Primary Care Billing Services

Primary care earns its money in small increments that add up — a correctly leveled office visit, a wellness visit that isn't confused with a physical, a between-visit care-management minute that actually gets logged, a diagnosis captured deeply enough to hold up under audit. Our primary care billing services exist to protect every one of those increments, because in family and internal medicine the revenue you lose is rarely one big claim. It's a hundred small ones a week: the complexity add-on nobody appended, the annual wellness visit that paid like a problem visit, the chronic-care time that was never captured, the diagnosis that dropped off the problem list and pulled your risk score down with it.

247 Medical Billing Services runs the complete revenue cycle for independent primary care, family medicine, internal medicine, pediatrics, nurse-practitioner-led clinics, and value-based and direct-primary-care practices. We treat the whole primary-care payment model — office and outpatient evaluation and management, preventive and wellness visits, the care-management stack, risk-adjustment coding, and incident-to supervision — as one connected system, not a pile of unrelated claims. The result is more first-pass payments, fewer takebacks, a cleaner risk score, and clinicians who spend their day on patients instead of on payer rules.

99% Clean-Claim Rate	~99% Net Collections	Under 25 Days in A/R
Claims built to pay on first submission	Nearly every earned dollar collected	Cash in weeks, not quarters

20+ years (since 2005) · HIPAA-compliant · SOC 2 Type II · HBMA member · AAPC/AHIMA-certified primary care coders

What our primary care billing delivers

Practices that move to us typically see denials fall by up to 40%, a first-pass clean-claim rate around 99%, net collections near 99%, and days in A/R pulled under 25 — with roughly nine of every ten worked denials overturned on appeal. We hold a 98% client-retention rate because those numbers hold month after month, not only in the honeymoon quarter. Every claim is scrubbed and filed within 24 hours, so revenue that used to age in a work queue starts landing in your account instead. Just as important for primary care, we work the quieter leaks a generalist never touches — the missing visit-complexity add-on, the wellness visit downcoded to a problem visit, the unbilled care-management program, the diagnosis that never got re-captured — because those are where a primary care practice actually loses the most. A free audit puts real figures against your own remits before you change a thing.

What makes primary care billing different

Most billing companies can push a clean office visit through a clearinghouse. Primary care needs far more than that, because the payment model has moved well past the simple sick visit:

• The visit is only the starting point. Office and outpatient evaluation and management is now leveled on medical decision-making or total time, and a primary-care visit-complexity add-on rewards you for being a patient's continuous, longitudinal source of care. Generalists routinely leave that add-on off every eligible claim — pure earned revenue, never billed.
• Preventive care and wellness are not the same thing. A commercial annual physical, a Medicare wellness visit, and a Medicare initial preventive exam are three different services with three different rule sets — and Medicare does not pay for a routine physical at all. Bill the wrong one, or bundle a same-day problem without the correct modifier, and the visit either denies or pays a fraction of its value.
• The money increasingly lives between visits. Chronic care management, principal care management, transitional care after a discharge, remote patient and therapeutic monitoring, behavioral-health integration, advance care planning, and the newer bundled monthly primary-care management program are all billable — but only with patient consent, real time tracking, one care-management "home," and no duplication. Miss any of those and the program is unbillable.
• Your diagnoses set your value-based payment. Under risk adjustment, the conditions you document and re-capture each year drive your risk score, which in turn drives Medicare Advantage and accountable-care revenue. Undercode and you're underpaid; document without clinical support and you invite a recoupment audit.
• Who provides the care changes what it pays. Services delivered by a nurse practitioner or physician assistant can be billed under the physician at the full fee schedule instead of the reduced mid-level rate — but only when strict supervision and established-patient rules are met.

Managing all of that on every encounter is exactly what professional primary care billing services are built to do — and it's the difference between a practice that merely gets paid and one that gets paid what it earned.

