Services

Complete Revenue Management – PMBS can manage all aspects of your practices accounts receivables process.

Electronic / Paper claims filing

PMBS provides expedient data entry and electronic claims submission, which means payment turn-around in as little as 7 days. Each client is provided a “dedicated” fax line for their practice billing documents and correspondence.

ICD-9, CPT-4, & HCPCS Coding  & Review

PMBS’s certified professional coders are available to assist with all of your coding needs.  All superbills are reviewed for accuracy prior to claims submission, which ensures optimal reimbursement for your practice?  Claims are ALWAYS coded based on the medical record documentation. **Remember the Golden Rule of Coding -  “If it’s not documented…it did not happen!”**

Payment/Adjustment Posting/EOB Analysis

PMBS accurately post all insurance and/or patient payments and adjustments, while reviewing all insurance EOB s to ensure payments are made according to negotiated contract rates and to identify claims which require additional follow-up and/or appeals.

Resubmission and Appeals

Insurance carriers deny thousands of claims every year with what appears to be substantial evidence to support such non-payment.  They do so knowing that most denials are accepted without question or any additional action. They know many medical providers do not have the time, or insurance industry experience to investigate the basis, or lack thereof, of the claim denials.  At PMBS we have the experience and expertise to get medically necessary claims paid.

Aggressive Claims Follow-Up

PMBS A/R staff aggressively monitors outstanding claims to ensure prompt payment and to keep aging claims to a minimum.

Patient Statements

Patient statements are processed bi-weekly or monthly depending on your practice needs.  All patient account inquiries are handled by PMBS staff, eliminating the time required for you staff to handle these types of calls.  In addition to paper statements, your patient’s can receive statements electronically via e-mail and have the ability to pay their account balances on-line via our Patient Payment Portal.

Soft Collections

Because we are seen as an extension of your office, we consult with you to ensure we completely understand and employ your definition of “soft collections” on all outstanding patient balances.

Old A/R Recovery

There are several situations that can cause a disruption in your billing process, which will ultimately create a backlog of unpaid, aging insurance claims, and lost revenue.  Insurance collections require the most highly skilled coders and billers to accomplish this task, as well as the time necessary to tenaciously research the denials, resubmit the claims, and continue the follow-up process with payers until each claim has be resolved.

Monthly Management Reports

Each month you will receive practice management reports that will provide a clear and concise picture of your practice’s performance.

Additional Services

In addition to revenue management, PMBS provides the following services to assist your practice.

• Credentialing
• Physician/Staff Training & Education
• Chart Auditing
• Coding Inquiry Services
• EHR/PM Solutions
• Practice consulting to identify compliance and/or reimbursement issues/problems
• Compliance Consulting: OSHA, HIPAA, STARK, False Claims Act, Anti-Kickback