claims built right the first time, not reworked after they deny
Family Practice billing · Florida
Family Practice Billing Services in Florida
247 Medical Billing Services delivers family practice billing services in Florida that get well-child, adult chronic-care, and Medicare visits paid across AHCA's Statewide Medicaid Managed Care and every commercial plan you see.
Since 2005, we have run the full revenue cycle for Florida family physicians — dedicated account manager, free 360° dashboard, HIPAA-compliant and SOC 2 Type II, no long-term contract.
HIPAACompliant
SOC 2Type II
Serving Since2005
Specialty-FocusedRCM
We bill family practice across Florida
Miami
Orlando
Tampa
Jacksonville
Fort Lauderdale
Medicaid, Medicare & commercial
And More
The Florida payer landscape we bill every day
The rules that decide whether a Florida family medicine claim gets paid — and who owns them once you're with us:
| Florida billing factor | The detail we manage |
|---|---|
| Medicaid program | AHCA — Statewide Medicaid Managed Care (SMMC 3.0) |
| Delivery model | Managed care — 8 statewide MCOs |
| Major plans | Sunshine (Centene), Simply, Aetna, Humana, Molina, UnitedHealthcare |
| Appeal window | 90 days (Medicaid fair hearing) |
| Managed-care enrollment | ~3.57 million Floridians |
Florida does not run Medicaid through a single fee schedule. The Agency for Health Care Administration (AHCA) delivers nearly all of it through the Statewide Medicaid Managed Care program, now in its SMMC 3.0 contract cycle, and roughly 3.57 million Floridians are enrolled across eight managed-care plans. That means a single family practice in Tampa may bill Sunshine Health, Simply, Humana, Molina, Aetna, and UnitedHealthcare in the same week — each with its own portal, prior-auth rules, and vaccine-administration pricing. We verify the exact plan before the visit so the claim is built for the payer that actually covers the patient.
The SMMC 3.0 rollout added two traps we watch on every account. First, plan and region reassignment creates churn: a patient's managed-care plan can change at recertification or when they move between the state's service regions, and a claim sent to last quarter's plan bounces as "not this payer." Second, Florida's HME and durable-supply licensing rules can strand otherwise-clean claims when a practice dispenses supplies or vaccines without the enrollment the plan expects. We reconcile eligibility and enrollment first so neither one quietly drains your collections.
Best Family Practice Billing Services in Florida (FL)
Practices that pick 247MBS aren't hiring a general billing company that dabbles in primary care — they get a partner that already knows how a Florida family medicine claim moves through SMMC 3.0, Medicare Part B, and commercial plans. As a dedicated, professional medical billing services company, we bring all-ages coding discipline to every claim: the well-child visit, the same-day sick complaint, the Medicare Annual Wellness Visit, and the chronic-care-management time your team is documenting but not capturing.
cash that arrives in weeks, not quarters
leakage caught before it compounds
a revenue cycle that runs on schedule
That focus shows up in the numbers that matter:
Every account gets a dedicated account manager and a free 360° reporting dashboard, so you always see what was billed, what paid, and what's being worked — with no long-term lock-in.
How family practice claims get paid
Family practice is the widest coding surface in primary care: one practice bills newborns, working adults, and Medicare seniors under one roof, each with its own edits. We code and scrub every line to the Florida payer that owns it — AHCA's managed-care plans, Medicare Part B, or commercial.
| Code(s) | What it covers |
|---|---|
| 99385-99387 / 99395-99397 | Preventive-medicine visits (new & established), age-banded |
| G0438 / G0439 | Medicare Annual Wellness Visit (initial / subsequent) |
| 99213-99215 + mod 25 | Problem E/M billed the same day as a preventive visit |
| 90460-90461 / 90471-90474 | Vaccine administration (with vs without counseling) |
| 99490 / 99491 | Chronic Care Management, staff vs physician time |
| 96160 / 96127 | Health-risk and behavioral-health screening add-ons |
The two lines that leak most in Florida are vaccines and same-day visits. Vaccine billing runs two components — the product and the administration — and Sunshine, Simply, Humana, and each Medicaid plan price and bundle them differently, with VFC rules layered on top for eligible children. A preventive visit plus a same-day problem complaint has to be split-billed correctly or the payer bundles the two and you lose the problem-visit revenue. We build both to each plan's rules so they're paid, not written off.
Where Florida family practices lose revenue
Most avoidable loss in Florida family medicine traces to four repeatable patterns. We prevent them at charge capture instead of chasing them after the remit:
The leak
Preventive and problem visit bundled
How we plug it
Split-bill with modifier 25 and diagnosis-linked documentation so both are paid
The leak
Vaccine admin denied or underpaid
How we plug it
Bill product + admin on correct lines; reconcile to each payer's fee schedule and VFC rules
The leak
AWV billed as a problem visit
How we plug it
Use G0438/G0439 with the required elements; keep the AWV distinct from the E/M
The leak
Chronic-care-management time not captured
How we plug it
Log and bill 99490/99491 against documented care-plan time
Add SMMC 3.0 churn — claims sent to a plan the patient no longer carries — and you have the short list of what quietly erodes a Florida family practice's margin every month. A revenue review shows exactly how much each pattern is costing you.
Revenue review
Put a dollar figure on what your family practice claims are leaving behind.
A certified family practice billing specialist reviews your coding, unit counts, authorizations and aged A/R against the payers you actually bill in Florida — and puts a number on what your current process is leaving on the table.
- Preventive and problem visits separated, with modifier 25 supported
- Annual wellness and preventive visits billed to each payer's own rules
- Chronic-care and care-management time documented against its code
HIPAA & SOC 2
Back to you within one business day
No long-term lock-in
Request a Revenue Review
Tell us about your practice.
