Who we serve · Primary care
Enrollment and billing for primary care, family medicine and internal medicine practices.
We enroll the practice and every clinician with each plan your patients carry, Medicaid managed-care plans included, then run the claims, the authorizations and the denials.
Primary care enrolls with many plans, and each is a separate application.
Your patients carry Medicare, traditional or through an Advantage plan, the state's Medicaid, and the commercial plans local employers buy.
In many states, Medicaid pays through managed-care plans, each with its own network. Enrolling with the state puts the practice in none of them. We map which plans your patients carry and file with each one that matters.
Each nurse practitioner and physician assistant needs a practitioner application with every payer, linked to the practice, before their visits are billed under their own name.
Once you are enrolled, prior authorizations become the weekly workload: the AMA puts it at about 40 requests per physician per week.A The payers you join decide which services sit on that list, so we plan enrollment and authorizations together.
Enrollment first, then the whole revenue cycle.
- Enrollment
- The practice and every physician, nurse practitioner and physician assistant, with Medicare through PECOS, your state's Medicaid and each managed-care plan, and the commercial plans on your list. Each one followed to an effective date.
- Authorizations
- Requested and tracked until the payer answers, so a visit or a referral does not wait on a form nobody chased.
- Claims and payments
- Built to each payer's rules, followed until paid, and posted against what the contract says the payer owes.
- Denials
- Traced to the cause, appealed where the practice is owed, and the cause fixed.
- Care-management codes
- Annual wellness visits, chronic care management, transitional care after a hospital stay, remote monitoring and the office-visit complexity add-on, G2211. Each carries its own consent, time and documentation rules, and we check the chart supports the code before the claim goes.
- Your work status
- Open applications with Medicare, each Medicaid plan and each commercial payer, then, once billing runs, the week's paid, denied and short-paid claims.
| Piece of work | Fee |
|---|---|
| The practice, with each payer | $450 |
| Each physician, NP or PA, with each payer | $350 |
| A clinician's CAQH profile, built or repaired | $300 |
| Billing and revenue cycle | By agreement |
Common questions from primary care practices.
Our new nurse practitioner starts soon. Where do we begin?
With the payers most of your patients carry. The practice is already on file, so each of those takes one practitioner application at $350, plus $300 if the CAQH profile needs building. Your work status shows which plans have said yes.
We are enrolled with state Medicaid. Why are Medicaid claims still denied?
Often because the patient belongs to a managed-care plan the practice has not joined. The review sets the managed-care plans in your state against your enrollment, plan by plan.
Can you take over billing from our current system?
Yes. We work inside the practice management system you use today where we can, and plan the handover so no open claim is dropped. How billing runs
Sources
- American Medical Association, Prior Authorization Physician Survey, 1,000 physicians. Survey fielded 2025.
Send us the plans your patients carry.
We check each one against your enrollment and tell you what is missing. The billing review starts from report totals.
Say whether any clinician is new to the practice or still waiting on a payer.