Payment: Contracting, Coding, Bundling and Claim Denials
Our Stance
It is the position of the AAFP that every reasonable effort should be made to devise a payment system that:
- Emphasizes fair payment for cognitive skills relative to procedural skills;
- Acknowledges and pays for case management services as necessary for the provision of continuous, comprehensive patient care; and
- Encourages and pays for preventive care. Read the full policy on physician payment.
AAFP Advocacy Activities
AAFP hears your concerns about payment. Our Private Sector Advocacy team works directly with payers to help ensure that you're compensated fairly for the care you deliver. We also provide you with tools to effectively engage private payers, such as the AAFP Contracting Guide (12-page PDF file; About PDFs). (Members Only)
We're in regular contact with private payers, urging them to:
We're in regular contact with private payers, urging them to:
- Stop bundling same-day acute and preventive services.
- Pay adequately for immunizations and their administration.
- Cover and pay for non-face-to-face services.
- Rescind payment policies that downcode and blend E/M services.
- Cease any family medicine-specific scope of services limitations (e.g. non-payment for delivered services, disallowing ordering certain tests/services, etc.).
- Learn about primary care-based Accountable Care Organizations (ACOs).
