Family Practice Medical Coding and Billing

Touseef Riaz

January 19, 2022

family practice medical coding and billing
A family practice specialist has to deal with people of all ages, making this field of medicine the busiest one of all. Family practice healthcare providers usually specialize in more than one medical field, which makes them have a ton of more responsibilities resulting in difficulty handling administrative tasks like medical billing. Like for every other kind of medical billing, the medical billers and coders must have extensive knowledge of family practice coding and billing methodology. This helps in doing the job more efficiently. All of these factors contribute to outsourced family practice medical billing services. It results in lesser stress and lesser errors in medical claims and coding. Don’t stress yourself if you are troubled by all the billing codes and claim denials. You can easily outsource your medical billing in the hands of medical billing experts or companies like UControl Billing and only worry about providing safe patient care.

How does Family Practice Medical Billing work?

As for every other medical and healthcare specialty, family practice billing also requires submission of clean claims with correct and complete documentation – errorless medical claims! If you choose to outsource your family practice medical billing to UControl Billing, we ensure HIPAA Compliance, timely follow-ups, affordable pricing, error-free claim submission, and denial management. We are here to focus on your primary cause, i.e., patient care.

With a medical billing company handling your medical claims, you can rely on,

– Clean claims

– Timely submissions

– Denial management

– Timely Follow-ups

– Increased revenues

– Higher reimbursement rate

– Customized financial reports with UControl billing


Family Practice CPT Code:

As family practice covers a vast range of diseases and patients, there are a number of different codes used for medical billing and coding in family practice. The two most common codes used in coding for family practice include 99213 and 99214. According to the CPT coding system and the rules of CMS (Center of Medicare and Medicaid Services) Evaluation and Management, 99213 code can be used to code for any stable chronic condition. For instance, stable cirrhosis of the liver.

Furthermore, code 99213 signifies 15 minutes and 99214 signifies the typical 25 minutes of face-to-face interaction between the patient and the physician.

Common coding mistakes in Family Practice:

One of the biggest challenges when it comes to medical coding and billing of family practice is keeping up with the changes in CPT codes. Family practice’s most revenues come from the use of ICD-9 and CPT codes in medical billing and coding. This is why using the right code in insurance claims is essential for being compensated for the medical services provided by the healthcare provider.

Every year, the CPT codes manual and documentation guidelines are updated for the healthcare providers. The most common error or mistake in medical billing is the use of the wrong code. Now, this requires being up to date about the recent changes in CPT and ICD codes, which is obviously time-consuming. Following are some of the medical coding mistakes in family practice:

– Not being up to date:

Entering the wrong code in medical billing results in late payments and lower revenues. This is why updating the amendments in codes is essential for submitting medical claims without any errors.

– Necessity of service provided:

The medical claim must prove the medical necessity behind the procedure or healthcare services provided as the insurance payers are getting more concerned.

– Use of wrong codes:

Using the wrong or old code can also result in claim denials, late payments, and lost revenues.

– Error in documenting E/M services:

When coding or documenting the E/M services (Evaluation and Management Services), the right and appropriate levels should be selected to avoid any errors.

– Using the wrong modifier:

Using a modifier comes with a set of requirements. Medical coders should have a vast knowledge of these requirements and use the right modifier. They are using the wrong modifier results in claim denials, late payments, and lower reimbursement rates.

– Charges:

Family practice healthcare providers are dealing with a number of medical procedures and services. This is why every one of the medical services provided should be documented, charged, and billed for in the medical claim.

How can error-free coding be achieved?

In order to submit an error-free claim, the above-mentioned errors or mistakes should be avoided at all costs. Be up to date and use the correct codes. Medical billing for family practice can be done in two ways: hiring an in-house team of medical billers and coders or outsourcing it to professional medical billing companies like UControl Billing.

Ways to maximize the Family practice revenues:

Due to a number of medical billing and coding errors, the revenues of family practice often suffer the cost. Medical billing and coding for family practice revenues can be increased by practicing the following plans or implementing strategies like:

– Maintain and manage your medical claims properly

The medical claims being submitted against the family medicine services provided by the physician must be error-free and submitted in time to avoid late submissions and rejections.

– Minimize the coding errors

There are a number of coding errors when it comes to family practice, as it involves coding for a wide range of procedures. Some of the common coding errors include the following:

o Confusion between two codes or use of wrong code

o Diagnosis or treatment codes that don’t match each other

o Use of wrong modifiers

Before submitting the claim, make sure to recheck the codes to avoid denials.

– Manage your claim rejections and denials in time

In case of denials or rejections, manage them promptly. There is a significant difference between a rejected claim and denied claim. A rejected claim has not been processed yet, whereas a denied claim has been processed. A denied claim needs to be appealed before resubmission, but on the other hand, the rejected claim can be resubmitted after correcting the errors.