How primary care billing actually works

We manage each revenue layer of a modern primary-care practice so nothing eligible goes unbilled and nothing billed goes unsupported:

Revenue layer	What it is	What we manage
E/M leveling + complexity add-on	Office/outpatient visits leveled on decision-making or time, plus the primary-care continuity add-on	Correct level on every visit and the continuity add-on appended wherever it's earned
Preventive & wellness visits	Commercial physicals, the Medicare Annual Wellness Visit, and the initial preventive exam — each with its own rules	The right visit chosen for the right payer, with the same-day-problem modifier applied so both services pay
Care-management stack	Chronic, principal, transitional, and remote monitoring plus behavioral-health integration and advance care planning	Consent, time tracking, and a single non-duplicated care-management home so every eligible minute is captured and defensible
Risk adjustment (HCC/RAF)	Diagnoses mapped to condition categories that scale value-based payment	Annual re-capture with Monitor/Evaluate/Assess/Treat documentation and a clean two-way review under the current model transition
Incident-to & supervision	NP/PA services billed under the physician at the full rate vs. the reduced mid-level rate	Supervision and established-plan rules confirmed before the claim, so the full-rate billing holds

Our primary care billing services

Everything it takes to move a primary-care encounter from the note to paid — run by one certified team sharing one record, instead of split across vendors that hand your claims back and forth:

• E/M, preventive & care-management coding — visits leveled correctly, the continuity add-on captured, wellness visits kept distinct from physicals, and every care-management program coded with the consent and time documentation behind it.
• Risk-adjustment & HCC coding — annual diagnosis re-capture with full clinical support, a two-way review that adds and removes conditions honestly, and clean documentation that survives an audit while your risk score reflects your real patient panel.
• Eligibility & benefit verification — coverage, plan type, and preventive-benefit rules confirmed before the visit, so nothing denies for a lapsed policy or a non-covered routine physical.
• Charge capture & clean-claim submission — encounters reconciled, scrubbed, and filed within 24 hours so complexity, wellness, and care-management revenue all leave the door on the first pass.
• Denial management & appeals — every denial worked to its root cause, from bundling edits to non-covered wellness visits, and appealed inside the payer's window.
• A/R recovery — aging claims pursued relentlessly across Medicare, Medicaid, Medicare Advantage, and commercial payers until they pay or resolve.
• Credentialing & payer enrollment — physicians, nurse practitioners, and physician assistants enrolled and re-credentialed so nothing rejects on provider eligibility or supervision setup.

If you'd rather keep your primary care billing and coding services under one roof, that's precisely the model — certified coders and billers on the same team, sharing the same record, instead of your claims changing hands between companies.

Why primary care practices choose 247MBS

Bringing us on isn't hiring a general biller who happens to accept primary-care claims. It's hiring a primary care billing company that already knows where family-medicine revenue leaks and how to stop it:

• We capture the complexity you're already earning. The continuity add-on goes on every eligible visit, so you stop giving away revenue you're entitled to on encounters you're already documenting.
• We keep wellness visits paying like wellness visits. Preventive and Annual Wellness Visits are coded to the correct payer rule and the same-day modifier is applied when a problem is addressed, so both services pay instead of one bundling into the other.
• We turn between-visit care into billable revenue. We stand up and run your care-management programs with the consent, time logs, and single-home discipline that keep them payable — often a five-figure line item practices had been leaving entirely on the table.
• We protect your risk score and your audit position. Diagnoses are re-captured annually with documentation that supports them, so your value-based payment reflects your panel without exposing you to a recoupment.
• You always see the work. A named account manager owns your account and a live dashboard shows every claim, denial, and dollar — with no long-term lock-in holding you in place.

247MBS vs. a general billing company

A generalist learns primary care on your claims. We show up already fluent in it — and the difference shows up on the remittance:

Capability	General billing company	247MBS
Visit-complexity / continuity add-on capture	❌	✅
Annual Wellness Visit vs. physical, coded correctly	Limited	✅ Full
Same-day preventive + problem, billed to pay both	❌	✅
Care-management programs (chronic, TCM, RPM) stood up and run	❌	✅
HCC re-capture with MEAT documentation	❌	✅
Incident-to supervision billed at the full rate	❌	✅
Dedicated account manager & live dashboard	Sometimes	✅ Always

The primary care denials and revenue leaks we prevent

Most primary-care losses trace back to the same handful of failure points. We close each one at the front end, before it becomes a denial, a downcode, or a recoupment:

