Family medicine runs on volume: dozens of visits a day, many payers and a mix of preventive, sick-visit and chronic care services. Bela Claim submits and follows up on those claims, including the small ones that are easy to let age.
In short: we verify eligibility for your daily schedule, submit claims after checking them against the visit, post payments, work denials and follow up on unpaid claims by age and payer. Your providers keep documenting and coding; we handle everything after that.
These are the billing situations we watch most closely in primary care.
When a chronic condition is managed during an annual physical, both services may be billable. Payers bundle or deny the second service when the claim does not reflect the documentation. We check the pairing before submission and follow up on denials.
Medicare annual wellness visits (G0438, G0439), transitional care management and chronic care management each have their own eligibility, frequency and documentation requirements. We track frequency and follow these claims through to payment.
A full schedule means plan changes, new member IDs and terminated coverage show up daily. We check coverage ahead of visits so your front desk can update details at check-in, not after a denial.
Vaccine claims need both the product and the administration billed correctly, and in-office tests need the right ordering details. We check these lines on each claim and follow up when one line is paid and another is not.
Primary care generates many small patient balances and partial payments. Left alone, they age past the point of collection. We post every payment, send statements on schedule and keep small balances visible in reporting.
When the same denial reason shows up across many claims, it usually has one upstream cause. We group denials by reason and payer so one fix at the front desk or in documentation covers all of them.
The full workflow is described on our end-to-end RCM page. If your team already handles part of this, billing team support or a dedicated biller may be enough.
Coding rules and payer policies change. Codes on this page are examples for U.S. practices; your providers remain responsible for code selection, and payer rules decide coverage. Canadian family practices: see billing support for Canadian clinics. Also see our mental health billing page if your practice offers integrated behavioral health.
Volume and variety. A family practice may bill preventive visits, problem-focused visits, vaccines, in-office tests and care management in a single day, across many payers. Small errors repeat quickly at that volume, and low-dollar balances are easy to ignore until they add up.
Yes. When your provider documents a significant, separately identifiable problem-oriented service during a preventive visit, both services may be billable, usually with modifier 25 on the problem-oriented visit. We check that the claim reflects the documentation and that the patient was told a cost share may apply, and we follow up when a payer bundles or denies the second service.
We submit and follow up on annual wellness visit claims (HCPCS G0438 for the initial visit and G0439 for subsequent visits) along with your other Medicare claims, and check eligibility before scheduling so frequency limits are caught early. Coding decisions remain with your providers.
Your providers document and select codes. Our role is to review claims for missing or mismatched information before submission, then submit, post, follow up and work denials. If we notice a recurring documentation or coding pattern behind denials, we report it so your team can address it.
Bring your provider count, approximate monthly visits, main payers and the billing problems you see most. We will show you how we would handle them in a free 30-minute consultation.