- Business Hours: 08:00 to 05:00 | Monday to Friday
- Contact: +1 713-702-7332
- Email: info@ombcs.com
- 906 W. Medical Center Blvd, Webster TX 77598

# Primary Care Billing Services

### Our Specialties

## Primary-Care Billing Services

Specialized billing solutions for family practice, internal medicine, and pediatric clinics to optimize revenue, reduce denials, and streamline billing for primary care services.

### Our Services

## Primary-Care Billing Expertise

- Expert coding for E/M services (99201-99215 series)
- Chronic care management billing optimization
- Preventive service coding and documentation
- Medicare Annual Wellness Visit billing

- Telehealth and virtual visit billing
- Transitional care management coding
- Primary care quality reporting programs
- Incident-to billing compliance

### Coding Expertise

## Common Primary-Care CPT Codes

Code | Description
--- | ---
99213 | Office visit, established patient, low to moderate complexity
99214 | Office visit, established patient, moderate complexity
99396 | Preventive visit, established patient, 40-64 years
99487 | Complex chronic care management, 60+ minutes
99495 | Transitional care management, moderate complexity

### Our Process

## Primary Care Billing Process

Our comprehensive approach ensures maximum revenue and minimal administrative burden for your Primary Care practice.

### Patient Registration & Insurance Verification

We verify primary-Care-specific insurance benefits and coverage for Primary-Care procedures, tests, and devices before services are rendered, including:

- Verification of coverage for diagnostic Primary-Care tests (cystoscopies, urodynamics)
- Pre-authorization for Primary-Care procedures and interventions
- Coverage confirmation for implantable Primary-Care devices
- Patient responsibility estimation for high-cost Primary-Care procedures
- Coordination of benefits for post-operative Primary-Care care

### Specialized Primary-Care Coding

Our primary-Care coding specialists ensure accurate code assignment for all Primary-Care services:

- Precise coding for diagnostic primary-Care services (cystoscopies, urodynamics, imaging)
- Expert coding for surgical Primary-Care procedures (prostatectomies, nephrectomies)
- Accurate device coding (stents, slings, prosthetics)
- Proper modifiers for multiple Primary-Care procedures
- Compliant documentation support for complex Primary-Care procedures

### Clean Claim Submission

We achieve a 98% clean claim rate for primary-Care services through our thorough process:

- Primary-Care-specific claim scrubbing to identify coding errors
- Verification of medical necessity documentation for Primary-Care procedures
- Inclusion of required diagnostic test results
- Proper sequencing of Primary-Care diagnosis and procedure codes
- Electronic submission to all major payers within 24-48 hours

### Primary-Care Denial Management

Our specialized approach to Primary-Care claim denials includes:

- Expertise in appealing medical necessity denials for Primary-Care procedures
- Management of bundling/unbundling issues common in primary-Care
- Documentation support for complex Primary-Care intervention appeals
- Appeals for denied device implantation procedures
- Monitoring and addressing primary-Care-specific payer policy changes

### Primary-Care Practice Analytics

Our primary-Care-specific reporting and analytics help optimize your practice:

- Procedure-specific profitability analysis
- Revenue analysis by service line (diagnostic, surgical, primary-Care)
- Payer-specific performance metrics for Primary-Care services
- Denial trend analysis by procedure type
- Recommendations for revenue optimization by service area

### frequently asked questions

## Primary Care Billing FAQs

Get answers to common questions about our primary care medical billing services, coding challenges, and revenue optimization strategies.

##

Our approach to chronic care management billing includes verifying proper enrollment documentation, tracking time spent with each patient, ensuring the minimum 20 minutes of clinical staff time is documented, and confirming appropriate use of CCM codes (99490, 99487, 99489). We also assist with implementing compliant workflow systems to track CCM services efficiently.

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We ensure accurate differentiation between preventive services and problem-oriented visits, properly apply modifiers when both services are provided on the same day, and help implement documentation templates that satisfy the specific requirements for wellness visits. Our team stays current with preventive service coverage policies across all major insurers.

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Our telehealth billing specialists ensure proper application of telehealth modifiers, verify coverage based on patient location, document technology used, confirm appropriate consent procedures, and stay current with evolving telehealth policies. We also help implement workflows to document the required elements for full reimbursement of virtual visits.

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We stay at the forefront of all E/M coding updates, including the significant 2021 guideline changes. Our team provides ongoing education to physicians and clinical staff, reviews documentation to ensure it meets current requirements, and conducts regular audits to identify opportunities for improvement. We help practices adapt to the medical decision-making approach while ensuring compliant and optimal coding.

## Ready to optimize your primary-Care revenue cycle?

Contact us today for a free consultation and learn how our specialized primary care billing services can benefit your practice.

Request a Free Consultation

### How can we help you?

I can help with primary-Care billing questions, insurance information, or scheduling assistance.