- +1 (773) 985-1869
- info@stream-rcm.com
- 14430 Ocean Point, El Paso, TX 79938
Stream RCM provides primary care medical billing services for family practice, internal medicine, and geriatric practices with high daily patient volumes. We coordinate all aspects of E&M coding, chronic care management, transitional care billing, and annual wellness visits into one cohesive billing system. Each claim is checked to conform with payer guidelines before it is submitted to ensure proper payment.
We make sure that you have the optimal revenue integrity model for primary care, instead of just handling claims. Our team of experienced coders and billing analysts are specifically trained in the 2026 AMA E/M coding guidelines, MDM based leveling and splitting or shared visits. We have helped our clients improve the net collection ratio from an industry standard of 87% to over 96%, by identifying all the missed opportunities in chronic care management (CCM), transitional care management (TCM), and annual wellness visits (AWV).
As a primary care medical billing company, we understand that the practice of primary care is the backbone of our entire health care system. We take care of the whole revenue cycle, from verifying eligibility and insurance benefits to analyzing root cause of denials. We strive to be your partner to lower your administrative costs, provide better cash flow predictability and remain compliant to payer changing policies.
Our knowledge of billing is comprehensive and encompasses all sub-specialties within primary care. Our approach is customized based on the unique requirements of coding and reimbursement for each.
There are specific ICD-10 codes to be used for child visit, vaccines, and developmental screening that we make sure of capturing for each age group accordingly.
Diabetes, hypertension, and CHF are complex chronic diseases that need comprehensive E/M documentation. Our coding shows the high level of MDM for such adult patients.
We cover all areas of family practice from acute illnesses to preventive care, which helps us to code the encounters effectively in both pediatric and adult populations.
Our specialty is in serving Medicare patients in AWVs, CCM, and TCM, which guarantees the complete collection of all chronic and transitional care services.
We code well-woman exams, contraceptive counseling, and menopause management with accuracy. We make sure that all preventive and diagnostic procedures receive proper reimbursement.
Stream RCM organizes the billing process for primary care as one interconnected cycle and not as separate activities so that nothing is billed separately from the visit where it was created.
We verify coverage, the need for referrals, and the existence of preventive benefits prior to the visit, so the front desk does not have to guess and the claims are not based on outdated information from the insurance company.
Our team compared all established and new patient visits with documented medical decision-making in order to assign a level, which replaces the process of coding by habits with a more reasonable one.
We determine chronic care and primary care management patients who qualify for these programs, maintain monthly time threshold records, and code accordingly when appropriate documents are supported.
In order to avoid automatic denials due to missing documentation and modifier conflicts, our experts check clean claims against payer specific edits prior to submitting them.
All denials are categorized by their root cause, appealed when appropriate with documentation, and then recycled through our review process to ensure that it does not happen again.
Practices get visibility on their collections rate, number of days in accounts receivable, and denial trend per payer by us, all in plain language and not just in raw claim data.
Our experts are now here to help you evaluate your current revenue cycle process and identify areas where improvement is needed.
The most important factor in primary care practice is a high volume of patients, which does not allow any space for an office staff to handle different billing procedures depending on payers, managing chronic care management, as well as corresponding with regard to appeals. The process of outsourcing primary care billing moves the responsibility of these processes onto the specialists who do nothing else but provide such a service. We give you access to a professional team that is able to deal with the complexities of Medicare, Medicaid, and private insurance, making sure that you earn the revenue that is coming your way. As a result, doctors have more time for patients rather than coding problems.
Our coders link the primary care claims to the codes that the payers evaluate, assigning each code with a clinical diagnosis indicating the need for treatment.
| CPT Code | Related ICD-10 | Description |
|---|---|---|
| 99214 | E11.9, I10, F41.1 | Our experienced and certified coders will properly use this high MDM code for managing the complex chronic illness to make sure that you get the full reimbursement. |
| 99490 | EE11.9, I25.10 | We consistently identify and bill Chronic Care Management for eligible Medicare patients, transforming what can be a neglected opportunity into a dependable source of income. |
| G0439 | Z00.00 | We guarantee proper documentation and split-visit billing for Annual Wellness Visits, thus enabling you to earn revenue from both preventive and acute care services in one visit. |
| 99495 | Z48.81 | Our team carefully monitors and bills Transitional Care Management within the 30 days to ensure timely payment and reduce chances of readmissions for your discharged patients. |
| 99213 | J06.9, R51 | We will audit E/M codes to avoid undercoding to make sure that whenever there is a need for a 99214 code, you do not miss out on your revenue by coding in this moderately complex code. |
Rural health clinics (RHCs) require a different approach to primary care billings, ranging from particular all-inclusive rates (AIR) to qualifying visit optimization. As a primary care billing company, we have extensive knowledge in RHC billing processes, and we make sure that we adhere to all relevant federal and state laws. We help rural health clinics optimize the payment process and complete their cost reports. Our team of experts understands RHCs, including their UB-04 and professional claims coordination, making sure that you focus on your service delivery and maintain financial health.
Stream RCM works with your EHR and revenue cycle systems to make billing easy with no disruptions or extra software charges.
Behavioral health as part of primary care is becoming increasingly common, and so are the billing opportunities that arise with this practice. Collaborative care management (CoCM) and behavioral health integration (BHI) are practices that have considerable earning potential. Stream RCM stays ahead of the curve by ensuring your practice bills appropriately for CPT codes such as 99492, 99493, and 99494. Our primary care billing experts will guide you on how to fulfill the documentation and time tracking needs of these procedures, making sure your practice gains from both a medical and business standpoint.
We offer solutions specifically designed to the common problems in primary care revenue cycle management.
We believe that our specialty-focused, data-based, and transparent method makes us unique as your long-term growth partner.
We offer our services for the provision of primary care and its specializations. We have good knowledge about MDM coding, CCM, AWV, and TCM so that all your services can be billed efficiently.
Our team offers CFO-level dashboards that will clearly tell you how well your revenue cycle is doing in terms of denial rate and Days in AR. We have a model based on trust and proven results.
We not only respond to denials but prevent them. Our team recognizes and rectifies the root causes of issues before they become recurring problems, resulting in a consistently high clean claims rate.
You have an experienced team that understands you and your practice and also your patients. We give personal service and are always available to cater to your requirements.
It is the unique procedure involved in coding and transmitting the codes for E/M visits, preventive medicine, and chronic illness management. It demands specialized knowledge about primary care coding guidelines and payers’ requirements.
Our specialty-specific coding accuracy ensures you bill at the correct level (e.g., 99214 vs. 99213), and we systematically capture missed revenue from CCM, TCM, and AWV services, boosting your net collection ratio.
Our fees are performance based and normally between 4-6% of collections. We provide you with transparent pricing without any hidden set up fees, which guarantees that our success is linked with yours.
Absolutely. We proactively appeal and resolve denials, identifying root causes to prevent recurrence. Our clients see a significant reduction in denial rates, often dropping below 5%.
Our certified coders and billing experts stay current on all CMS and payer regulations. We conduct regular audits to ensure accuracy and protect your practice from compliance risks.
Receive a free evaluation of your present collections and denied claims.