A family practice specialist will reach out within one business day.
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A family practice specialist will reach out within one business day.
Why Florida family practices outsource billing
When you outsource to a team that already lives in AHCA's managed-care rules, the result is a revenue cycle that runs itself — and a practice that can add providers without adding billing headcount. Outsourcing also removes the single-biller risk: no more collections gap when the one person who knows your payer mix is out. For the national view of how we run this specialty, see our complete family practice billing overview.
split-billing, vaccine reconciliation, and worked appeals recover money in-house teams leave on the table
first-pass-clean claims pay in weeks, not after rounds of resubmission to the wrong SMMC plan
front-end eligibility and plan verification stop wrong-payer rejections before they happen
transaction-based pricing instead of headcount, software seats, and staff churn
your front desk stops untangling eight managed-care portals and gets back to care
Family Practice Billing Services in Florida for Every Practice
Whether you're a solo physician in Jacksonville or a multi-site group across Orlando, we handle the entire cycle — one team, one account manager, one dashboard:
— the exact SMMC plan, Medicare, or commercial payer confirmed before the visit, with eligibility verification that catches recertification churn early
— preventive, problem, AWV, vaccine, and CCM lines built to each Florida payer's edits
— worked to root cause and refiled inside the 90-day fair-hearing window
— Medicaid and MCO paneling kept current so claims never reject on enrollment
— the full front-to-back cycle, reported to you in real time
Every service runs inside our nationwide family practice billing practice, tuned to the plans Florida providers actually bill.
Who we serve across Florida
We run billing for the full range of Florida primary care — from the Panhandle to South Florida:
Miami to Pensacola, one provider or one location
several clinicians, one payer mix to manage
where product-plus-admin billing has to be exact
heavy Medicaid and VFC volume
hybrid models that still bill Medicare and commercial
Whether you sit in Miami, Orlando, Tampa, Jacksonville, or Fort Lauderdale, you get the same statewide command of Florida's Medicaid, Medicare, and commercial cycle.
Getting started in Florida
Switching billing partners sounds disruptive. With us, it isn't.
we work inside your existing EHR/practice-management system, not a new platform
credentialing and MCO enrollment run while claims keep going out
your dedicated account manager leads from day one
From kickoff we review your Medicaid and plan enrollment, map your payer mix against the eight SMMC plans, and take over without a gap in submissions — so you feel the drop in denials fast, not a quarter from now.
Medical Billing for Family Practice in Florida
Medical billing for family practice in Florida means keeping pace with eight managed-care plans at once — Sunshine Health, Simply, Humana, Molina, Aetna, and UnitedHealthcare all deliver AHCA's Statewide Medicaid Managed Care under the SMMC 3.0 contract, each with its own portal and pricing. 247MBS verifies the patient's current plan before the visit, splits same-day wellness-plus-problem encounters, and reconciles vaccine lines to each plan's schedule so managed-care churn never bounces a claim to the wrong payer. Practices from Miami and Tampa to Orlando and Jacksonville see denials fall and A/R held under 25 days, delivered by AAPC/AHIMA-certified coders under HIPAA and SOC 2 Type II controls since 2005. Request a revenue review and see what plan churn is costing you.
Choosing a Family Practice Billing Services Provider in Florida
Let's get your Florida family practice claims paid faster
Start with a revenue review: we'll analyze your claims, denials, and aging A/R and show you exactly what 247MBS can recover for your Florida practice — no cost, no obligation.
Family Practice billing in every Florida city we serve
Each city page covers the local payer mix, the practices we bill for there, and the denials we prevent.
Cape Coral
Clearwater
Coral Springs
Davie
Fort Lauderdale
Gainesville
Hialeah
Hollywood
Jacksonville
Lakeland
Miami
Miami Gardens
Miramar
Orlando
Palm Bay
Pembroke Pines
Pompano Beach
Port St Lucie
St Petersburg
Tallahassee
Tampa
West Palm Beach
These are the Florida markets we cover in depth. We bill family practice practices right across the state — tell us where you are and we will walk you through billing in your area.
Family Practice Billing in Florida — FAQ
We're a primary-care billing specialist that knows Florida specifically — AHCA's Statewide Medicaid Managed Care under the SMMC 3.0 contract, the eight managed-care plans, and the split-billing and vaccine rules that trip up general billers. A generalist billing company learns your payer mix on your claims; we already know it, which is why practices rate us among the best family practice billing options in the state.
We verify each patient's current managed-care plan before the visit, not after a claim denies. When a patient is reassigned at recertification or moves between service regions, we catch the change at eligibility so the claim goes to the plan that actually covers them — not last quarter's payer.
Yes. When a wellness visit and a same-day sick complaint are documented, we split-bill the problem E/M with modifier 25 and diagnosis-linked documentation so both are paid instead of the payer collapsing them into one.
We bill the product and the administration on the correct lines and reconcile each to the specific plan's fee schedule and VFC rules. That's where most vaccine underpayment hides, and it's exactly what we audit first.
Yes. We maintain AHCA and managed-care plan enrollment alongside live billing, running re-enrollment in parallel so a lapse never becomes an eligibility rejection.
Yes. We operate inside your existing EHR and practice-management software. There's no new platform for your staff to learn — we work behind the scenes and report through your free dashboard.
preventive vs problem·modifier 25·wellness visit·care management
Ready to get more Florida claims paid on the first pass?
Whether you are a solo practice or a multi-site group, we bill Family Practice across Florida under one dedicated account manager and a live dashboard — and treat every counted unit, authorization and appeal as recoverable revenue until it is safely paid.
Prefer email? sales@247medicalbillingservices.com