👨‍⚕️ Physician & Professional Fee Billing

Physician Billing That Maximizes Professional Fee Collections

All SpecialtiesGroup Practice SupportE&M OptimizationValue-Based Care

Overview

Physician billing requires specialty-specific expertise, intimate knowledge of E&M documentation guidelines, and sophisticated understanding of each payer payment policy. A one-size-fits-all approach consistently leaves 10-30% of potential revenue unrealized.

Rafsons Med Billing assigns specialty-trained billing and coding teams to each physician client. Your internal medicine group gets billers who understand primary care coding nuances. Your cardiology practice gets coders expert in cardiac catheterization and echocardiography billing. This specialty alignment consistently delivers superior financial results.

We serve individual solo practitioners, small group practices, large multi-specialty groups, and employed physician organizations within health systems, with scalable billing operations that grow with your organization.

Key Benefits & Outcomes

🎯

Specialty-Aligned Teams

Dedicated billing teams with specialty-specific expertise in your medical discipline for optimal coding.

📈

E&M Level Optimization

Documentation review ensures appropriate E&M level assignment, eliminating undercoding that costs most practices 15-20%.

💊

Modifier Expertise

Correct modifier usage protects reimbursement and prevents inappropriate bundling by payers.

🤝

Value-Based Care Support

MIPS and MACRA reporting assistance, quality measure tracking, and value-based payment optimization.

📊

Provider-Level Analytics

Individual provider performance reports show collections, denial rates, and payer performance by physician.

🏥

Multi-Location Support

Unified billing across multiple practice locations with site-specific and provider-specific reporting.

Our Process

1

EHR Integration and Charge Setup

We connect to your EHR, configure your fee schedule, and verify payer enrollment for all providers.

2

Charge Capture and Documentation Review

Charges are captured and clinical documentation is reviewed for coding accuracy and completeness.

3

Specialty Coding and Claim Preparation

Specialty-certified coders assign appropriate ICD-10, CPT, and modifier codes for each encounter.

4

Clean Claim Submission

Claims are scrubbed and submitted electronically within 24-48 hours of charge entry.

5

Payment Posting and Provider Reporting

Payments posted, reconciled, and provider-level performance reports delivered monthly.

Frequently Asked Questions

How do you prevent E&M undercoding?+
Our coding team performs regular documentation audits comparing physicians actual documentation complexity to the E&M levels being billed. We identify undercoding patterns and provide physician education to support appropriate level selection.
Do you handle billing for employed physicians within health systems?+
Yes. We work with health system-employed physician groups, academic medical centers, and faculty practice plans. We understand the unique billing requirements of employed physician organizations and hospital-based professional billing.
Can you handle telemedicine billing?+
Yes. Telehealth billing has evolved significantly and requires current knowledge of POS codes, applicable modifiers, state licensure requirements, and payer-specific telehealth policies. Our team stays current with all telehealth billing regulations.
What specialties do you have billing expertise in?+
We have specialty-trained billing teams for: cardiology, internal medicine, family medicine, orthopedics, neurology, psychiatry, dermatology, gastroenterology, OB/GYN, oncology, urology, ophthalmology, ENT, pulmonology, rheumatology, endocrinology, and 15+ additional specialties.

Maximize Your Professional Fee Collections

Specialty-aligned billing expertise that captures every dollar you have earned.