Who we serve · Primary care
Primary care, family and internal medicine. A long payer list, run as one file.
A primary care practice bills a long list of plans, and a state Medicaid program that often runs through several managed-care plans at once. We enroll the practice and every clinician with each of them, then run the claims, the authorizations and the denials.
Breadth is the work. Every plan is its own file.
Many plans, each with its own door.
Your patients carry Medicare, traditional or through an Advantage plan, the state's Medicaid, and the commercial plans local employers buy. Each of those is a separate enrollment with its own application and its own clock.
Medicaid is where primary care loses the most time. In many states the program pays through managed-care plans, and each plan runs its own network, so enrolling with the state does not put the practice in any of them. We map which plans your patients carry and file with each one that matters.
Nurse practitioners and physician assistants carry a large share of the visits in primary care. Each one needs a practitioner application with every payer, linked to the practice, before their visits are billed under their own name.
Then comes the week. By the AMA's count, a practice completes 40 prior authorization requests for each physician, every week. The payers you join decide which services sit on that list, so we plan enrollment and authorizations together.
Fees printed. Billing priced from your numbers.
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 fixed at the source so the same denial stops coming back.
- The Friday board
- Every open application and, once billing runs, every claim that was paid, denied or paid short.
| Piece of work | Fee |
|---|---|
| The practice, with each payer | $350 |
| Each physician, NP or PA, with each payer | $250 |
| A clinician's CAQH profile, built or repaired | $150 |
| Billing and revenue cycle | By agreement |
Total your own enrollment with the calculator.
What primary care owners ask us.
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 $250, plus $150 if the CAQH profile needs building. The Friday board 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, with no patient records involved.
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
Send us the plans your patients carry.
We check each one against your enrollment and tell you what is missing. No patient information is needed.
We get back to you as quickly as possible.