– Strategize and figure out the areas that need improvement

There are a number of ways to improve your revenue cycle when it comes to family practice. One of the biggest and most efficient ways for improvement is to outsource the family practice billing and coding services to a medical billing company like UControl Billing. As discussed already, the codes are gradually changing, and being up to date can be extremely time-consuming.

Outsourcing your medical billing services to a company like UControl Billing can be very effective. We offer you a user-friendly complete revenue cycle management (RCM) with our expert team of medical billers and coders. Along with our 24-hour timely follow-ups, we offer lesser errors and a higher reimbursement rate.

In-House Vs. Outsourced Family Practice Coding:

In medical billing and coding, you get to choose between the two; hiring an in-house medical biller or a team of specialists overlooking your claims or outsourcing the services to another medical billing company. When we talk specifically about family practice, outsourcing is being more commonly adopted. As mentioned, family practitioners deal with a variety of patients, and a huge patient base comes with a number of different procedures in a wide range of medical fields. Therefore, if the provider chooses to do the medical billing in-house, the billing staff must have vast knowledge and experience in medical billing and coding.

Outsourcing Family Practice Medical Billing:

In this era of digitalization, family medical practice billing has become easier due to a number of companies handling medical billing and coding for the family practice healthcare providers. Not only this, the medical billing company handles the complete RCM (Revenue Cycle Management), costs you less, maximize your practice and the best thing, you won’t even have to purchase any billing software.

Why outsource family medicine billing?

There are a number of benefits and advantages of outsourcing family practice billing to a medical billing company. To sum it up, the benefits of outsourcing out ways the cons of in-house medical billing.  Following are some of the reasons why you should choose to outsource your family practice medical billing and coding:

–  A wide range of patients and procedures

When we talk about family practice healthcare providers, they are dealing with a number of patients belonging to different age groups, with a variety of disease and treatment options. They have to deal with patients in different specialties and medical fields.

Now considering all of this, an in-house medical biller would have to have a vast knowledge and understanding of family practice billing. Not only this, but they also would have to memorize a huge amount of billing codes for the different procedures and treatments being performed. Firstly, someone, this experienced is very hard to find and secondly even if you do, when it comes to salary the cost is way too high.

However, medical billing companies have vast experience of working with family practice and various other medical fields. They are highly trained, updated, and specialized in getting the work done properly.

– Customized billing

Every family practice has its own needs and demands regarding medical billing. When you outsource your medical billing services, the company provides you with a customized plan, considering all your needs.

At UControl Billing, we don’t believe in “One Size Fits All”; rather, we adapt according to your needs and requirements.

– Being up to date about medical billing and coding amendments

With all the vast number of procedures being done in family medical practice comes being up to date about any changes or amendments in the billing codes. With so many procedures, checking for updates is very time-consuming.

But the professional medical billing companies are constantly updating themselves to avoid any errors in medical billing and coding.

– Lesser errors, higher revenue, and reimbursement rate

Reducing errors and increasing the reimbursement rate is one of the major goals behind outsourcing medical billing. Medical billing companies have an expert team solely determined to reduce errors and increase your revenues. Medical claims get submitted fast with lesser errors, resulting in higher reimbursement rates and an improved revenue cycle.

– Faster payments

Professional medical billing companies are working to reduce the errors in medical claims and get them submitted within the available timeline. Hence, lesser denials and faster payments.

– Primary focus remains intact

The primary focus of any healthcare provider is to give their patients the safest healthcare and treatment. With an outsourced family practice billing, the practitioners can focus on patient care without having to worry about any administrative or management tasks regarding medical billing staff, medical claims, denials, or revenues.


Frequently Asked Questions (FAQs)

1. How much do medical coders make working from home?

There are a number of benefits when we talk about work from home medical billing and coding, including that you get flexible hours. In the United States, the average annual or yearly salary of work from home medical coder or biller is around $54,797. With approximately about 26.36 dollars per hour.

2. What are the four types of medical coding systems?

Medical coding is a process of converting the medical procedures performed by the healthcare provider into medical codes for submitting the insurance claim. Following are the four major types of medical coding classification systems:

o   ICD (International Classification of Diseases) Codes

o   CPT (Current Procedure Terminology) Codes

o   HCPCS (Healthcare Common Procedural Coding System)

o   Modifiers

3. What type of medical coding pays the most?

Medical coders and billers work in the billing department of any healthcare provider (hospital, clinic or medical centers, etc.). A Certified Professional Coder or Biller is the highest paying certification. However, the salary may vary based on geographical location.

4. Can I work from home as a medical coder?

Yes, you can work from home as a medical coder. Working from home as a medical coder or medical biller has become increasingly common these days. There are a number of benefits when it comes to remote working as a medical coder. For instance;

– Flexible schedule

– Transport cost gets eliminated

–  An increased productivity

– You can go on a vacation somewhere and still be working.

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