Expert General Practice Billing Services for Your Practice

general practice medical billing

We specialize in providing comprehensive general practice medical billing services that allow you to focus on what matters most – your patients. Our expert team understands the unique challenges and intricacies of dermatology billing and is committed to improving your revenue cycle while ensuring compliance and accuracy in every step.

Common General Practice CPT Codes

Below are some commonly used CPT codes for a general practice:

Evaluation and Management (E/M) Codes:

  • 99201 - 99205: New patient office visits (based on complexity and time spent).

  • 99211 - 99215: Established patient office visits (based on complexity and time spent).

  • 99217 - 99220: Observation care services (for patients under observation in a hospital).

  • 99381 - 99387: Initial preventive care exams (based on patient age).

  • 99391 - 99397: Periodic preventive care exams (based on patient age).

Diagnostic Services:

  • 81002: Urinalysis, non-automated.

  • 93000: Electrocardiogram (EKG) with interpretation.

  • 36415: Venipuncture for blood draw.

  • 93010: Electrocardiogram, rhythm interpretation.

Minor Surgical Procedures:

  • 10060: Incision and drainage of abscess (simple).

  • 12001 - 12007: Simple wound closure (based on size and location).

  • 11056: Paring or cutting of benign hyperkeratotic lesions (corns or calluses).

Injections and Immunizations:

  • 96372: Therapeutic, prophylactic, or diagnostic injection (e.g., B12 shots).

  • 90471: Administration of vaccines (e.g., flu vaccine).

Preventive Care:

  • G0438: Annual wellness visit (Medicare).

  • G0439: Subsequent annual wellness visit (Medicare).

Miscellaneous:

  • 99241 - 99245: Office consultations (specialist evaluation).

  • 99217: Observation discharge, with or without complications.

  • 99173: Visual acuity screening.

General Practice Medical Billing Best Practices

To ensure accurate and efficient billing, keep the following in mind:

  • Accurate Diagnosis Codes (ICD-10): Make sure to match the diagnosis code with the correct treatment.

  • Thorough Documentation: Ensure all patient interactions and treatments are thoroughly documented to support the codes submitted.

  • Payer Requirements: Different insurers may have specific rules for submitting claims. Always confirm payer-specific requirements to reduce the chance of denials.

  • Timely Filing: Submit claims as soon as possible to avoid any issues with claim acceptance and reimbursement.

Insurance Coverage and Reimbursement

General Practice are typically covered by most major insurance plans, including Medicaid, Medicare, and private insurers. However, reimbursement rates and coverage may vary based on:

  • The specific condition being treated

  • The patient's insurance plan

  • Whether the service is provided in-network or out-of-network It’s important to verify insurance coverage before providing treatment to ensure that services will be covered and that the correct billing codes are used.

Our Denials and Appeals Process

Medical claim denials are a common challenge in general practice billing. Our process:

  • Understanding the Denial Reason: Denials could be due to incorrect coding, insufficient documentation, or missing information. We thoroughly review the insurance company’s reason for denial and address it appropriately through various modes of response.

  • Appeal Process: If the claim is denied based on coverage or medical necessity, an appeal may be necessary. We review the insurance company’s appeal process and act quickly to submit it and reduce potential delays or timely submissions.

How we can help:

  • Comprehensive coding and claim submission

  • Insurance verification and prior authorization

  • Denial management and appeals

  • Contracting and Credentialing

  • Patient statements and collections

  • We specialize in ensuring your practice receives timely reimbursements while remaining fully compliant with industry standards and payer requirements

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