REVENUE CYCLE MANAGEMENT SERVICES- Billing & Practice Management
How It Works
The most basic expectation that a healthcare professional should have about any competent billing service is that it possesses the knowledge & ability to maximize potential reimbursement for services performed while concurrently minimizing the length of time that it takes to receive the reimbursement. PCMG Revenue Cycle Management Services exceeds this essential requirement because we have even higher expectations for our clients and ourselves.
Our Billing & Practice Management Service is intended for practices that wish to outsource their billing and reimbursement requirements. Services are customized to provide each client with the flexibility and convenience that they need.
Billing & Practice Management Service:
Each client’s data is forwarded to PCMG via the client’s preferred method (EHR, electronic superbill, scan, fax, courier) . All data is entered into our software and examined for appropriate CPT, ICD-9, HCPCS, and modifier code usage. Prior to claims submission, audits are performed to ensure that all data is complete and compliant with current regulations. Reimbursement is pursued. ERAs are applied. All other payments and EOB’s are forwarded to PCMG for reconciliation. Extensive follow-up steps are taken to assure maximum and correct reimbursement. Management reports detail all activity for proper practice analysis. Consulting is provided on an ongoing basis (including: coding/billing updates as they relate to your practice and employee training in PCMG procedures.
Includes:
• Data entry of patient demographics & billing information
• Pended claims/Insurance requests processing
• Data entry of charges, receipts, & adjustments
• Appeals on under/improper payments/denials
• Production & submission of claims (both electronic & paper)
• Standardized A/R tracking & follow-up
• Production & submission of capitated claims
• Refund processing
• Production & submission of WC/NF claims & attachments
• Patient ledger requests
• Production & mailing of patient statements
• WC & NF arbitration complaint forms
• Production & mailing of collection letters
• Insurance Commissioner Complaint forms
• Account transfer processing to collection company
• Patient services support
• Standardized claims tracking & follow-up
• Appropriate modifier usage edits
• Bundling/unbundling edits
• CCI edits
* Verification of Benefits/Eligibility*
* Precertification/Referrals*
• Claims based PQRS reporting
• Claims based reporting for E-prescribing
• Claims based functional reporting for PT/OT
Value-added Consulting :
• Initial: Fee Schedule Review & Analysis
• Initial: Superbill Review/Proper Coding Analysis
• Initial: Patient Registration/Master Templates Creation
• Initial: EHR integration/EHR implementation
• Ongoing: Billing/Reimbursement updates
• Ongoing: Staff training
• Annual: Fee Schedule Review & Analysis
• Annual: Superbill Review/Proper Coding Analysis
Features:
• System Access:
Each client is given secure remote access to their patient database. There are no software installation concerns and you can view your data from wherever you are (not just the office.)
• HL-7 Compliance & Interoperability with ANY EHR
PCMG’s practice management system works with any EHR. We have extensive experience with many EHRs (allscripts, prognocis, practicefusion, traknet, macpractice, allegiancemd, medisoft clinical, webpt, reportmaster) and can interface with your EHR or utilize any template/platform. Whether you are happy with your current EHR or are shopping for a new one, PCMG makes your transition virtually seamless-you focus on the EHR features your office needs without compromising on the practice management.
• Electronic Document Storage Solution:
PCMG will provide you with secure access to all billing related documents. You are able to store, view, and print all of your eobs, superbills, and notices instead of keeping a paper copy for the several years that your state requires. There are no software installation concerns and you can view your data from wherever you are.
How It Works
The most basic expectation that a healthcare professional should have about any competent billing service is that it possesses the knowledge & ability to maximize potential reimbursement for services performed while concurrently minimizing the length of time that it takes to receive the reimbursement. PCMG Revenue Cycle Management Services exceeds this essential requirement because we have even higher expectations for our clients and ourselves.
Our Billing & Practice Management Service is intended for practices that wish to outsource their billing and reimbursement requirements. Services are customized to provide each client with the flexibility and convenience that they need.
Billing & Practice Management Service:
Each client’s data is forwarded to PCMG via the client’s preferred method (EHR, electronic superbill, scan, fax, courier) . All data is entered into our software and examined for appropriate CPT, ICD-9, HCPCS, and modifier code usage. Prior to claims submission, audits are performed to ensure that all data is complete and compliant with current regulations. Reimbursement is pursued. ERAs are applied. All other payments and EOB’s are forwarded to PCMG for reconciliation. Extensive follow-up steps are taken to assure maximum and correct reimbursement. Management reports detail all activity for proper practice analysis. Consulting is provided on an ongoing basis (including: coding/billing updates as they relate to your practice and employee training in PCMG procedures.
Includes:
• Data entry of patient demographics & billing information
• Pended claims/Insurance requests processing
• Data entry of charges, receipts, & adjustments
• Appeals on under/improper payments/denials
• Production & submission of claims (both electronic & paper)
• Standardized A/R tracking & follow-up
• Production & submission of capitated claims
• Refund processing
• Production & submission of WC/NF claims & attachments
• Patient ledger requests
• Production & mailing of patient statements
• WC & NF arbitration complaint forms
• Production & mailing of collection letters
• Insurance Commissioner Complaint forms
• Account transfer processing to collection company
• Patient services support
• Standardized claims tracking & follow-up
• Appropriate modifier usage edits
• Bundling/unbundling edits
• CCI edits
* Verification of Benefits/Eligibility*
* Precertification/Referrals*
• Claims based PQRS reporting
• Claims based reporting for E-prescribing
• Claims based functional reporting for PT/OT
Value-added Consulting :
• Initial: Fee Schedule Review & Analysis
• Initial: Superbill Review/Proper Coding Analysis
• Initial: Patient Registration/Master Templates Creation
• Initial: EHR integration/EHR implementation
• Ongoing: Billing/Reimbursement updates
• Ongoing: Staff training
• Annual: Fee Schedule Review & Analysis
• Annual: Superbill Review/Proper Coding Analysis
Features:
• System Access:
Each client is given secure remote access to their patient database. There are no software installation concerns and you can view your data from wherever you are (not just the office.)
• HL-7 Compliance & Interoperability with ANY EHR
PCMG’s practice management system works with any EHR. We have extensive experience with many EHRs (allscripts, prognocis, practicefusion, traknet, macpractice, allegiancemd, medisoft clinical, webpt, reportmaster) and can interface with your EHR or utilize any template/platform. Whether you are happy with your current EHR or are shopping for a new one, PCMG makes your transition virtually seamless-you focus on the EHR features your office needs without compromising on the practice management.
• Electronic Document Storage Solution:
PCMG will provide you with secure access to all billing related documents. You are able to store, view, and print all of your eobs, superbills, and notices instead of keeping a paper copy for the several years that your state requires. There are no software installation concerns and you can view your data from wherever you are.
Email - information@practicecare.com
Telephone - (800) 374-7045
Facsimile - (888) 851-2111
Copyright 2013 - Practice Care Management Group Ltd
Telephone - (800) 374-7045
Facsimile - (888) 851-2111
Copyright 2013 - Practice Care Management Group Ltd