We understand that denied claims directly affect revenue and profitability, which is why we develop solutions to reduce the probability of recurring denials.
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With extensive expertise with claim analysis, accurate billing, and claim reviews, we can help you minimize denials and shorten the reimbursement process.
Priority of Appeal Claims
Common Denial Analysis
Claim denials can be a time-consuming pain point for many practices, but PRM has the experience to help every practice shorten their accounts receivables cycle.
If you do not prioritize your appeal claims, you will likely lose revenue. Most states require healthcare providers to file their appeals within one year from the date of injury, but even if an appeal is filed within this time frame, the healthcare provider could be liable for up to five years of interest on the outstanding debt, should there not be a timely response from the insurance company.
At PRM, we analyze all prior denied claims so we can establish a trend. Once we figure out the gap between submitting and full reimbursement, we develop solutions to reduce the probability of rejections reoccurring. One of the primary causes of denials is errors in coding and billing. Our team is well trained in accurate billing, and all claims are thoroughly reviewed before they are submitted, so the reimbursement cycle is as short as possible.
The urgency and uncertainty associated with these claims can make them difficult to file in a timely manner. If there is no process in place within your practice, late filings will likely occur, resulting in lost revenue.
Many circumstances can lead to late filing and result in loss of revenue or slower return of revenue. Using PRM's proactive approach, we will help you prevent late filing, providing you with quicker and higher returns.
A practice that does not have a set process to analyze claim denials can create issues that may go unnoticed for weeks, months, or even longer.
The experts at PRM will track and analyze all your claims in order to identify specific issues/ denials. Analyzing common denials gives a better scope and insight on what is going on within the practice and also identifies trends that can be spotted that are leading to these denials.
Whether you’re a solo practitioner, a large facility-based group of physicians, or somewhere in between, we understand the specific nuances of your business.
No matter if you’re a Solo provider, from a Mid-Sized Practice, or a part of a Large Facility-Based Group, we understand your needs and can provide the specific services and solutions to fulfill them
Based on the services you provide, we understand that your business comes with unique challenges which PRM is ready to tackle.
With our broad range of RCM services including claims submission, medical coding, and scheduling, our team is well-equipped to work with primary care providers.
OB/GYN practices need specialized RCM services like time-sensitive scheduling, and specific billing codes and modifiers for a range of procedures. Our medical coding team offers comprehensive HCFA and UB ICE-10 claims, and we offer integrated EHR services to streamline the scheduling process.
Billing staff must have a good grasp of concepts like margins, shaving, and destruction to effectively bill and appeal dermatology claims. Our experienced team ensures your claims are submitted at the highest possible value without over-coding and while curbing billing errors.
For Orthopedic surgeons, practice challenges can hinder your business cycle. Not the least of which is having an efficient revenue cycle in the form of error-free medical billing and coding that enhances your reimbursement rates. This is one of the top focuses of our team for Orthopedic practices.
With nephrology, you need a medical billing team that understands the different documentation and specific ICD-10 coding of claims and related EDI processes for nephrology. At PRM, we boast a 100% success rate on clearing claims with a dedicated Claims Denial and Appeals Management team.
As a cardiologist, you frequently work with patients who require complex procedures. PRM offers a team of experienced medical coding staff who are accurate and ensure legal compliance at every step.
If you have any doubts, we put together this simple scored quiz for you to find out… here’s the first question