Confirm active coverage, copays, deductibles, preventive benefits, referral rules, and Medicare wellness eligibility before the visit.
Primary Care Medical Billing Services
Primary Care Billing That Handles Visits, Coding, and Claims
Billing support for office E/M, preventive care, Medicare wellness visits, chronic care, transitions of care, immunizations, and same-day problem visits.
HIPAA compliant
Certified billing and coding professionals
Nationwide service
🔒 100% confidential. We never sell your data. Privacy Policy
Primary care revenue support
Less Billing Work for Your Primary Care Team
Thrive manages the revenue work behind high-volume primary care, including benefits checks, charge review, coding support, claim submission, payment posting, denials, and unpaid balances. The team pays particular attention to preventive and problem-oriented services performed on the same date, Medicare wellness eligibility, E/M documentation, care-management requirements, and payer-specific edits.
The goal is straightforward. Submit supported claims promptly, resolve payment barriers before they age, and show practice leaders where revenue is delayed or missed.
HIPAA compliant
Certified coders and billers
U.S. payer experience
Fewer avoidable rejections
Eligibility, demographics, provider enrollment, coding, and claim data are checked before submission.
Better capture of separately billable work
Documentation and same-day services are reviewed for supported E/M, preventive, and care-management billing.
Less preventable A/R aging
Unpaid claims are segmented by payer response, filing limit, denial reason, and next required action.
Clearer financial accountability
Reports focus on claim status, denials, aging, payments, and unresolved workflow issues.
Full-cycle billing execution
Your Primary Care Revenue Cycle, Managed From Start to Finish
Each task is connected to the next, so a front-end error does not become an unpaid claim months later.
Eligibility and benefit checks
Authorization and referral follow-up
Track payer requirements for selected imaging, medications, procedures, and referred services when prior approval is needed.
Charge and coding review
Review E/M levels, preventive services, care-management codes, diagnosis linkage, modifiers, and in-office services against the record.
Clean claim submission
Prepare and transmit claims with the correct provider, payer, place-of-service, demographic, and encounter information.
Denial correction and appeals
Separate eligibility, frequency, coding, documentation, authorization, and payer-edit denials, then take the required corrective action.
Accounts receivable follow-up
Work unpaid Medicare, Medicaid, Medicare Advantage, and commercial claims by age, balance, filing limit, and payer response.
Payment posting and reconciliation
Post insurer and patient payments, contractual adjustments, denials, and take-backs while flagging underpayments for review.
Patient statements and balances
Issue understandable statements and manage follow-up with accurate insurance adjustments and documented patient responsibility.
Credentialing and performance reports
Support payer enrollment and provide recurring visibility into claims, collections, denials, aging, and outstanding actions.
Coding reference
Primary Care Coding Checks That Help Prevent Claim Errors
This primary care CPT code cheat sheet highlights common code families tied to office visits, prevention, longitudinal care, and post-discharge management. It is a scannable reference, not a substitute for the current code set, documentation rules, or payer policy.
- 99202–99205
New patient office or outpatient E/M
Code selection depends on supported medical decision making or total time under current E/M rules.
- 99211–99215
Established patient office or outpatient E/M
Documentation must support the reported level and show the work performed for the condition addressed.
- 99381–99387
New patient preventive medicine
Age-based preventive examinations typically used under commercial payer benefits, subject to plan coverage.
- 99391–99397
Established patient preventive medicine
Age-based preventive services that may be paired with a distinct problem-oriented E/M when supported.
- G0402
Initial Preventive Physical Examination
The Medicare “Welcome to Medicare” visit is limited to the first 12 months of Part B coverage and is generally once per lifetime.
- G0438 and G0439
Medicare Annual Wellness Visit
G0438 is the initial AWV. G0439 is the subsequent AWV. Frequency and prior wellness history must be checked.
- G2211
Longitudinal E/M complexity add-on
Used with eligible office or outpatient E/M services when the ongoing practitioner-patient relationship and visit context support it.
