Revenue Cycle Management

Team Knowledge

Our 200+ team of professionals has access to a real-time database of payer rules and regulations (including procedures, diagnosis, appointment types, payers and more). This global information is shared with our clients.

We provide physician revenue cycle management services throughout the United States, from coast to coast.

There are many advantages of outsourcing with PracticeForces:

Fotolia_57896461_Subscription_Monthly_MInsurance verification and real-time data including deductibles, secondary and tertiary claims are possible through our physician revenue cycle management services. These services use AAPC (The American Academy of Professional Coders) certified coding which is done by professionals who are prepared for the ICD-9 to ICD-10 code transition. Charge entry for any volume of charges and coding analysis, including all modifiers, is used as well to ensure that all patients receive high quality and efficient care.

Our revenue cycle management services use claim scrubbing to ensure there are no coding or claim information errors with immediate electronic transmission of claims within 12 hours from the time of your patient's visit. This immediate claims filing allows consistent cash flow for your practice. Our services allow you to receive claim status verification within 24 to 48 hours after submitting the claim, allowing our claims-acceptance rates to be above 95% with more than 96% of claims being processed in fewer than 21 days.

All required insurance claim forms are generated from the PracticeForces' office and receive immediate insurance follow up. This allows a timely follow up on electronic remittance advice from the insurance companies.

Payment posting is easily done through our revenue cycle management services containing staff that is experienced in analyzing EOBs and payer rejection codes. Our EOB follow up consists of experienced representatives analyzing explanations of benefits and claims, and then taking the necessary actions to recover the amounts due. We utilize denial management to allow minimal days in accounts receivable, in which highly effective specialists perform claim-by-claim denial review, pursue payment, and execute appeals on your behalf.

Our claim tracking, denial management, payment pursuit, and appeals are all rigorously tracked in our AR control center and provide your practice with continuous follow up with both patients and insurance carriers. Here at PracticeForces, we accept all calls on our toll free number regarding outstanding claims and questions at our headquarters in Clearwater, Florida.

“Soft Touch” collection methods are used with patients through our revenue cycle management services and allows submissions of patient statements. Payments are deposited directly to the doctor’s or hospital accounts, as per your requirements. Our services support reporting & analysis reports, daily reports, month end reports, and capitation reports. If at any time you are in need of any special report, we will be happy to provide you with it free of charge.

To learn more about our billing process here at PracticeForces, please feel free to check out this free whitepaper: The PF Standard Billing Process Manual.

Increased Control and Cash Flow

Streamline patient processing, practice workflow and report generation are available through our industry-leading practice management software. This software enables you to track practice activity and claims in real-time through our Workflow Dashboard, which allows you to see, understand and manage your operations.

You can bring control, consistency and clarity to daily activities at your practice by relying on PracticeForces to execute eligibility verification, insurance package management, claims submission and remittance posting.

With our revenue cycle management solutions, your practice can benefit from having the expert eyes of PracticeForces’ Client Service Managers on your team and be in full HIPAA compliance with regards to privacy, security and transactions. Our solutions eliminate all payer-facing work and its headaches through PracticeForces’ AR Control Center, where we track claims, handle denial management, payment pursuit and appeals. This brings greater predictability, transparency and peace of mind to your practice.

Incorporate your practice-specific coding rules into our rules engine, with programming provided by PracticeForces. Have you seen our 7 Advantages of Outsourcing Your Medical Billing with PracticeForces?

Enhanced Strategic Decision Making

Fotolia_12762427_XSOur revenue cycle management services allow you to gain a strategic view of your practice by accessing operational and financial performance data via powerful, real-time reporting professionals. This allows you to compare and optimize the financial performance of individual areas of your practice, and benchmark your performance against that of similar practices with Medical Group Management Association (MGMA) data.

You are able to run aggregate reports on billing performance with our services to determine which payers need monitoring, and which lines of business are most successful. You can then receive PracticeForces’ generated Practice Performance Reviews and Clinician Performance Reviews to better evaluate your practice and its individual contributors.

With our revenue cycle management solutions, you can focus on patients and making smarter decisions based on greater insight by freeing your practice from routine billing and collection tasks. This will significantly reduce business burdens, and enable practice leaders to optimize today’s opportunities while planning strategically for tomorrow.