High patient volume, thin margins, and E/M rules that punish under-coding. Helix levels your visits accurately, captures wellness and chronic-care revenue you're missing, and keeps modifier 25 clean.
Clean-claim rate
Avg. collections lift
Days in A/R
Denials overturned
Primary care runs on thin margins and huge claim counts. Under-leveled E/M visits, missed annual wellness revenue, and modifier-25 denials add up to real money across thousands of encounters a month.
Helix codes to current MDM/time guidelines, captures preventive and chronic-care programs you may be leaving on the table, and scrubs every same-day visit so the AWV and the problem visit both get paid.
2021 MDM/time coding that captures earned level without over-coding.
AWV (G0438/G0439), preventive visits and screening capture.
CCM, PCM and RPM billed with the right time documentation.
Same-day wellness + problem visits scrubbed and supported.
Across thousands of visits, small capture gaps become big numbers. We make sure the wellness, chronic-care and add-on revenue is actually billed.
| 99214 | Office E/M, established, moderate MDM | -25 |
| G0439 | Annual wellness visit, subsequent | +99214 |
| 99490 | Chronic care management, first 20 min | +99439 |
| 99406 | Smoking cessation counseling, 3–10 min | preventive |
| 90471 | Immunization administration, first | +90472 |
| G2211 | Visit complexity add-on, continuity care | add-on |
A problem E/M on the same day as a wellness visit or procedure bundled away for lack of modifier 25.
Helix fix: same-day logic flags separately identifiable E/M and applies modifier 25.
Screening labs or services billed as diagnostic (or vice versa), failing payer preventive rules.
Helix fix: preventive-vs-diagnostic dx mapping aligns each service to coverage.
Chronic care management billed without the clock-time and care-plan documentation payers require.
Helix fix: CCM checklist confirms time and care-plan elements before billing.
Immunization product billed without the administration code, or the add-on for additional vaccines dropped.
Helix fix: product-plus-administration pairing rules capture every dose given.
Automated benefit checks for high daily visit volume.
MDM/time coding plus wellness and chronic-care capture.
Modifier 25 and preventive/problem logic validated.
Fast rework on high-volume rejections and aged A/R.
"We were systematically under-coding and barely billing chronic care. Helix found the revenue we'd been giving away every single day."
A busy clinic averaging level-3 visits where documentation supported level 4, almost no chronic-care billing, and recurring modifier-25 denials on same-day wellness encounters.
Helix re-coded to MDM/time guidelines, stood up a CCM program with time documentation, and built same-day modifier-25 scrubbing — without pushing into over-coding territory.
Clean-claim rate hit 99.1%, A/R days dropped to 17, and the practice added roughly $268K in annual collections from accurate leveling and chronic-care capture.
Representative composite based on Helix engagement outcomes. Individual results vary.
"We never billed chronic care before. Now it's a real, steady line of revenue."
Result: $108K new annual CCM/RPM collections.
"Same-day visits used to be a denial guarantee. Helix made them clean."
Result: +14% net collections in two quarters.
Representative composites based on Helix engagement outcomes. Individual results vary.
Get a free audit of your E/M leveling, wellness capture and chronic-care revenue, and a clear picture of what you could be recovering.