Preventative Medicine Billing Services

Comprehensive Billing for Preventive Medicine Practices

Preventive medicine focuses on maintaining health and preventing illnesses through screenings, immunizations, and counseling. Billing for preventive medicine services can be complex due to detailed coding requirements, payer-specific guidelines, and overlapping services. Hello MDS specializes in preventive medicine billing, ensuring accurate claims, maximizing reimbursements, and reducing administrative burdens so your practice can focus on patient health.

Challenges in Preventive Medicine Billing

Differentiating Preventive and Diagnostic Services: Misclassification of preventive care as diagnostic services can lead to claim denials.

Modifier Usage: Proper use of modifiers is critical when billing for combined preventive and diagnostic services during the same visit.

Payer Coverage Variations: Insurance policies often vary in coverage for screenings, vaccines, and wellness visits, leading to potential disputes.

Documentation Complexity: Precise documentation is required to support services billed under preventive care codes.

Key CPT Codes for Preventive Medicine Services

Annual Wellness Visits and Screenings:

99381–99397: Preventive visits (new and established patients by age)

G0438: Medicare annual wellness visit (first visit)

G0439: Subsequent annual wellness visits

Vaccination Administration:

90460–90461: Vaccine administration with counseling

90471–90474: Immunization administration (single or multiple vaccines)

Screening Services:

77067: Mammography screening

99173: Visual acuity screening

93000: Electrocardiogram (EKG)

Lifestyle Counseling and Risk Management:

99401–99404: Preventive medicine counseling

99406–99407: Smoking and tobacco use cessation counseling

Hello MDS ensures precise coding for these and other preventive services to optimize reimbursements while adhering to payer policies.

Hello MDS’s Preventive Medicine Billing Solutions

Accurate Coding and Claims Submission

Our certified coders are proficient in distinguishing between preventive and diagnostic services, ensuring accurate claims.

Insurance Verification

We verify patient eligibility and coverage for preventive services, minimizing out-of-pocket surprises for your patients.

Denial Resolution and Appeals

We analyze denied claims, address documentation issues, and submit appeals promptly to recover lost revenue.

Revenue Cycle Management

Streamlined processes from charge entry to payment posting ensure a consistent cash flow for your practice.

Regulatory Compliance

Stay compliant with CMS guidelines and payer-specific rules for preventive care billing.

Why Choose Hello MDS for Preventive Medicine Billing?

Increased Collections: Accurate claims submission and timely follow-ups reduce denials and improve cash flow.

Tailored Expertise: Our team specializes in preventive medicine billing and stays updated with coding and regulatory changes.

Enhanced Patient Satisfaction: Efficient billing reduces administrative delays, improving patient experience.

Transparent Reporting: Get actionable insights into your practice’s financial health with comprehensive reporting.

Partner with Hello MDS for Preventive Medicine Billing Success

Preventive medicine is the cornerstone of healthcare, but billing complexities can hinder your practice’s efficiency. At Hello MDS, we manage your billing needs so you can focus on improving patient outcomes. From annual wellness visits to lifestyle counseling, we ensure your practice is reimbursed accurately and promptly. Contact us today to learn how Hello MDS can transform your preventive medicine billing operations and boost your practice’s profitability.