Guidelines
With the constant regulatory changes and coding compliance issues to keep up with in the healthcare provider industry, having a team of top-tier billing professionals to support your Primary Care practice’s needs will help increase revenue and alleviate major stress. Our Physician, Nurse Practitioner, and Physician Assistant billing clients enjoy the ability to focus their time and energy on providing high quality patient medical care while also having full confidence in the world-class job MBS does on the back end to sort through primary care coding and insurance reimbursement headaches.
Medical Billing and CPT Coding for Physicians
The Evaluation and Management (E/M) coding of patient visits is core to Primary Care and Family Medicine practices. Our staff assists by not only providing updated guidelines for Medicare and commercial insurances but also by supporting practices on how to properly document and code E/M visits for audit preparedness. By ensuring proper primary care coding guidelines are followed, proper reimbursement is the reward. We go the extra mile to provide custom reference guides, primary care billing cheat sheets, and ongoing education to help practice staff stay on top of key points related to insurance changes, referrals, prior authorizations, and other instructions from our expert billing staff.
At a basic level, payers reimburses for visits according to the patient type designation of New vs. Established Patient:
New Patient – An individual who did not receive any professional services from the physician/non-physician practitioner (NPP) or another physician of the same specialty who belongs to the same group practice within the previous 3 years.
Established Patient– An individual who received professional services from the physician/NPP or another physician of the same specialty who belongs to the same group practice within the previous 3 years.
In addition to patient type, providers must also consider the following 7 components of the visit in order to determine the correct level of E/M service:
coordination of care
review of presenting problem
One of the common documentation errors in patient charts is the absence of total face-to-face time that providers spend with patients. Providers must ensure that medical record documentation supports the level of service reported to a payer to safeguard against potential audits and justify the level of service that was billed. Below are examples of the most common CPT codes for Family Practice and Primary Care together with reference of the typical times for each level of service. Typical Times for New Patient Office Visits:
Typical Times for Established Patient Office Visits:
Full Service Physician Billing & Code Review
MBS always recommends conducting an internal coding audit for our new physician billing clients (and physician extenders) to help us identify areas of opportunity where the practice may be losing revenue on services that aren't being properly billed (or that are being performed but not billed).
Common areas of opportunity for revenue improvement are listed below:
Proper coding guidelines for scheduled Annual Wellness Visits (AWV) and Preventive Medicine services when the patient also presents a non-routine problem during the time of service.
Appropriate use of modifiers for E/M services along with procedures and proper sequencing using RVU (Relative Value Unit) when multiple procedures are performed.
Coding of minor surgical procedures performed in office location such as lesion excision, ear lavage, foreign body removal, etc.
Coding of ancillary procedures performed in a Primary Care or Family Medicine practice such as venipuncture, injections, EKG, etc.
Proper coding of vaccinations for all ages to each insurance, including state supplied.
Elevate the Performance of Your Primary Care & Family Medicine Practice
At MBS, education, communication, and strategic planning is key to the success of any practice's performance. Our goal is to help maximize your practice’s productivity, increase reimbursement opportunities, and ensure billing efficiency with our integrated technologies to ensure long-term success. Beyond the special attention, manual QA checkpoints, and rules-based automation we employ in order to perfect your practice's use of CPT and ICD-10 code combinations and modifiers, our highly trained staff will also verify patient and insurance information, handle statements and patient billing questions, work though insurance denials and appeals, and keep on top of aging unpaid claims for timely follow-ups. Our top priorities are to maintain steady cash flow for your practice, decrease costly and avoidable denials, provide superior customer service to both patients and practice staff, and ultimately to increase your practice's revenue performance. We've been managing Family Medicine and Primary Care medical billing and coding for physicians for over 30 years. With our deep experience, exceptional leadership team, and hyperfocus on quality control and accuracy, you'll be hard pressed to find another outsourced physician billing service partner that outperforms our KPI metrics and satisfaction rates. When new practices transition to our value-add full service RCM, they often realize 8-15% gains in revenue within the first year. Client references are available upon request.
Contact us today by phone or web to start a discussion about your Primary Care or Family Medicine practice's specific needs and revenue improvement goals.