Primary Care Billing Services
Managing a primary care practice comes with complex billing challenges, from navigating CPT codes to handling insurance claims. In-house billing can lead to administrative burdens and revenue loss due to denied claims and coding errors.
Our primary care billing services ensure accurate claim submissions, faster reimbursements, and reduced overhead costs. Our team specializes in coding, claim management, and compliance, helping your practice optimize revenue while you focus on patient care.
Our Primary Care Medical Billing Services
Insurance Verification & Eligibility Checks
We verify patient insurance coverage, co-pays, and deductibles before services are provided, ensuring accurate billing and reducing claim denials.
Patient Registration & Pre-Authorizations
We streamline patient intake and secure pre-authorizations for primary care services such as routine checkups, chronic disease management, and preventive screenings, ensuring smooth approvals and uninterrupted care.
Accurate Coding & Claims Processing
We assign the correct CPT, ICD-10, and modifier codes for primary care services, including acute illness treatment, immunizations, and diagnostic tests. Our meticulous coding minimizes errors and accelerates claim approvals.
Payment Processing & Reimbursements
We maximize revenue by ensuring complete documentation of medical necessity, tracking underpayments, and securing full reimbursements for primary care visits and procedures.
Denial Management & AR Recovery
We proactively address claim denials through detailed follow-ups, appeals, and efficient accounts receivable recovery, ensuring steady cash flow and minimizing revenue loss.
Primary Care Billing Challenges and Solutions
Complex Coding for Primary Care
Accurate coding for office visits, preventive care, and diagnostic tests is essential. We ensure precise coding to avoid claim rejections and ensure proper reimbursement.
Insurance Variability
With varying insurance policies and reimbursement rates, navigating payer requirements can be tricky. We stay updated on payer guidelines to reduce denials and underpayments.
Pre-Authorization Requirements
Some services, like advanced imaging and specialty referrals, require pre-authorization. We handle this process to prevent delays and ensure timely approvals.
Cost of In-House Billing
Running an in-house billing department can be expensive. Outsourcing reduces operational costs while maintaining efficient billing and timely reimbursements.
Billing for Preventive Care
Preventive care services require correct coding to maximize reimbursement. We ensure accurate coding to capture all eligible benefits and minimize patient costs.
Managing Denied Claims
Denied or underpaid claims disrupt cash flow. We identify denial causes, correct errors, and resubmit claims for faster, complete reimbursement.
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Leadership Team
Dimitar Talevski
Dimitar is a seasoned marketing specialist and the visionary behind CLICKVISION. With over 10 years in digital marketing, he excels in crafting marketing strategies that boost rankings, which in return increase leads, conversions, sales, profits, and ROI.
Filip Dimitrijevski
With a strong background in the marketing industry and healthcare leadership roles, Filip is responsible for CLICKVISIONBPO's sales strategies and onboarding new clients. With a passion for sharing insights gained from his experience, he also shares valuable knowledge through industry related articles.
Compliance in Our Primary Care Billing Company
Primary care billing requires strict adherence to regulations to protect patient data and ensure accurate reimbursements. Below are key compliance areas we follow:
| Compliance Area | Description |
|---|---|
| HIPAA Compliance | Protects patient data and ensures secure handling of medical records. |
| Quality Payment Program (QPP) | Ensures compliance with MIPS and APMs to optimize Medicare reimbursements. |
| Medicare & Medicaid Guidelines | Adheres to federal and state policies for accurate claims and reimbursements. |
| Telehealth Billing Compliance | Follows billing rules for virtual consultations and remote patient care. |
| Coding Accuracy & Modifiers | Ensures proper use of CPT, ICD-10, and HCPCS codes to prevent claim denials. |
| Claim Submission & Audits | Uses clearinghouses for clean claims and conducts audits to maintain compliance. |
ICD-10 & CPT Codes in Primary Care Billing Services
We handle key ICD-10 and CPT codes daily in primary care billing services, ensuring accurate claims and reimbursements for checkups, chronic care, and diagnostics. Below are the most common ones:
| ICD-10 Code | Description | CPT Code | Description |
|---|---|---|---|
| I10 | Essential Hypertension | 99213 | Office visit, established patient, moderate complexity |
| E11 | Type 2 Diabetes Mellitus | 99381 | Preventive medicine, new patient, infant (under 1 year) |
| J45 | Asthma | 99214 | Office visit, established patient, high complexity |
| Z23 | Immunization Encounter | 99397 | Preventive medicine, established patient, senior (65+ years) |
| R10.9 | Unspecified Abdominal Pain | 99203 | Office visit, new patient, moderate complexity |
Related Specialties We Excel In
Family Medicine Billing Services
Primary care and family medicine are closely related in providing comprehensive healthcare to patients of all ages. Family medicine specialists offer ongoing care for both children and adults, ensuring continuity and coordination across all stages of life.
Pediatrics Billing Services
Primary care often includes pediatric care, focusing on the health of children from infancy through adolescence. Pediatricians provide specialized care for younger patients, addressing preventive health, vaccinations, and common childhood illnesses.
Help center
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ICD-10 codes are used to identify medical diagnoses, while CPT codes are used to describe the medical procedures and services provided. Both coding systems are essential in primary care billing to accurately report the services rendered and ensure reimbursement.
Reducing claim denials involves accurate coding, thorough documentation, and staying up-to-date with payer-specific requirements. It's also important to submit claims in a timely manner and follow up on any denied claims promptly for corrections or resubmissions.
Preventive care billing involves coding for services aimed at preventing illness or detecting diseases early, such as annual check-ups, screenings, immunizations, and health counseling. These services are often covered at no cost to patients under certain insurance plans, but accurate billing is necessary to ensure proper reimbursement.
Yes, billing for telemedicine visits may differ slightly from in-person visits. While both require appropriate CPT and ICD-10 codes, telemedicine billing often requires modifiers to indicate the use of virtual platforms. It's important to ensure that both the provider and payer are aligned on telemedicine billing procedures.