- 99490, 99439, 99487, 99489, 99491, 99437
Chronic Care Management
Code selection varies by complexity, who performs the work, and documented time during the calendar month.
- 99495 and 99496
Transitional Care Management
Post-discharge contact, medical decision making, medication reconciliation, and face-to-face timing must meet the selected code.
- 99497 and 99498
Advance Care Planning
Time, voluntary discussion, participants, and the care-planning work should be documented for separate reporting.
- G0556–G0558
Advanced Primary Care Management
Monthly Medicare bundles are selected by patient medical and social complexity and require the full applicable service elements.
Preventive visit versus problem-oriented E/M
A preventive service and a problem-oriented E/M may both be payable on the same date when the additional problem work is significant, separately identifiable, and documented beyond the preventive service. Modifier 25 is generally appended to the problem-oriented E/M, not the preventive code. Medicare AWV services are also different from routine physical examinations.
Where primary care claims break down
Where Primary Care Claims Can Go Wrong
Primary care denials often start with a small mismatch between the encounter, documentation, benefit, code, or timing rule.
Preventive and sick visit overlap
When a new or worsening condition is addressed during a scheduled preventive visit, the note must separate the additional history, assessment, and management that support a second E/M service.
AWV and IPPE eligibility errors
Medicare wellness claims can deny when the wrong code is selected, the patient is outside the IPPE window, or a prior AWV falls within the frequency limit.
Unsupported E/M levels
Templates alone do not establish code level. The record must support medical decision making or total time, including the problems managed, data reviewed, and risk addressed.
Incorrect G2211 use
The add-on code depends on the visit context and longitudinal relationship. Modifier 25, preventive-service exceptions, and payer adoption can affect payment.
Care-management overlap
CCM, TCM, APCM, and related services have distinct eligibility, consent, time, concurrency, and practitioner requirements. Duplicate or overlapping reporting can trigger edits.
Missed TCM deadlines
Delayed post-discharge contact, late face-to-face visits, or incomplete medication reconciliation can prevent the selected TCM code from meeting its requirements.
Point-of-care test billing gaps
In-office testing may require an active CLIA certificate, a code listed as waived, the QW modifier when applicable, and documentation of medical necessity.
High-volume charge lag
Unclosed encounters, missing orders, unsigned notes, and delayed charge entry compound quickly in primary care and make timely-filing recovery harder.
Thrive’s billing process
One workflow from pre-visit checks to final payment
Each step is designed to prevent the next common failure point and give your practice one accountable billing team.
Map the encounter and payer mix
We review your visit types, clinicians, locations, payer contracts, Medicare volume, care-management programs, existing A/R, and recurring denial categories.
Verify coverage before the service
Eligibility, benefits, wellness history, referral rules, patient responsibility, and authorization requirements are checked where the workflow allows.
Review charges against the record
Billers and coders check E/M support, diagnosis linkage, preventive-service coordination, care-management requirements, modifiers, and missing encounters.
Submit and monitor claims
Claims are sent promptly, clearinghouse and payer responses are reviewed, and rejections are corrected before they become aging receivables.
Resolve denials by root cause
We correct data errors, obtain supporting records, appeal when appropriate, and feed recurring denial causes back to the front end and coding workflow.
Reconcile payments and report action
Payments, adjustments, underpayments, patient balances, and open claims are reconciled. Reports show what was paid, what remains open, and what needs practice input.
Why practice leaders choose Thrive
A billing team that owns the work, not another platform to manage
Thrive is positioned as an outsourced billing partner. The value comes from execution, specialty awareness, follow-up, and transparent ownership of open claims.
Primary care coding awareness
Claims are reviewed with attention to E/M selection, preventive services, wellness eligibility, longitudinal care, same-day services, and common payer edits.
Certified billing professionals
Thrive publicly states that its services are supported by certified professional coders and certified professional billers.
HIPAA-focused handling
Protected health information is managed through HIPAA-compliant billing workflows and access practices.
