MEDICAL & CHRONIC CARE
Primary care, internal medicine, and chronic care programs do not win on appeals. They win on first-pass accuracy, short charge lag, and denial patterns caught while they are still small. MBS bills this group to measurable targets and shows you the working behind every one of them.
What we report monthly
Your figures, from your system. We publish the definition of each metric so it cannot quietly change between months.
At primary-care reimbursement levels, a claim that needs rework can cost more to fix than it pays. We optimize for clean submission first and appeals second.
A template problem that affects two percent of claims is invisible on one encounter and material across a month. We report at the pattern level so it gets fixed once.
No blended scores. Each metric can be opened to the claims behind it, by payer, provider, and reason code.
HOW WE MEASURE IT
Most billing reports are not wrong, they are just too coarse to act on. This is what we change about the definition of each measure.
Denial rate
One practice-wide percentage, reported monthly with no breakdown.
Segmented by reason code, payer, and provider, so the top three causes are named and assigned.
Days in A/R
A single average that hides a long tail of aged claims.
Reported with aging buckets alongside it, because a good average with a heavy 120+ bucket is not a good result.
E/M leveling
Assumed correct until an audit says otherwise.
Distribution tracked against your own baseline, with outliers reviewed before they become a pattern.
Chronic care programs
Billed monthly if someone remembers the time threshold was met.
Time and eligibility tracked per patient per month, with the months that do not qualify excluded on purpose.
Charge lag
Not measured at all.
Measured per provider, because unsigned notes are the quietest cause of timely-filing loss.
Enter six figures into the A/R & denial benchmark and see where a high-volume medical practice like yours sits against published bands — with the sources and verification status shown for every band, so you can judge how much weight to give it.
These specialties share a billing model, but not the same failure point. Each one gets its own scrubbing rules and its own line in the monthly read.
Highest encounter volume, thinnest margin per claim, and the most exposure to preventive-versus-problem visit coding.
What we watch
Preventive and problem services on the same visit, billed without the distinction documented.
Complex patients, multiple chronic conditions, and heavy documentation requirements for risk-adjusted work.
What we watch
Chronic conditions treated in the visit but never carried into the diagnosis coding.
Office encounters mixed with diagnostics, so professional and technical components have to be split correctly.
What we watch
Global versus professional-only billing on in-office diagnostics.
Infusion, injectable, and drug-administration billing sits alongside routine office work.
What we watch
Drug units and waste documentation, and prior authorizations that expire mid-course.
Recurring monthly revenue that only holds up when time, consent, and eligibility are all on file.
What we watch
Consent on record, minimum minutes met, and no overlap with another provider's program.
Procedure-plus-office mixes with their own global-period and bundling rules.
What we watch
Procedures bundled into the visit by payer edits that the fee schedule does not reflect.
A monthly package covering first-pass resolution, days in A/R with aging buckets, denial rate by reason code, charge lag by provider, and E/M distribution — plus a short written read on what changed and what we are doing about it. Anything in the report can be opened to the underlying claims.
Yes. These are time- and eligibility-based, so we track minutes, consent, and enrollment per patient per month, and we deliberately do not bill months that do not meet the requirement.
We do not dictate clinical documentation. We tell you which documentation patterns are producing denials or audit exposure, with the payer's own criteria attached, and let your clinical lead decide the change.
Possibly not, and that is worth knowing early. Our benchmark bands are published with sources and verification dates, so if your figures differ we can compare the definitions rather than argue about the number.
The full cycle under one owner when high volume has outgrown the current setup.
Provider enrollment and revalidation kept current across a growing group.
Authorization-led billing for the behavioral side of an integrated practice.
Looking for another specialty? See all specialties.
We will return your first-pass rate, denial mix by reason code, and charge lag by provider — computed from your own data, with the method shown. No obligation, and the findings are yours regardless.
How does your A/R and denial rate compare?
Free benchmark tool — enter six numbers, see your bands against published industry sources, and download a branded PDF.
