What is physician billing?
Physician billing is the process of converting documented patient encounters into accurate insurance claims and collecting the payment due to a provider. It includes eligibility verification, charge capture, CPT, ICD-10, and HCPCS coding, claim submission, payment posting, denial resolution, patient balances, and accounts-receivable follow-up. Effective physician billing also monitors payer rules, documentation quality, and reimbursement trends to prevent revenue leakage.
What is a UB04 vs CMS 1500?
A CMS-1500 is the standard claim form generally used for professional services, such as office visits and other services billed by physicians and outpatient practitioners. A UB-04, also called CMS-1450, is generally used by institutional providers, including hospitals and facility-based outpatient departments. The correct form depends on the provider type, place of service, and payer billing requirements.
Which physician specialties does Persistex support?
Persistex supports mental health, family medicine, internal medicine, general and primary care, pediatrics, chiropractic, and podiatry practices. The team also has focused experience with behavioral health and TMS therapy billing. Specialty knowledge matters because requirements differ for psychotherapy time codes, E/M levels, vaccines, chiropractic modifiers, routine foot care, telehealth, and payer authorization rules.
How does medical billing reduce denied claims?
Denials are reduced by checking eligibility and benefits before services, submitting claims with accurate codes and modifiers, validating documentation, and applying current payer requirements. Persistex also reviews denial patterns to address recurring root causes rather than simply resubmitting claims. Its full-cycle approach includes appeals and A/R follow-up, helping ensure denied or underpaid claims receive timely, documented attention.
How long does it take to improve billing performance?
Persistex reports that practices often see measurable improvements within 30 to 60 days of onboarding. The timeline depends on claim volume, existing A/R, payer mix, documentation patterns, and the age of unresolved denials. Early work typically focuses on workflow review, eligibility processes, coding accuracy, and high-value A/R opportunities, followed by ongoing reporting and optimization.
What does a free billing audit include?
The free billing audit includes a comprehensive review of your current billing process, an analysis of denial patterns, and identification of potential revenue opportunities. It is available for practices of all sizes and specialties, including as a transition resource for practices using another billing company. The review is no-obligation, requires no contract, and is conducted through HIPAA-compliant operations.
Does Persistex work with my EHR or practice management system?
Persistex integrates with major EHR and practice management systems, including AdvancedMD, Kareo, athenahealth, DrChrono, and TherapyNotes. During onboarding, the team reviews your existing workflow and system setup to establish efficient processes for claims, coding, payment posting, reporting, and follow-up. This helps reduce manual handoffs while maintaining visibility into billing activity.
What pricing options are available for physician billing?
Persistex offers flexible percentage-based and flat-rate pricing models based on practice size and claim volume. The company states that it has no hidden fees and does not require long-term contracts. A billing audit can help identify the scope of support needed before selecting a model, allowing a practice to compare options against its current administrative workload and collections performance.