BLOG • Feb 19, 2025
Unlocking Revenue Potential: Why CARC Codes Are Essential for Denial Management
RCM Medical coding
🟢 Family Practice Services
Specialized Medical Billing Services for Family Practice Clinics
Making Payments Easier for Every Family Member
Schedule a Call16,800
Total Patient Visits Billed
27 Days
Avg Time for Office Visit Claim Processing
20%
Payer Rejections for Telehealth Services
Overview
Streamlined Family Practice Billing for Maximized Revenue
Family practices face complexity in billing due to multiple codes, ICD-10 updates, and guidelines. Our dedicated billing service ensures correct code usage, rapid claim submission, and thorough insurance checks, accelerating reimbursements and reducing denials
Primary Phase: Patient Enrollment & Authorization
During the Primary Phase, we handle all aspects of patient registration, insurance verification, and authorization checks. Confirming coverage at the start prevents complications down the road—especially for preventive services like health‐risk assessments and immunizations. Our systematic approach ensures accurate data entry and fast authorization turnaround
Secondary Phase: Coding & Billing Using Advanced Software
We rely on cutting‐edge billing platforms such as Lytec, Medic, Misys, Medisoft, and NextGen to convert your family physicians’ diverse services into accurate invoices. Whether it’s a routine visit, an internal medicine procedure, or a preventive screening, our specialists use CPT and ICD‐10 codes correctly-aligning with AMA and CMS guidelines to avoid costly denials
Tertiary Phase: Specialized Family Medicine Coding
Our billing experts excel at coding acute, chronic, and preventive services. From diagnosing internal illnesses to documenting wellness checkups, we apply the right CPT modifiers and ICD‐10 details for each scenario. By meticulously translating these services into compliant claims, we help you receive optimal reimbursement without errors or denials
Customized Reporting & Reconciliation
Through personalized monthly reports and accounting reconciliations, we provide complete visibility into your practice’s financial performance. These reports outline revenue trends, claim status, and outstanding accounts receivable, helping you spot opportunities for improvement. In turn, our strategies keep you compliant with HIPAA, CMS, and AMA regulations
Comprehensive Family Practice Billing Services
We handle the entire billing process, including: • Insurance appeals & eligibility verification • Fast, accurate patient enrollment • Compliance with coding & billing • AR follow-ups & balance collection • Patient billing calls for a smooth experience By ensuring every claim is correctly submitted and followed up, we eliminate partial reimbursements or outright rejections
Operations
How We Streamline Your Family Practice Billing Workflow
Our proven operations model integrates advanced billing software, CPT/ICD‐10 coding accuracy, and dedicated follow‐up to produce a swift, error‐free billing cycle. Each phase is tailored to address the specific needs of family physicians, from preventive care screenings to chronic disease management
Patient Registration & Insurance Checks
We begin by gathering patient demographics, verifying coverage, and determining pre‐authorization requirements. This step is critical for ensuring that services like annual wellness visits or screening tests will be promptly covered under the patient’s plan
Charge Entry & Accurate Coding
Using Lytec, Medic, Misys, Medisoft, or NextGen, our team enters charges with precision. We map each service to the correct CPT, ICD‐10, and HCPCS codes, applying any necessary modifiers and confirming alignment with AMA and CMS requirements to prevent rejection
Claim Submission & Tracking
All claims—whether electronic or paper—are submitted promptly. Our automated system flags missing documentation or coding discrepancies before submission, reducing denial rates. Real‐time tracking enables proactive follow‐up on older claim
Accounts Receivable & Follow‐Up
Timely AR follow‐ups are crucial for maintaining cash flow. Our specialists monitor unpaid claims, coordinate with insurers, and escalate appeals when necessary. This thorough approach helps keep your reimbursement cycle healthy and predictable
Patient Communication & Billing Calls
We also manage patient billing inquiries—handling statements, payment arrangements, and resolving outstanding balances. Clear, empathetic communication fosters patient satisfaction while ensuring prompt payments for your practice
Reports, Reconciliation & Continuous Improvement
Detailed monthly KPI dashboards provide insights into claim status, reimbursement rates, and any coding or process bottlenecks. We perform regular accounting reconciliations and use analytics to refine processes, ensuring your practice stays profitable and compliant with HIPAA, AMA, and CMS guidelines
Testimonials
Client Success Stories
FAQ
Frequently asked questions
Once we have securely received your patient and encounter data, we code, review, and submit claims to payers. We manage appeals and denials, track payments, and provide regular updates. Our process is designed to be efficient and transparent.
Our certified coders and billing specialists review every claim carefully. We use quality‑control checks, regular coding audits, and payer‑specific validation to reduce coding errors and the risk of denials.
Our denial‑management team reviews each denied claim to identify root causes. We correct issues, resubmit claims promptly, and, when needed, pursue appeals with payers to maximize reimbursement.
We offer flexible pricing tailored to client needs — including fixed fees, per‑claim pricing, or percentage‑of‑collections models depending on volume and services required. Contact us for a custom quote.
Yes. We specialize in seamless transitions from in‑house systems or other vendors. To ensure secure data migration, our team works closely with you and provides training as needed.
Resources
Your Go-To Source for Resources, Industry Updates, and Expert Insights
Ready To Get Started
Share your details with us, and we'll set up a tailored demo just for you.
