SpecialtiesPrimary & acute care
How we see family medicine billing.
Reviewed by the VisMed primary & acute care billing team
A family practice bills more encounters per physician than almost any other specialty, and each one is worth comparatively little. That changes what good billing looks like. A cardiology practice can afford to chase one claim for an hour; a family practice cannot. We have to get the whole cycle right the first time, at volume, without anyone touching a claim twice.
The other thing volume does is hide undercoding. A physician who documents a level-four visit and bills a level three never receives a denial, so nobody ever looks. Across a year of visits that is the single largest leak we find in family medicine, and it is invisible from the aging report your current biller sends you.
So VisMed treats a family practice as a throughput problem with a coding-accuracy problem inside it. Our eligibility desk clears every visit two days ahead, our charge team reconciles the schedule against claims every evening, and our coders read notes rather than claims to find the visits that were billed a level low.
Where family medicine practices lose money
The patterns we find in the aging and denial history before anything else changes.
Preventive visit with a problem addressed
The annual physical where the patient also brings up knee pain is two services. Without modifier 25 on the problem E/M, and documentation that separates the two, the second service is given away. We see this on most new family medicine accounts.E/M leveled by habit
Since 2021 the level follows medical decision-making or time, not the number of body systems examined. Physicians trained under the old rules still level down. Every level-three that should be a four is money left on the table, with no denial to flag it.Medicare wellness visits billed as physicals
The Annual Wellness Visit is not a physical exam and Medicare does not cover one. Practices that bill the physical get a denial; practices that skip the AWV forgo a well-paid visit with no copay for the patient.Vaccines without the administration code
The product and the administration are separate lines, and the administration codes differ by route and by whether counseling happened. Miss one and the practice absorbs the cost of the vaccine.Eligibility checked at check-out
Family practices see a lot of Medicaid and exchange plans, where coverage changes month to month. A plan that lapsed last week produces a denial you discover 30 days later, when the patient is unreachable.
What we do differently for family medicine
Specialty-matched coders and a denials specialist, working inside your own system.
We verify eligibility 48 hours ahead, not at the desk
We check every scheduled visit two days out and push the copay, deductible status and plan-specific rules into the appointment, so your front desk collects the right amount without a conversation.Our undercoding review reads the note
Our coders compare the documented decision-making against the billed level on a rolling sample and on every visit with chronic-condition management. We send the physician a short weekly note with what we found, not a lecture.We reconcile the schedule every day
Every appointment on your schedule must end as a claim, a no-show or a documented reason. We close that list every evening, so a visit cannot quietly go unbilled.We keep preventive and problem services separate
We give you templates that keep the preventive and problem-oriented portions distinct, and a coder checks each note before the claim leaves, so modifier 25 survives review and the second service is paid.
What we bill
The procedure and code families your account team already works in.
Family medicine billing, asked and answered.
What a physician-owner in this specialty asks on the first call.
How much revenue does undercoding actually cost a family practice?
VisMed quantifies it from your own notes in the AR audit rather than quoting an industry figure. The gap between a level-three and a level-four established visit is a meaningful sum, and a physician who levels down on a fraction of visits a day does so hundreds of times a year.
Can VisMed bill preventive and problem-oriented services on the same visit?
When the documentation supports a significant, separately identifiable problem service, we bill the preventive code and the problem E/M with modifier 25, and we check the note supports both before it leaves. Where the note does not, we tell the physician what was missing.
Does VisMed handle Medicaid and managed-Medicaid plans?
Family medicine is where we see the most Medicaid volume, and each state and each managed-care plan has its own enrollment, eligibility and timely-filing rules. Your VisMed account team works those rules daily.
We tried chronic care management and stopped. Why would it work with VisMed?
Most practices stop because the time tracking and consent work fell on the clinical staff. VisMed runs CCM as a program with our own care managers, so the practice gets the monthly revenue without adding to the nurses’ day.
Does VisMed bill Medicare Annual Wellness Visits correctly?
We bill the AWV as its own service, not as a physical, and when the physician also manages a problem in the same visit we bill both with the documentation separated. Our recall lists make sure every eligible Medicare patient is offered one each year.
Also in primary & acute care
Internal medicine
E/M leveling, chronic-care codes and complex payers.
Pediatrics
Well-child schedules, vaccines and Medicaid rules.
Geriatrics
Medicare-heavy panels, TCM and annual wellness.
General practice
Broad code sets, kept accurate at volume.
Urgent care
Walk-in registration, S-codes and fast turnaround.
Emergency medicine
Facility and professional claims, critical-care time.
Osteopathic medicine
OMT with E/M on the same visit, modifier-correct.
Sleep medicine
Studies, home testing and DME crossover.
Sports medicine
Injections, imaging and therapy bundles.
All specialties
The full list, in six groups
See where your family medicine practice is losing money. Free.
Six months of aging and denials, read by people who bill your specialty every day — quantified as monthly leakage with a recovery estimate. Yours to keep.
or write directly hello@vis.med