Full Service Medical Billing
Charge Entry
Claim Submission
Claim Submission
PRMS provides complete medical billing services. Your office provides the demographic information on each patient and charge information for each visit. We then take over with the remainder of the billing cycle. PRMS has checks in place to ensure that each patient encounter is is captured for submissions to the insurance company. We also offer coding services.
Claim Submission
Claim Submission
Claim Submission
Our team of experienced and knowledgeable professionals validate each claim and ensure the claim is clean. PRMS has processes in place to ensure acceptance of the claim by the payer.
Payment Posting
Claim Submission
Payment Posting
PRMS staff accesses the payment information in several ways.
1. Electronic Remittance Advice files or ERA's, which are posted automatically to the patients financial account. When this option is used, PRMS staff reviews each transaction that has posted electronically to ensure the claim has been processed correctly. There are several dif
PRMS staff accesses the payment information in several ways.
1. Electronic Remittance Advice files or ERA's, which are posted automatically to the patients financial account. When this option is used, PRMS staff reviews each transaction that has posted electronically to ensure the claim has been processed correctly. There are several different issues that can arrise when posting ERA files. For example, the patients secondary insurance is not on the patients file and the ERA is received the ERA file will transfer the balance to the patient instead of secondary payer. This is why PRMS has checks in balances in place to ensure ERA files are properly reconciled.
2. Paper Remittance Notices, which are forwarded to the PRMS office by the practice. PRMS can use various process's to send the paper EOB's to our office. This includes electronic file transfers, faxing, etc. Or you can select to use Snail Mail.
Some of our clients choose the option to have all payments sent to PRMS to remove the extra work of opening and sorting mail. Our lead managers of payment posting then work with your office to obtain a bank scanner in which PRMS can scan daily deposits. PRMS has several checks in balances in place for this process.
A/R Follow Up
Solutions for Every Step
Payment Posting
This step is crucial to an efficient Revenue Cycle!
Although PRMS utilizes processes to limit the number of claims that deny. It is inevitable that some claims will deny. PRMS has various levels of rigorous follow-up protocols in place if denials do occur.
Our staff are trained to identify the denial reason codes and take action immediate
This step is crucial to an efficient Revenue Cycle!
Although PRMS utilizes processes to limit the number of claims that deny. It is inevitable that some claims will deny. PRMS has various levels of rigorous follow-up protocols in place if denials do occur.
Our staff are trained to identify the denial reason codes and take action immediately to resolve the denial. Any patterns that are found are immediately reported to management for further review to prevent denials in the future.
PRMS will also appeal any claims that have denied incorrectly. The appeal process has 4 basic steps.
> Establish appeal legitimacy
> Gather needed appeal information and documentation
> Send the appeal to the payer
> Receive some amount payment or another claim denial. When this occurs we reach out to Provider Relations to see if we can get the claim paid.
Solutions for Every Step
Solutions for Every Step
Solutions for Every Step
If you are left doing any work that applies to medical billing, then you are not really getting FULL SERVICE Revenue Cycle Management Services.