Your Medical Billing Company
A medical billing company should increase your reimbursements. In fact, a medical billing service should be more efficient and effective at medical billing then your own office. A medical billing service should let you and your personnel focus on practicing medicine. Whether you have private or faculty practice or you are a primary care physician or a specialty practice; like surgery, cardiology, dermatology, or orthopedics your medical billing service can make your practice more profitable.
Outsourcing Medical Billing Can Increase Profits
Preferred Health Resources is more then a claims processing center because we offer multiple Benefits and Services. Our state-of-the-art billing system daily generates your claims, which are accurately coded and electronically submitted. Once your superbills are processed, payment can be received in as little as seven days.
A Medical Billing Company Can Reduce Expenses
Preferred Health Resources is unique in the field of medical billing.
We offer a complete business solution to your medical billing needs, and we do it all for one fee. All the Services and Benefits you receive are included, even your overnight mail for shipping your demographics.
Overall our fees are comparable to the national average, just ask us for a quote. Our goal is simply to provide the highest return on your claims, without sacrificing service or patient support, at a competitive price.
The Affordable Healthcare Act – ObamaCare/TrumpCare
Health Care bill has made it a more complicated effort to deal with the insurance carriers with all the continuous changes in rules, upgrades and conformity regulations. Add to this the ICD-10 change over.
Whatever the new administration decides you can be sure your office is going to be hard pressed to adjust to all the changes. We know this and work with many small practices to make sure your reimbursements continue to flow.
Further, no matter what changes are made we know that the insurance companies will continue to play the game of NOT paying on the initial submission. That’s why PHR allocates over 50% of its charge prices to the successful group of the last 20-30% of fees that usually don’t get paid on first entry. Reach and resolution of the claims can require 10 times more attempts to successfully get a payment. Most practices have limited resources that virtually never possess enough time to achieve this work timely or fully.
Preferred Health Resources medical billing specialists focus on getting as much of your cash for you personally as possible. By regularly using timely and aggressive follow-up much more consistent revenue can be achieved for our practices.
Preferred Health Resources
The billing process generally break into three stages. Before a PHR starts to process any of a practices encounters. As your practice’s encounters are received and last once we’ve start the filing of the claims.
Your Superbill – Coding Guildlines
The superbill includes all the essential information regarding medical service supplied. Including the name of the individual, the name of the doctor, the name of the supplier, the processes performed, the codes for the analysis and process, as well as other relevant medical advice.
We work with your practice to create, and keep current, your superbill. It doesn’t matter if is a paper version or one done off of your EMR/PM system. PHR works to get this master document done right in order to keep encounter processing prompt and appeal free.
We enter these details into our database and get advice from your office if we see issues.
One into our initial system our staff or expert in ICD 9 CM, CPT, and HCPCS codes and standards, insurance and governmental regulatory demands, and payer-specific coding demands.
Utilizing the most complex and innovative technology helps us to deliver services that are timely while freeing your health care customers from training and recruiting staff that is coding.
After the Patient Encounter
After seeing a patient and you’ve submitted your encounter, via electronic or paper, we take charge of getting you paid. As we said earlier we’ve have lined up with your system and ours to get the pieces in place.
PHR’s Clearing Houses
We work with Emdeon-Change Healthcare, the leading medical claims clearinghouse, to improve claims speed and compensation. In the case of New York State, we are a unique medical billing company that files directly with Blue Cross/Blue Shield, the contractor for NYS for Medicare/Medicaid.
Follow-Up – Your Practice’s Financial Lifeline
Improper billing is an issue of physicians and patients. In a 2014 study by NerdWallet they found an error rate of 49% for Medicare claims. This after most organizations have gone electronic with EMRs. BTW, did you know that interfacing to billing systems wasn’t part of the AHA?
So we spend extra time pursuing cases in which denial or a payment continues to be made incorrectly, we challenge the insurance providers for the most compensation. We are a medical billing company that the insurance companies pay attention too, we’ve processed millions of claims. We are not afraid to call your State Insurance Board, on your behalf, to get your claim paid!
The accounts receivable follow-up team at Preferred Health Resources looks after denied claims and reopening them to receive maximum reimbursement from the insurance companies. Medical billing A/R and revenue cycle management handled by an in-house team or a billing company that is only doing initial claims processing is leaving your practices money on the table.. Follow-up demands billing professionals with specialized skill-set to look after the A/R follow-ups.
It must be noted that along with A/R follow-ups, there are several other important processes such as charge entry, verification, and posting that need to be completed first. During these procedures a medical billing specialist determines the exact procedure code and diagnosis code based on the treatment plan. There are chances that the insurance company will deny claims if they don’t adhere to each insurance company’s rules, therefore it is crucial to have a dedicated A/R team who can follow-up with the insurance firm to resolve denied claims.
Reimbursements from the Insurance and Patients are accounted appropriately to the respective patient accounts in the PHR system. Besides applying the payments our skilled and analytical staff checks for down coded payments, contracted fee-schedule and contractual adjustments. The account rep alsoreviews overpayments and processing of refunds.
Our services include managing and reporting the daily deposits, EFT payments, Patient cash receipts and credit card payments. A daily and MTD reconciliation is reconciled at the batch and deposit level to ensure that all the payments received are posted.
We post payments in to our database, as we receive payments and explanations of advantages from customers. Each EOB will probably be audited for correct payment or advantages. At this stage secondary paper claims, write-offs and adjustments are done.
Mailed out of our office for facility or the practice.
Because each provider or practice differs, we customize our reports as needed. We have over 1,200 type of reports!
Pricing that Fits Your Needs
There is a reason that almost all of our new business comes from referrals from some other doctors – and this is service and the outstanding support we give our customers.
Every practice is exceptional, and insurance charge may be challenging. To not worry! we are going to work around your requirements and availability, so there is not any reason to hold back. Call now 877-877-6900!