Maximize Revenue and Streamline Billing for Family Medicine & Internal Medicine Practices
Is your practice losing revenue due to denied claims, delayed reimbursements, or complex coding regulations?
At Health & Billing, we provide end-to-end Revenue Cycle Management (RCM) solution for family medicine and internal medicine practices. From medical coding and billing to provider credentialing and claims follow-up, our mission is clear: maximize your reimbursements, reduce denials, and allow you to focus on patient care.
At Health & Billing, we provide end-to-end Revenue Cycle Management (RCM) solution for family medicine and internal medicine practices. From medical coding and billing to provider credentialing and claims follow-up, our mission is clear: maximize your reimbursements, reduce denials, and allow you to focus on patient care.
Why Family & Internal Medicine Practices Struggle with Revenue Cycle Management
Family medicine and internal medicine practices face an increasingly challenging financial and administrative environment.
Key challenges include:
Regulatory Complexity
Primary care practices must comply with evolving regulations, such as:
Even slight errors in compliance or coding can lead to delayed reimbursement or denied claims.
→ No Surprises Act (price transparency, surprise billing)
→ Telehealth reimbursement updates
→ Advanced Primary Care Management (APCM) services
→ Behavioral health integration codes
→ Telehealth reimbursement updates
→ Advanced Primary Care Management (APCM) services
→ Behavioral health integration codes
Even slight errors in compliance or coding can lead to delayed reimbursement or denied claims.
Pre-Authorization Burden
Insurance carriers increasingly leverage AI tools to process pre-authorizations, often denying requests incorrectly. Key stats:
These delays not only affect revenue but also patient satisfaction and care continuity.
→ 60% of physicians report AI-driven authorization denials
→ 80% of all denied claims relate to missing or incorrect prior authorizations
→ 80% of all denied claims relate to missing or incorrect prior authorizations
These delays not only affect revenue but also patient satisfaction and care continuity.
Financial Performance Impact
Inefficiencies in payment posting, A/R follow-up, claim reconciliation, or insurance verification can significantly impact:
→ Clean Claims Rate (percentage of claims submitted without errors)
→ Days Sales Outstanding (DSO)
→ Net Collection Ratio
→ Cost-to-Collect Ratio
→ Days Sales Outstanding (DSO)
→ Net Collection Ratio
→ Cost-to-Collect Ratio
Claims & Denial Management
Common denial reasons include:
Every denied claim increases administrative workload and slows accounts receivable (A/R).
→ Incorrect or incomplete CPT/ICD-10 coding
→ Missing modifiers
→ Failure to secure prior authorizations
→ Non-compliance with payer-specific documentation
→ Missing modifiers
→ Failure to secure prior authorizations
→ Non-compliance with payer-specific documentation
Every denied claim increases administrative workload and slows accounts receivable (A/R).
Administrative Burden & Coding Complexity
Primary care billing involves intricate documentation across:
Inaccurate charge capture, miscoded ICD-10 diagnoses, or missed modifier usage can trigger claim denials and revenue loss.
→ Evaluation & Management (E/M) codes
→ Preventive medicine codes
→ Immunizations & vaccines
→ Lab & diagnostic testing
→ Radiology procedures
→ Preventive medicine codes
→ Immunizations & vaccines
→ Lab & diagnostic testing
→ Radiology procedures
Inaccurate charge capture, miscoded ICD-10 diagnoses, or missed modifier usage can trigger claim denials and revenue loss.
Why Family & Internal Medicine Practices Struggle with Revenue Cycle Management
Family medicine and internal medicine practices face an increasingly challenging financial and administrative environment.
Key challenges include:
Regulatory Complexity
Primary care practices must comply with evolving regulations, such as:
→ No Surprises Act (price transparency, surprise billing)
→ Telehealth reimbursement updates
→ Advanced Primary Care Management (APCM) services
→ Behavioral health integration codes
→ Telehealth reimbursement updates
→ Advanced Primary Care Management (APCM) services
→ Behavioral health integration codes
Even slight errors in compliance or coding can lead to delayed reimbursement or denied claims.