Issue	The denial or revenue loss it triggers	How we prevent it
Routine physical (99381–99397) billed to Medicare	Non-covered denial — Medicare pays no routine physical	We bill the Medicare AWV (G0438/G0439) or IPPE (G0402) instead, matched to the patient's history
AWV + problem visit same day without modifier 25	Bundling denial — one service pays, the other is lost	We append modifier 25 to the E/M so both the wellness visit and the problem visit pay
Visit-complexity add-on (G2211) omitted	Lost complexity revenue on every eligible longitudinal visit	We append G2211 wherever continuity of care supports it
Care management (99490, 99424, 99457) without consent or time	CCM/PCM/RPM denial or recoupment	We document consent, log time, and keep a single non-duplicated care-management home
HCC diagnosis unsupported by MEAT or not re-captured	RADV recoupment plus a depressed RAF and underpayment	We re-capture annually with Monitor/Evaluate/Assess/Treat support and a two-way review
Incident-to billed without direct physician supervision	Recoupment to the 85% mid-level rate	We confirm supervision and the established plan before billing at the full rate

Every one of these is preventable before submission rather than argued after the fact. Get your free primary care billing audit and we'll show you which of them is hitting your remits right now.

Primary care billing for every practice model

The rules shift with the model, and we bill each one to the detail it demands:

• Independent family & internal medicine practices — high-volume office and outpatient visits where correct leveling and the continuity add-on decide whether the practice is paid its true value.
• Nurse-practitioner-led and direct-primary-care clinics — scope-of-practice and supervision billing done right, plus the membership and hybrid models that a generalist rarely understands.
• Pediatric and multi-provider group practices — well-child and preventive schedules, immunization administration, and multi-payer complexity across a full provider roster.
• Value-based, ACO, and Medicare Advantage practices — risk-adjustment coding, annual re-capture, and quality reporting run as a discipline, so your shared-savings and capitated revenue reflect the panel you actually manage.
• Practices adding care-management or remote-monitoring lines — programs stood up, documented, and billed from day one so a new revenue stream doesn't stall on compliance.

What switching to 247MBS looks like

Changing billers shouldn't mean a gap in cash flow, and with us it doesn't. We work inside your existing electronic health record and practice-management system, so nobody relearns a platform. Credentialing and payer-enrollment review run in parallel while your claims keep going out the door, a named account manager leads the transition from day one, and most primary care practices are fully live within a few weeks. The denial drop, the recovered complexity revenue, and the faster A/R show up in the first cycles — not a quarter later. And because we handle the full spectrum of physician billing services, a growing practice can add providers, locations, or new care-management lines without ever outgrowing its billing partner.

Primary care billing FAQ

Do you capture the primary-care visit-complexity add-on on our visits?

Yes. We append the continuity add-on to every eligible office and outpatient visit where your documentation supports being the patient's ongoing source of care. For most practices it's found revenue — earned on encounters you're already seeing, but never billed by a generalist.

How do you handle Medicare wellness visits versus annual physicals?

We code the Medicare Annual Wellness Visit and initial preventive exam correctly instead of billing a routine physical Medicare won't cover, and when a problem is addressed at the same visit we apply the same-day modifier so both services pay rather than one bundling into the other.

Can you set up and bill our care-management programs?

Yes. We help stand up chronic care, transitional care, and remote-monitoring programs and then bill them with the consent, time tracking, and single-care-management-home discipline that keep them payable — turning between-visit work into a reliable revenue line.

Do you handle HCC and risk-adjustment coding for value-based contracts?

We do. We re-capture chronic conditions each year with Monitor/Evaluate/Assess/Treat documentation and run an honest two-way review, so your risk score reflects your real panel and holds up if a validation audit ever arrives.

Do you offer primary care billing and coding together?

Yes. Certified primary care coders and billers work as one team sharing one record, so E/M leveling, preventive coding, care management, and claim submission stay aligned instead of being split across two vendors.

We're a small independent practice — is outsourcing worth it?

Usually more so, not less. Small practices feel every missed add-on, downcoded wellness visit, and unbilled care-management minute, and a transaction-based fee replaces the cost and turnover risk of an in-house biller expected to master all of primary care's rules alone.

Ready to get more of your primary care claims paid the first time?

Whether you're a solo family physician, an NP-led clinic, a pediatric group, or a value-based practice, our primary care billing services protect every layer of your revenue — the visit, the wellness exam, the care-management minute, and the risk score behind your value-based payment. Outsource primary care billing services to a primary care billing services company that treats E/M leveling, preventive rules, care management, and risk adjustment as routine — and put the revenue you're leaving on the table back where it belongs.

Get Your Free Primary Care Billing Audit  ·  +1 888-502-0537  · 

Compare the best primary care billing companies before you choose, or talk to our team about professional primary care medical billing built for how family medicine actually gets paid.