Our Revenue Cycle Management
- Eligibility and benefits verification Authorization request and tracking patient registration
- Charge entry Medical coding Payment posting Electronic remittance posting (exceptions)
- Submission of paper and electronic claims Manage clearinghouse and payer rejections
- Denial review and management
- Insurance and patient follow-up
- Appeal of all denied or underpaid claims
- Return mail processing Daily/Monthly close Fee schedule review and analysis
- Medical record reviews
- Coding audits provider enrollment and contracting
- Customized management reports Old accounts receivable clean-up
Credentialing Services
Provider credentialing is a verification of your experience, expertise, interest and willingness to provide medical care. Without successful credentialing, provider reimbursement for medical services can be delayed and, even, denied Provider credentialing is more than just another form to fill out or a minor nuisance; it’s a complex, ongoing process and a critically important one at that. Without successful credentialing, provider reimbursement for medical services can be delayed and, even, denied. Given its many steps, critical deadlines and lurking uncertainties, provider credentialing is business critical for your practice. We at PCC Inc. make sure that each and every provider is credentialed with the payers.
Auditing Services
We at PCC Inc. provide practice review and auditing system for the providers to find out the leaks which
are dropping the revenue and make suggestions to fill those leaks. This Audit is only a one time service
on very cheap rates for the new providers interested in the analysis of their practice.
A dedicated and experienced staff dive deep into the practice and analyze it, point out the glitches
and issues, prepares a detailed report. The report is thoroughly reviewed with the provider and solutions
are suggested free of cost.
We are offering access to our providers direct on their systems through Remote Desktop. And we also have dedicated Practice Management Software. Its custom developed in collaboration with the active clients. The Providers can run any kind of detailed report from this application and a new report can be added on request.
PCC Inc. can help clients design forms that improve efficiency and clearly communicate critical information.
PCC INC. will audit its clients E & M procedure coding to ensure proper coding to avoid audits for “over-coding” or to increase revenues when “under-coding.” PCC Inc. will pinpoint the trouble spots and help correct problems before a claim is submitted to the insurance company.
In addition to providing the standard monthly financial management reports that include Accounts Receivable, Aging, Payments, and Detailed Patient Information, PCC INC. can tailor reports to the practice’s specifications. These reports are a valuable tool in providing assistance for analyzing and visualizing the practice’s financial goals and objectives.
PCC Inc. provides this simple yet effective way for the physician and practice to enhance their financial profile both in cost and results. If a physician’s current fees are below what is being reimbursed in their market, this review becomes a valuable guide to bring fees in line with their marketplace enabling practices to put their profile in order before negotiating their managed health care contracts.
PCC Inc. Medical Billing provides access to specialised medical billing tools, techniques, technologies, and knowledge that can only be maintained by a company that has focused its learning and business on providing top rate medical billing services.
The single most important tactical reason for outsourcing the medical billing function is to reduce and control operating costs. Achieving greater economies of scale and advantages based on specialisation, is clearly and simply one of the most compelling tactical reasons for outsourcing.
Eliminate cash flow interruptions that occur when in-house medical biller leaves or goes on vacation. Developing a steady cash flow will only enhance the practice’s bottom line.
Redirect the medical practice’s resources from non-core activities towards activities that have the greater return in providing medical services to patients. By outsourcing a non-core function such as medical billing, staff’s energy is free to focus on greater value-adding activities for the practice.
By devoting too much attention to areas that do not contribute to the bottom line, medical practices can dilute precious resources and decrease flexibility and agility. Outsourcing the billing function to PCC Inc., physicians are able to concentrate on practicing medicine instead of the varied support functions required to run a successful practice.
Paper claims are submitted to smaller carriers who either do not accept electronic claims or require non-electronic attachment. PCC Inc. identifies which carriers require paper submission and avoid improper claims processing.
PCC INC. provides claims management advice, and problem solving strategies for the practice, as well as staff training.
PCC Inc. benchmarks client’s fee schedules against local averages in order to provide recommendations for higher reimbursement rates.
PCC Inc. Medical Billing provides full claims management services at a competitive fee schedule to medical professionals and group practices throughout Northern New Jersey. PCC Inc.’s medical billing services encompass the entire reimbursement cycle – from claim submission to collection.
PCC INC. submits medical claims electronically to all accepting insurance companies, including, but not limited to, Medicare, Medicaid, Blue Cross/Blue Shield, Aetna, TRICARE/CHAMPUS, and Workman’s Compensation. The timely submission of insurance claims results in faster return on profits for the medical practice since claims are submitted with fewer mistakes and are received directly by the insurance carrier in an approved HIPAA format.
PCC INC. submits all secondary & tertiary insurance claims, alleviating the medical practice from this task
PCC Inc. conducts all of the necessary follow-up for claims – researching and reviewing unpaid and denied claims in order to ensure maximum insurance reimbursement
PCC INC. posts all payments made by insurance carriers and patients and notifies the patient of any required deductible and/or co-pay.
According to individual insurance coverage policies, patients will be invoiced for deductibles, co-pays, and outstanding balances. PCC INC. ensures excellence in customer service when handling patient inquiries and requests.
Delinquent patient accounts receive monthly statements and “soft” collection letters from PCC Inc.. After 90 days, the matter can be taken to a collection agency of the medical provider’s choice, or written off at the physician’s discretion.
PCC INC. reviews a practice’s backlog of claims to determine if they are eligible for submission or re-submission. If so, PCC INC. will process those claims and provide follow-up and collection services as usual.