Pre-Authorization Burden
Insurance carriers increasingly leverage AI tools to process pre-authorizations, often denying requests incorrectly. Key stats:
→ 60% of physicians report AI-driven authorization denials
→ 80% of all denied claims relate to missing or incorrect prior authorizations
→ 80% of all denied claims relate to missing or incorrect prior authorizations
These delays not only affect revenue but also patient satisfaction and care continuity.
Financial Performance Impact
Inefficiencies in payment posting, A/R follow-up, claim reconciliation, or insurance verification can significantly impact:
→ Clean Claims Rate (percentage of claims submitted without errors)
→ Days Sales Outstanding (DSO)
→ Net Collection Ratio
→ Cost-to-Collect Ratio
→ Days Sales Outstanding (DSO)
→ Net Collection Ratio
→ Cost-to-Collect Ratio
Claims & Denial Management
Common denial reasons include:
→ Incorrect or incomplete CPT/ICD-10 coding
→ Missing modifiers
→ Failure to secure prior authorizations
→ Non-compliance with payer-specific documentation
→ Missing modifiers
→ Failure to secure prior authorizations
→ Non-compliance with payer-specific documentation
Every denied claim increases administrative workload and slows accounts receivable (A/R).
Administrative Burden & Coding Complexity
Primary care billing involves intricate documentation across:
→ Evaluation & Management (E/M) codes
→ Preventive medicine codes
→ Immunizations & vaccines
→ Lab & diagnostic testing
→ Radiology procedures
→ Preventive medicine codes
→ Immunizations & vaccines
→ Lab & diagnostic testing
→ Radiology procedures
Inaccurate charge capture, miscoded ICD-10 diagnoses, or missed modifier usage can trigger claim denials and revenue loss.
Transform your practice’s revenue cycle from a source of stress into a Strategic advantage with Health & Billing
At Health & Billing, we combine technical expertise, advanced RCM technology, and regulatory knowledge to help practices optimize revenue and improve operational efficiency.
Comprehensive Revenue Cycle Management
→ Verify patient coverage with real-time insurance checks
→ Utilize CPT, ICD-10, HCPCS Level II, and modifier-specific coding to ensure precise billing for all services.
→ Navigate complex payer requirements, including pre-certifications for advanced imaging, therapeutic injections, and specialty labs.
→ Track claims through electronic claim submission
→ Implement root-cause analysis for denied claims
→ Utilize CPT, ICD-10, HCPCS Level II, and modifier-specific coding to ensure precise billing for all services.
→ Navigate complex payer requirements, including pre-certifications for advanced imaging, therapeutic injections, and specialty labs.
→ Track claims through electronic claim submission
→ Implement root-cause analysis for denied claims
Technology-Driven RCM
→ Proper provider credentialing ensures maximum reimbursement and compliance
→ Medicare, Medicaid, Blue Cross, UnitedHealthcare, and other commercial plans
→ Customized Credentialing Plans
→ Reduce delays with eligibility verification and payer enrollment tracking
→ Medicare, Medicaid, Blue Cross, UnitedHealthcare, and other commercial plans
→ Customized Credentialing Plans
→ Reduce delays with eligibility verification and payer enrollment tracking
Technology-Driven Insights
→ Monitor claim denial trends by CPT, ICD-10, and payer
→ Track A/R aging and net collections
→ Identify under-billed or missed services
→ Predict future revenue gaps and optimize cash flow
→ Track A/R aging and net collections
→ Identify under-billed or missed services
→ Predict future revenue gaps and optimize cash flow
Compliance & Risk Management
→ 100% HIPAA-compliant operations to ensure patient data security at every step
→ Evolving CPT/HCPCS coding and payer regulations
→ Perform compliance audits, medical audits, and pre-submission reviews to minimize claim rejections
→ Evolving CPT/HCPCS coding and payer regulations
→ Perform compliance audits, medical audits, and pre-submission reviews to minimize claim rejections
Health & Billing Brings
To Your Healthcare Practice
So, You can focus on what’s more important: Patient Care!
Reduced Administrative Burden | Improved Cash Flow | 100% HIPAA-compliance
Cost Efficiency | Certified medical coders and credentialing specialists | Scalable Solution