Competitive Analysis

At PracticeForces we go above and beyond the competition

We recognize there are a lot of choices when it comes to billing companies. Based on our client’s experiences, we have found there is a tremendous difference in service levels between companies. MAXIMIZING REVENUE, in the most ethical way, should be the primary focus of your RCM partner. To that end, following is a summary (not by any means exhaustive) of what we provide our clients to ensure we capture ALL the revenue our Providers have worked hard for and deserve. These are the functions that are most often asked about.


The Choice is Clear

All of the following functions are part of our service and there are no additional charges.

PracticeForces:

  • We guarantee we will raise your practice revenue by 20% (and often more) in the first 90 days
  • We insure carriers are paying our Providers fairly and completely. When necessary, we will renegotiate your contract(s)*
  • Electronic transmissions of claims within 12 hours of patient visit
  • Real-time eligibility of all carriers connected to the patient
  • Insurance verification of deductibles, secondary and tertiary claims - including claim status verification within 24 hours
  • Continuous follow up with patients and management of all patient calls
  • Continuous follow up with insurance carriers and management of all carrier calls
  • Quarterly updates of:
    • Availity (or other clearinghouse) directory
    • Individual insurance directories
    • CAQH>Medicaid disclosure attestations on internet
  • Timely EOB follow up with carriers: analysis of electronic remittance advice, rejections codes and then necessary actions taken to recover all amounts due
  • This includes all required insurance claim forms, which are generated and submitted by our office
  • Systematic chart review/claims scrubbing to ensure the highest, ethical codes and fees are being captured and billed. This includes coding from hospital/facility notes as necessary
  • Rigorous denial management, payment pursuit, and appeals in which highly effective specialists perform claim-by-claim review and execute appeals on your behalf
  • Contract flexibility – the term of PracticeForces contract is two years. We only want clients that want to be with us, thus the contract can be terminated with a 90-day notice
  • Customized reporting – delivered (via email about 5am) to you at your chosen time interval (daily, weekly, monthly) which will detail the data points that you specifically want to see such as: received revenue, deposits, a/r summary, cancelled appointments, etc.
*Possible small fee required

Competition:

  • No revenue guarantees are typically given
  • No carrier oversight on Provider reimbursements typically provided
  • Many services transmit claims only once or twice a week, or less
  • Many services provide eligibility verification only on the primary carrier
  • Insurance verification of deductibles is only provided for the primary carrier and many services do not provide claim status verification at all, much less within 24 hours
  • Many services do not take any patient calls
  • Many services do not take any carrier calls on the Provider’s behalf
  • Many services do not provide any of these update services
  • Many services provide little to no claims follow up and/or merely go through the motions, without getting satisfactory resolution
  • Most services do not provide any additional forms or paperwork a carrier may require. Further, they do not inform the Provider of the need for additional documentation
  • Many services provide sporadic to no chart/claims review or charge additional fees to do so
  • Many services do not pursue payments at all after the initial claims submission
  • Many services have very punitive contracts that last 3-5 years long and cannot be terminated early
  • Many services provide no or superficial data points that may not be the area that your practice wants to focus on

Let us start capturing all of your Practice revenue today.

Effortless Billing

Billers write off difficult or old cases, that may require extending extra effort, without Provider knowledge or approval

Non Committal Contract

Many services have very punitive contracts that last 3-5 years long and cannot be terminated early or superficial data points that may not be the area that your practice wants to focus on

Thorough Reporting

An A/R that is too clean likely deserves further investigation as revenue is statistically being left uncollected or old fees may be hiding in mass “re-billing”

Extensive Support

Over 200 experienced, certified experts identifying underpayments, preventing claim denials, and focusing on the health of your practice - so you can focus on the health of your patients