Specialty: Family Medicine | Location: Southwest United States | Practice Size: 3 physicians, 1 PA | Timeline to Results: 90 Days to Full Program Launch
$8,400/mo CCM Revenue — New recurring revenue stream
99% Clean Claim Rate (91% → 99%) — +8 points
The Challenge
A three-physician family medicine practice had systematically under-coded E/M visits for years — 84% of all visits were billed as 99213 regardless of complexity — and had never captured a single Annual Wellness Visit or Chronic Care Management dollar.
84% of all office visits coded as 99213, including complex patients with 4+ chronic conditions who qualified for 99215
Zero AWV (Annual Wellness Visit G0438/G0439) or IPPE (G0402) claims billed in practice history despite qualifying patient panel
No CCM (Chronic Care Management 99490/99491) program in place — 127 qualifying patients identified in EMR with no billing
Practice management reports showed average collection per visit of $68 against a benchmark of $103 for comparable practices
The Medtransic Solution
Medtransic conducted a full E/M audit using 2024 AMA guidelines, implemented an AWV scheduling workflow integrated with the EMR, and launched a CCM program that converted 89 qualifying patients to monthly managed care billing within 90 days.
E/M re-education for all providers: visit documentation mapped to AMA complexity criteria, with real-time coding feedback on submitted encounters for 60 days
AWV scheduling workflow built within existing EHR — front desk prompted to schedule G0439 for all qualifying established patients at annual physical
CCM program launched: 89 high-complexity patients enrolled, monthly care coordination documented in EMR, claims generated automatically
Transitional Care Management (99495/99496) protocol implemented for all hospital-discharged patients — a category previously unbilled
Measurable Results
Average revenue per visit increased 28% within six months through proper E/M level documentation
$62,000 in AWV revenue captured in year one — previously $0
CCM program generating $8,400/month in new recurring revenue from 89 enrolled patients
Annual practice revenue increased by over $180,000 without adding a single new patient
Clean claim rate improved from 91% to 99% through documentation coaching
Client Testimonial
I had no idea we were leaving that much money on the table. We had been billing the same way for eight years. Medtransic's audit was eye-opening — and the AWV and CCM programs they helped us launch created revenue streams I didn't even know existed.
Practice at a Glance
Specialty: Family Medicine
Location: Southwest United States
Practice Size: 3 physicians, 1 PA
Timeline to First Results: 90 Days to Full Program Launch
Engagement Year: 2025
Client name and identifying details anonymized per HIPAA compliance guidelines and client request. All metrics and outcomes are verified against actual billing records from this engagement.