Internal Medicine Billing Services
E/M levels, chronic care management, annual wellness visits and Medicare Advantage documentation.
Internal medicine revenue now turns on the visits you are not billing, as much as the ones you are. Annual wellness visits, chronic care management and transitional care management are all payable. All three are under-used. And all three have documentation and time rules you have to meet first. Our internal medicine billing services find the eligible patients instead of waiting for the charge to arrive.
Practices comparing internal medicine medical billing services should ask about Medicare Advantage in particular. MA contracts reward accurate chronic condition documentation. With a large MA panel, you are paid on how well your coding reflects the patients you manage.
Our Services
A Wide Specialty, and a Wide Code Set
Internal medicine covers a lot: diabetes, high cholesterol, heart disease, infections, blood disorders, endocrine problems and much else besides.
That range makes the billing complicated. Assigning the right codes and getting internal medicine medical billing through cleanly is not simple, and errors add up quietly. Our team watches the detail, from coding through billing to collection.
What benefits are provided by our Internal Medicine Medical Billing Services?
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Procedural Embodiment
We keep up with how the industry changes, and we hire the people that change calls for. That means we can cover any internal medicine procedure or condition you bill.
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Supplementary Authentication
Most companies charge extra for verification work. We do not. Eligibility checks, sorting out conflicts and the rest are included, and that is part of why practices stay with us.
Procedure
Coding and billing for various internal medicine procedures are handled with equal proficiency, ensuring accuracy and efficiency in the process:
- Nephrology
- Gastroenterology
- Neurology
- Oncology
- Psychiatry
- Hematology
- Dermatology
- Critical Care Medicine
- Ophthalmology
- Cardiovascular Diseases
- Gynecology
- Pulmonary Diseases
- Otorhinolaryngology
- Infectious Diseases
- Non-surgical Orthopedics
- Rheumatology
- Palliative Medicine
- Endocrinology
- Rehabilitation Medicine
The visits internal medicine under-bills
Internal medicine has the widest gap we see between work performed and work billed, and it is concentrated in a few services.
Preventive visits are not all the same thing
The Medicare annual wellness visit and a commercial annual physical are different services with different requirements. The wellness visit is not a head to toe examination. It is a structured set of elements: a health risk assessment, a review of medicines and providers, a check for memory problems, and a written prevention plan the patient keeps. Write up a physical and bill it as a wellness visit, and it fails on review. Do the wellness visit properly and bill it as a problem visit, and you give away the higher payment.
When a chronic problem is genuinely addressed at the same appointment, that work is separately billable with the right modifier and a note that stands on its own.
Chronic care management
Patients with two or more long term conditions can be enrolled in chronic care management. It pays every month for work the practice is already doing between visits: care coordination, sorting out medicines, phone calls with families. Most internal medicine panels have several hundred eligible patients and most practices bill it for none of them.
The rules are real, but they are paperwork rather than clinical work: written consent, a care plan the patient has a copy of, round the clock access, and time logged each month.
Transitional care management
After a discharge, contacting the patient within two business days and seeing them inside the window pays substantially more than a routine follow up, for work the practice already does. It is missed because nobody is watching the discharge feed, not because it is difficult.
Where the audits land
Two patterns attract attention: modifier 25 applied to almost every preventive visit, and a level of service that never varies across a panel. Both are fine when the notes back them up. Neither is, when they are just habits.
Internal Medicine Credentialing and PCP Panel Assignment
For internal medicine, one detail decides more revenue than anything else: whether you are listed as a primary care provider on the payer panel, or as a specialist. The PCP listing is what puts you in the directory patients search. On many plans it is also what triggers the per-member payment and the quality bonuses.
That listing is not automatic. It is a separate request at enrollment, and it can be refused if the panel is full in your county. Ask for it in writing and check it once the contract is live. Practices often find out two years later that they were filed as specialists all along.
We handle the enrollment and the PCP listing together. See our medical credentialing services.