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511 SW 10th Ave 1206,
Portland, OR United States

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Primary Care

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24/7 Support: +1 800-123-1234

Expert Medical Billing Services for Primary Care Practices

Simplify your billing process, maximize reimbursements, and ensure compliance with specialized medical billing services for primary care providers. Primary care practices play a critical role in providing comprehensive healthcare, from routine check-ups to chronic disease management. Billing for primary care services can be complex due to the wide range of services offered, insurance variances, and the evolving nature of healthcare regulations. Without proper billing, practices risk delayed payments, claim denials, and lost revenue.

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98% First-Pass Pay Rate

: Our expertise in primary care billing ensures accurate coding and faster approval from insurers.

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30% Reduction in AR Days

By reducing denials and optimizing the billing process, we help your practice reduce accounts receivable days and improve cash flow.

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15% Revenue Increase

Primary care practices that work with us experience an increase in revenue, thanks to better coding, efficient claim processing, and faster payments.

accuracy

99% Claim Accuracy

Our commitment to accurate billing ensures that claims are processed right the first time, reducing the need for follow-up and minimizing errors.

Common Billing Challenges in Primary Care

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Accurate Coding for Routine and Preventive CareAccurate Coding for Routine and Preventive Care

Primary care involves a variety of services, from annual physical exams and immunizations to routine screenings and chronic disease management. Correctly coding these services ensures proper reimbursement and reduces the risk of claim denials.

How We Solve It:

Our certified coders are experts in primary care coding, including preventive care (such as annual physicals and wellness exams) and chronic disease management. We ensure that all services are billed with the appropriate ICD-10, CPT, and HCPCS codes, reducing errors and ensuring you are reimbursed fairly for the full spectrum of services you provide.

challenge

Insurance Verification and Coverage Variability

Each patient has a unique insurance plan, and navigating the variations in coverage can be time-consuming and complex. Incorrect verification can lead to claim denials and payment delays.

How We Solve It:

Our team works directly with insurance companies to verify patient benefits and determine the specific coverage for primary care services. We ensure your claims are submitted according to each payer’s specific guidelines, increasing approval rates and reducing denials.

challenge

Managing Preventive Care and Chronic Disease Codes

Many primary care services require the use of specific codes for preventive care (such as wellness visits, screenings, and immunizations) and chronic disease management (such as diabetes care or hypertension). If not properly documented or coded, these services may result in payment issues.

How We Solve It:

We have deep knowledge of the codes and guidelines for preventive care and chronic disease management. Our billing team ensures that all services related to these visits are correctly documented, coded, and submitted for reimbursement, so your practice receives fair compensation for all services rendered.

challenge

Denials and Underpayments

Primary care practices often deal with claim denials or underpayments due to incorrect coding, insufficient documentation, or lack of prior authorization for certain services. This can delay payment and result in lost revenue.

How We Solve It:

We proactively manage the entire billing process, ensuring that all claims are accurately coded and properly documented. In case of denials, our team works quickly to address the issue, resubmit claims, and negotiate with insurers to ensure appropriate reimbursement.

challenge

Prior Authorization Requirements

Certain services, such as specialist referrals, diagnostic tests, and certain medications, may require prior authorization from insurance providers. Without proper authorization, claims may be denied.

How We Solve It:

Our team ensures that all services requiring prior authorization are submitted well in advance, ensuring approval before services are rendered. This reduces the risk of denials and helps to maintain a smooth revenue cycle.

How We Solve Primary Care Billing Challenges

Accurate and Efficient Coding
We handle all aspects of primary care coding, including preventive care, wellness exams, immunizations, and chronic disease management. Our certified coders ensure that all services are properly documented and billed using the most current ICD-10, CPT, and HCPCS codes.
Thorough Insurance Verification and Claim Submission
Our team works closely with insurance companies to verify patient benefits and determine coverage for primary care services. We ensure that your claims are submitted to the right payer and follow the correct guidelines, which increases approval rates and speeds up reimbursement.
Expertise in Preventive Care and Chronic Disease Management Billing
We help ensure that all preventive and chronic disease management services are coded correctly. From wellness visits to ongoing treatment for chronic conditions like diabetes and hypertension, we make sure you receive the full reimbursement for the services you provide.
Efficient Denial Management and Appeal Process
In the event of claim denials or underpayments, our team quickly investigates the issue and works with insurance providers to resolve any discrepancies. We handle the entire denial management and appeals process to ensure that your practice is reimbursed as quickly as possible.
Prior Authorization Management
We take care of obtaining prior authorizations for services that require approval, such as diagnostic tests, specialty referrals, and medications. By managing the authorization process, we help your practice avoid payment delays and denials.

What Our Primary Care Clients Are Saying

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"Primary care practices like mine depend on steady revenue to operate smoothly. NY Practice Partner has made our billing efficient and reliable. Their RCM services reduce denials, accelerate payments, and give us the financial foundation to better serve our patients."

Dr. Jonathan Ellis, Family Physician

"NY Practice Partner has taken the stress out of billing for our primary care clinic. With their support, our revenue cycle is consistent, reimbursements are faster, and my focus stays on preventive medicine and long-term patient relationships."

Dr. Karen Mitchell, Primary Care Physician

"Maple Grove Family Practice used to struggle with slow collections and high administrative burdens. After working with NY Practice Partner, our primary care clinic is financially stable, reimbursements come in on time, and our staff can dedicate more energy to patient care."

Rachel Simmons, Practice Manager – Maple Grove Family Practice

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