One connected revenue workflow
Eligibility, coding, claims, denials, posting, and A/R are managed as related stages instead of isolated tasks.
Visible follow-up
Practice leaders receive reporting on claim status, denials, aging, payments, and items that require clinical or administrative input.
Support across the United States
Thrive works with U.S. healthcare practices and structures billing around each organization’s payer mix, providers, locations, and services.
Free 15-minute revenue review
Talk with a primary care billing specialist
Use the review to identify denial patterns, aging balances, charge lag, preventive-service issues, or gaps in follow-up. Thrive can then prepare a custom fee schedule based on your claim volume, service scope, provider count, payer mix, and current A/R.
- No software purchase or forced system migration
- Review tailored to solo, group, and multi-location primary care practices
- Option to include current A/R and denied-claim takeover
Book Your Free Revenue Analysis
Schedule a 15-minute meeting to review where anesthesia claims, denials, payments, and AR follow-up are slowing collections.
🔒 100% confidential. We never sell your data. Privacy Policy
Questions before outsourcing
Primary care billing services FAQ
What is included in Thrive’s primary care billing service?
Thrive can manage eligibility checks, charge and coding review, claim submission, payment posting, denial correction, appeals, A/R follow-up, patient statements, credentialing support, and financial reporting. The scope is adapted to the practice’s provider count, encounter mix, payer mix, locations, current staff responsibilities, and outstanding receivables.
How much do primary care billing services cost?
Pricing depends on monthly claim volume, collected revenue, provider count, services included, payer mix, and whether the engagement includes coding, credentialing, old A/R, or patient balances. Thrive prepares a custom fee schedule after reviewing the practice. Any public percentage or starting price should be added only after internal approval.
How long does onboarding usually take?
Thrive states that onboarding can take less than a week when system access, provider information, payer details, workflows, and required documents are available. The exact timeline depends on practice size, locations, existing billing arrangements, data quality, and whether old claims or credentialing work are included in the transition.
Can Thrive take over existing A/R and denied claims?
Yes. Existing insurance balances and denials can be separated by payer, age, filing limit, denial reason, balance, and likelihood of recovery. The team can correct claim data, submit records, appeal supported denials, follow up with payers, and identify balances that require practice decisions or documented write-off approval.
Do you handle same-day preventive and problem-oriented visits?
Yes. The record is reviewed to determine whether the additional problem-oriented work is significant and separately identifiable from the preventive service. When supported, the E/M service may require modifier 25 and distinct documentation. Final billing depends on the service performed, current coding rules, and the patient’s payer policy.
How are primary care denials managed?
Denials are grouped by root cause, including eligibility, frequency, coding, modifier, authorization, medical necessity, timely filing, provider enrollment, and documentation. Thrive corrects or appeals supported claims, tracks deadlines, follows up with the payer, and reports recurring causes so the underlying workflow can be fixed instead of repeatedly reworking claims.
Is Thrive HIPAA compliant?
Thrive publicly identifies itself as a HIPAA-compliant medical billing company. Before signing, the practice should complete its normal vendor review, confirm the Business Associate Agreement, define access controls, and document how protected health information, user accounts, incident reporting, record retention, and staff responsibilities will be handled during the engagement.
Do you work with primary care practices in every state?
Thrive serves healthcare practices across the United States. During the revenue review, the team should confirm experience with the practice’s Medicare Administrative Contractor, state Medicaid program, Medicare Advantage plans, commercial payers, credentialing requirements, and any state-specific billing or patient-balance rules that affect the proposed scope.
FREE REVENUE ANALYSIS
Primary Care Billing Services
Billing support for office E/M visits, preventive care, Medicare wellness visits, chronic care management, transitional care, immunizations, minor procedures, and same-day problem visits.
Primary care billing helps turn routine, preventive, acute, and ongoing patient care into accurate, payer-ready claims while reducing coding errors, denials, missed charges, and delayed reimbursement.
- HIPAA Compliant
- Certified Billing & Coding Support
- Surgical & Procedure Claims
- Nationwide Support