rcm solutions Family Medicine facilities

Medical Billing And Revenue Cycle Management Solutions For Family Medicine Practices

Family medicine providers deal with a wide range of care across different age groups, which results in varied billing codes, frequent patient visits, and complex payer requirements. At StafGo Health, we specialize in comprehensive RCM and medical billing services tailored specifically for family medicine practices. Our customized RCM services are made in a way to suit your billing operations, reduce claim denials, and maximize reimbursements.

Certified Coders For Your Family Medicine Practice At Stafgo Health

Our team of certified coders at StafGo Health ensures that they correctly apply the commonly used CPT codes in family medicine, including 99202–99215 for office or outpatient evaluation and management (E/M) services, 99381–99397 for preventive medicine services (new and established patients), 99406–99409 for smoking and tobacco cessation counseling, 99495–99496 for transitional care management, and 99490–99491 for chronic care management, which are crucial for practices managing long-term conditions.

Why Outsource Medical Billing And RCM To Stafgo Health For Your Family Medicine Practice?

Family medicine practices handle a wide variety of services, which makes their billing more complex and time-consuming. Lower reimbursement and consistent review of your documentation are ongoing concerns for Family Medicine Providers. To overcome all these issues, StafGo Health provides tailored Revenue Cycle Management (RCM) and medical billing solutions designed specifically for the ongoing needs of family medicine providers. Our team of experts has a comprehensive understanding of new codes for diverse patient populations, ensuring accurate claim submissions and faster reimbursements.

Common RCM Challenges Faced by Family Medicine Practices

Family medicine practices are the frontlines of healthcare, which offer a wide range of services from preventive screenings to chronic disease management, and due to their nature, they have complex billing requirements as well. Here are some challenges that these practices face-

High Volume and Variety of Services - Family medicine provides several services, from a normal visit to immunizations for chronic diseases, which involves a broad range of CPT codes. This leads to complex billing and more chances of coding error.
Frequent Coding Updates - Few codes are frequently subject to change, e.g., CPT and ICD codes for preventive services, screenings, and chronic care. Staying updated with these changes is challenging and often results in claim rejections or underpayments.
Inconsistent Documentation - Sometimes, all the necessary documents may not be maintained by physicians, which can lead to missed revenue opportunities and potential compliance risks.
Underutilized Preventive and Care Management Codes - Many family medicine practices miss out on revenue by not fully leveraging codes for chronic care management (99490, 99491), transitional care management (99495, 99496), and preventive services (99381–99397). These codes require detailed documentation and follow-up processes.
Claim Denials and Rejections - There are several reasons that can lead to claim denials and rejections, like incorrect coding, insufficient documentation, or payer-specific requirements. It can impact the smooth cash flow and increase the administrative burden on providers.
Limited Staff for Billing Follow-Up - A/R follow-up and denial appeals can become challenging when small or mid-sized family practices operate with lean administrative teams. It hampers their overall performance and financial growth.

Solving Your Family Medicine Practice’s Challenges with StafGo Health

Accurate Coding and Documentation Support - At StafGo Health, certified coders are well aware of the wide range of CPT and ICD codes that are being used in family medicine. Our team makes sure that every patient encounter is coded correctly and documented properly to capture all billable services.

Real-Time Insurance Verification—Primary care providers generally face eligibility-related issues. At StafGo Health, our team does insurance eligibility and benefit checks in advance to make sure that providers are informed at the proper time and can avoid coverage-related delays or rework.
Automated Claims Submission and Tracking - At StafGo Health, an automatic billing system is used, which submits claims after the encounter is documented. Our systems submit the claims very quickly and also track them in real time. Our team promptly follows up on all outstanding claims and makes sure that no payment is missed.
Expert Denial Management - Our team analyses the denials deeply, finds out the root cause, and applies targeted solutions to minimize recurring issues. We promptly address the denials and appeal them to ensure reimbursements on time.
Patient Statement Management and Support—Our team streamlines patient billing by making clear and easy-to-understand statements that mention balances and due dates. Hence, we can help you maintain positive relations with patients by providing them details related to billing, explaining charge,s and assisting with payment options
Custom Reporting and KPI Tracking - StafGo Health believes in transparent services. We provide customized dashboards and reports that provide keen insights regarding days in AR, Net Collection Rate, AR Aging, and denial rates.