Under-coded evaluation and management
Office visits are leveled on medical decision making or total time. Many primary care practices systematically bill a level below what the documentation supports, which is legal but expensive.
Specialties › Primary Care & Family Practice
Primary Care & Family Practice Billing Services
Primary care rarely loses money to dramatic denials. It loses money quietly — visits coded a level lower than the documentation supports, preventive and problem-oriented care collapsed into one billable service, and care-management programs that are never billed at all. Across thousands of visits a year, those small omissions are usually the largest recoverable opportunity in the practice.
What makes it hard
Primary Care & Family Practice billing challenges we solve
These are the issues that repeat every month in primary care & family practice practices — and the ones we fix at the source rather than reworking claim by claim.
Preventive and problem visits together
When a problem is addressed during a wellness visit, both may be reportable with the correct modifier. Practices routinely bill only one and give away the other.
Annual wellness visit requirements
Medicare wellness visits have specific required elements. Missing an element turns a payable wellness visit into a denied or downcoded claim.
Unbilled care management
Chronic care management, transitional care and remote monitoring are recurring revenue streams most primary care practices are eligible for but never bill.
Payer mix complexity
A single primary care panel can include Medicare, multiple Medicaid plans, commercial payers and Medicare Advantage — each with different rules, and each needing its own follow-up discipline.
Coding depth
Common code families we work with
- 99202–99215 — new and established office evaluation and management
- G0438 / G0439 — initial and subsequent Medicare annual wellness visits
- 99381–99397 — preventive medicine visits by age
- 99490 / 99439 — chronic care management
- 99495 / 99496 — transitional care management
- 99453 / 99454 / 99457 — remote physiologic monitoring
- Modifier 25 — problem visit on the same day as a preventive service
Listed for context only — this is not billing advice, and payer policy varies. Our certified coders work to AAPC and AHIMA standards.
Denial prevention
Top denial drivers in primary care & family practice
- Problem visit denied as included in the preventive service
- Wellness visit missing a required element
- Care management billed without meeting time or consent requirements
- Level of service not supported by documentation
- Eligibility or plan mismatch at time of service
We root-cause denials by payer and procedure, then fix the upstream workflow so the same denial stops recurring.
Why ERG
What you get with ERG
Specialty-trained billers
Your account is worked by people who bill primary care & family practice every day — not a general pool learning your rules on your claims.
95%+ net collection rate
Relentless follow-up on every claim, with aged A/R worked rather than written off.
No long-term contract
Performance-based pricing — a percentage of what we collect. Stay because the results are good, not because you are locked in.
5–10 day onboarding
We run parallel with your current process until the transition is verifiably clean.
Human-led, AI-supported
Our certified coders work every claim; AI tools help them catch more before submission.
HIPAA-compliant throughout
Strict PHI controls, access limits and staff training across the whole workflow.
FAQ
Primary Care & Family Practice billing — common questions
Can you tell us if we are under-coding?
Yes. Our A/R analysis includes an E/M distribution review. If your visit levels skew lower than your documentation supports, that is usually the fastest revenue improvement available to a primary care practice — with no change in patient volume.
Do you help us bill chronic care management?
Yes. CCM, transitional care and remote monitoring are eligible recurring revenue for most primary care panels and are very commonly unbilled. We set up the billing workflow and handle the claims.
Can you bill preventive and problem visits on the same day?
When a separately identifiable problem is addressed and documented during a preventive visit, both are reportable with the correct modifier. We make sure that revenue is captured rather than written off.
We are a small independent practice — do you work with us?
Yes. We work with solo and small independent practices as well as groups, with no long-term contract and pricing as a percentage of what we collect.
Client results
What practices say about working with us
★★★★★Our A/R days dropped from 58 to 31 in one quarter. First time in years I actually trust my numbers.
— Sarah M., Practice Manager
★★★★★We switched from a big billing company and collections went up, with better communication. Didn't expect both.
— Jennifer C., Owner / Provider
Next step
See what your primary care & family practice practice is leaving uncollected
A no-obligation A/R analysis. We review your aging, denial patterns and coding mix, then show you exactly where the recoverable revenue is.
Other specialties: Mental Health & Behavioral Health Cardiology Physical Therapy Pain Management Orthopedics · see all