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Smarter Claims Processing

A health insurer needed more intelligent claims processing. We reduced their cycle time by 75%, to 2.5 days.

Billing, Coding, Collections

Medical Billing Services

  • Full Service Revenue Cycle Management

  • Claims Management, Claims Tracking & Followup

  • Coding and Compliance

  • EHR Integration

  • Practice Metrics and Analysis

  • Provider Enrollment and Credentialing

     

Revenue Cycle Management Services (RCM)

From appointment scheduling and patient registration until each claim balance reaches zero, The Billing Pros provide professional revenue cycle management services and personal service available nowhere else.

 

 We work with our providers to verify eligibility and accurately gather all patient information necessary and manage every step of the medical billing process.

 

As new third-party payment plans emerge and the healthcare industry transitions from traditional fee-for-service to pay-for-quality models, successful revenue cycle management requires a more complex skill set. Conventional revenue streams are giving way to more complex payor mixes and payment methodologies, many of which shift the financial risk of providing care from payors to physicians.

 

 Quality measures (PQRS), pay-for-performance (P4P), accountable care organizations (ACOs), E-Prescribing, EHR meaningful use, and capitation are all becoming vital elements in a healthy revenue makeup.  New, robust technologies and analysis tools are standard equipment for smart managers.

Claims Management and Claims Tracking

Using our powerful electronic medical claims monitoring tool, we identify problem claims early and take necessary steps to assure medical claims are processed in a timely manner.  Automatic account follow-up tools aid our medical billing specialists in working denials and resolving payor issues, an integral part of our revenue cycle management process.  

 

Medical billing is primarily a human endeavor and we give our clients the most personal service in the industry.  Timely and accurate billing and effective claims follow up is often the difference between merely paying the bills and being truly successful.  PRSG sets itself apart with insurance follow-up efforts that get results and make sure our physicians are paid fairly for their work.  

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