General Practice Medical Billing Services

Check the requirement at booking rather than at billing. Some plans will not pay a specialist visit without a referral already on file, and by the time the claim denies it is often too late to obtain one retroactively. Store the reference number on the patient record so it flows onto the claim automatically. We handle the chasing so your reception desk does not have to.

Individually no, in batches yes. A forty dollar denial repeated two hundred times a year is real money, but working each one separately costs more than it recovers. We group denials by cause and fix the pattern once, which resolves many claims at a time. That turns a queue nobody wants to open into a short, high-return task.

Weekly, against the coming schedule. Patients change plans at renewal and often do not mention it, so coverage confirmed at registration can be wrong months later. Batch verification takes minutes and catches the problem before the visit rather than after the denial. It is the highest-return administrative habit a small practice can adopt.

Almost certainly some. Injections, lesion removals, wart treatments, and simple repairs all carry value beyond the visit, and in a busy general practice they get documented clinically and never charged. We compare a week of clinic notes against submitted claims and flag encounters where a procedure appears in the record but not on the bill.

Yes, because most general practice loss is administrative rather than clinical. Authorisation chasing, eligibility refreshes, denial batching, and statement cycles are all work your team performs without billing for it. Moving that off your front desk frees capacity you can either use for patients or simply stop paying overtime for.

With a fixed statement cycle and a help desk that answers balance questions directly. General practice balances are small, so they age quietly and get written off. A predictable cycle plus someone available to explain the charge collects substantially more than sporadic statements. Your staff stops fielding those calls entirely.

That is the normal case, and it is exactly where small practices lose ground. We maintain a rule table per payer covering referral requirements, filing deadlines, and authorisation triggers, then apply it automatically. Your team no longer has to remember which plan wants what, which removes a large share of preventable denials.

Daily, with clearinghouse rejections worked the same day. General practice claim values are low enough that a backlog becomes hard to clear and easy to ignore. Daily submission also keeps patient statements timely, which matters because balances collect far better when the visit is still recent in the patient's mind.

Yes, and they usually benefit most. A solo practice faces the same payer complexity as a large group with none of the administrative capacity. Percentage-based pricing scales with your collections rather than charging a flat fee, so a smaller practice pays proportionally. You keep your own system and your own workflow.

Cleaner eligibility and faster submission in month one, since those depend on process rather than payer behaviour. Denial volume falls through months two and three as batched corrections take effect. Aged balances take longer. We report those separately so you can see which improvements came from workflow and which from recovery work.