Family practice billing services are essentially outsourced administrative tasks that help family practices manage the financial aspects of patient care. Checking a patient’s insurance plan to ensure they are covered for the services being provided. Assigning the correct medical codes to procedures and diagnoses for accurate billing. Electronically submitting claims to insurance companies for reimbursement. Billing Care Solutions family practice billing services take the burden of medical billing off the shoulders of physicians and their staff, allowing them to focus on patient care.
Billing Services
Medical Billing & Coding
Billing Care Solutions goes beyond basic coding to utilize advanced automation tools. Its software can automatically identify and rectify coding errors before claim submission, significantly reducing denials due to incorrect coding. Billing Care Solutions system integrate with real-time code lookup databases, ensuring you’re always using the most up-to-date and accurate codes for each service.
Revenue Cycle Management (RCM)
Billing Care Solutions leverage data analytics to predict potential issues in your revenue cycle, allowing proactive intervention and preventing claim denials before they occur. Billing Care Solutions RCM system offer real-time visibility into claim status, enabling you to quickly identify and address any delays or rejections.
Account Receivable Management
Billing Care Solutions utilize automated tools for sending out appointment reminders, statements, and past-due balance notifications, improving patient engagement and reducing the need for manual follow-up. Billing Care Solutions offer an online patient portal where patients can easily access their statements, make payments, and update insurance information, streamlining the billing process.
Provider Enrollment & Credentialing
Billing Care Solutions have a system that automates credentialing verification with various insurance companies, expediting the process and reducing delays. Billing Care Solutions proactively notify you of upcoming credentialing renewals, ensuring uninterrupted billing for your services.
Eligibility & Benefit Verification
Billing Care Solutions offer real-time eligibility verification tools, allowing you to confirm patient insurance coverage and benefits at the point of care, preventing claim denials due to coverage issues. Billing Care Solutions integrate with various insurance networks, streamlining eligibility verification for patients with multiple insurance plans.
Authorization and Referral Services
Billing Care Solutions utilize an ePA platform for submitting authorization requests electronically, significantly reducing processing times and minimizing delays in patient care. Billing Care Solutions offer real-time tracking of authorization requests, allowing you to stay updated on the status and expedite approvals if needed.
Business Intelligence Reporting Services
Billing Care Solutions provide customizable dashboards that offer real-time insights into key performance indicators (KPIs) like denials rates, collections trends, and coding accuracy. These dashboards allow you to drill down into specific data points for further analysis. Billing Care Solutions reporting system leverage data analytics to generate reports that predict future revenue and identify areas for improvement in your billing practices.
Patient Support
Billing Care Solutions offer a multi-lingual call center to accommodate patients who speak different languages, ensuring clear communication and a positive patient experience. Billing Care Solutions offer an online patient support portal where patients can submit questions and receive timely responses through a secure platform.
Coding System
Current Procedural Terminology (CPT) codes: These codes define the specific medical services provided during a patient visit. Some common CPT codes used in family medicine include:
- Office visits (99213, 99214)
- Immunizations (90471, 90472)
- Minor skin procedures (11400, 11401)
Healthcare Common Procedure Coding System (HCPCS) codes: These codes encompass non-physician services provided in your practice. Examples include:
- Lab tests (80051, 82544)
- X-rays (78000, 78002)
- Durable medical equipment (E0446, E0480)
Modifiers
Evaluation and Management (E/M) Service Modifiers:
- Modifier 25: Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service. This signifies a separate and essential service beyond the typical E/M visit.
- Modifier 59: Distinct procedural service. This indicates a separate procedure performed on the same day that’s unrelated to the E/M service and deserves separate payment.
Procedural Modifiers:
- Modifier 51: Multiple procedures performed on the same day by the same physician during a single surgical session. This is used for procedures that are not normally bundled together.
- Modifier 76: Repeat procedure by the same physician on the same day. This signifies an unplanned additional procedure necessitated by the original procedure.
Place of Service Modifiers:
- Modifier 24: Unrelated E/M service by the same physician during the post-operative period. This is used for an E/M visit related to a different condition within 90 days of a major surgery.
- Modifier 95 (GT): Telehealth service. This indicates the service was delivered via telecommunication technology.
Other Modifiers:
- Modifier 22: Increased complexity. This signifies a service with unusual procedural difficulties.
- Modifier 53: Incomplete service. This indicates a planned procedure that couldn’t be completed due to unforeseen circumstances.
In conclusion, Billing Care Solutions aims to provide a more efficient, accurate, and data-driven approach to family practice billing compared to what most billing companies skip to offer.
We specialize in Medical Billing and Coding and provide comprehensive support for your practice. For more information visit
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