Revenue Cycle Management.

Let PRMS Revenue Cycle and Practice Management Services help you achieve your revenue goals.

 

The revenue cycle and the management of the processes contained within this plan are vital to obtaining accurate reimbursement.

Reduction in administrative excess and optimize administrative efficiency.

Identify key indicators for your practice.

Achieve and maintain optimal performance levels at your practice for improved revenue.

Free up energy to focus on other areas of improved profitability for your practice in this ever changing healthcare delivery model.

Accounts Receivables.

PRMS addresses current accounts receivable through the Revenue Cycle Management assessment and development process.

PRMS stands apart as a medical billing company.

Not only do we have the system solutions such as Lytec by McKesson, but our expert staff receives extensive training in Revenue Cycle Management so they are ready to teach your staff a complete improved cycle of billing components from intake to claims submission. Our process ensures that clean and complete claims will be transmitted to the payer. Before sending claims PRMS reviews all claims to make sure all patient/guarantor information is correct.

 

All claims will be reviewed down to the patient detail to determine the claim’s collectability.

Identify any potential for write-off.

Staff will grow in their understanding during this process as your practice revenue cycle policies and practice procedures are effectively updated.

Consulting.

Our staff has been involved in Revenue Cycle Management in the hospital setting and the physician office setting and we have been called on more frequently to assess, identify, and correct claims submission issues that result in delayed cash flows and an aging accounts receivable. Moreover, our staff members are part of various colleges and universities as faculty that teach ICD-10, Healthcare Reimbursement, Healthcare Delivery, Healthcare Ethics, Healthcare Finance, Healthcare Ethics, Healthcare Policy, and Electronic Health Records.  Our experience in the field sets PRMS apart

from the other organizations, as we understand Revenue Cycle Management and ICD-10 and can help bring the processes and attention to your accounts receivable that, in the past, only the larger healthcare organizations have had the ability to utilize. This has allowed us to utilize a consulting team that is comprised of Certified Coding Specialists (CCS), Registered Health Information Administrators (RHIA), and other coding specialists such as physician coding specialists (CCS-P) that can handle any size problem from claims submission to submitting data to CMS or other payers.

Electronic Claims Process.

With our Electronic Claims Processing your business will run better.  It’s that simple.

PRMS provides superior Revenue Cycle Management services by supporting claims submissions for many types of providers and facilities including physicians, therapists, surgery centers, rural health, imaging centers, DME providers, dialysis and other medical centers.

PRMS electronic claims processing sends your insurance claims online directly to the insurance company or to a clearinghouse that then sends the claims to the insurance company.  PRMS uses billing systems to send your claims to a clearinghouse and modules to send directly to insurance companies.

 

PRMS uses the RelayHealth clearinghouse for electronic claims processing and eligibility verification.

 

PRMS offers systems that have pre-configured connectivity to the most popular direct payers and also supports adding connections to other payers or clearinghouses.

 

PRMS seamlessly integrates training, education, and processes into your existing workflow. Once you enter your data into your system we will have made sure that your process is complete and accurate to create clean claims.

 

PRMS will also provide your practice with reports and complete ERA activities along with posting primary, secondary, or tertiary payments along with updating claim status for crossover claims.

Key Indicators.

We track and measure.

So that your practice has the best chance for success.

Deciding exactly what indicators are the most meaningful to measure for your practice is important.  That’s where our experience and know-how makes the difference.  PRMS will look at each step of the Revenue Cycle in your practice so we can identify where improvement is needed.

Some things we might look at:

Once PRMS has worked with your practice we can assist in supporting contract negotiations with commercial payers.

With all the data collected in the Key Indicators, we can more effectively identify commercial payers with compromised margins and initiate negotiations that better align reimbursement.

 

Your practice will have the ability to better evaluate pricing for commercial payers, based on fee schedules from Medicare and Medicaid, and establish pricing based on desired profit to help steer the negotiation process.  Quality measures and data reporting from the system selected will further support the negotiations.

 

Your organization will now be able to look at such things as case mix, utilization, and outcomes during negotiations with individual commercial payers.

 

Practice operating margin.

Practice cash collection percentage.

The average number of days it takes to collect payment on services rendered and PRMS will measure practice revenue cycle effectiveness and efficiency.

PRMS will measure revenue cycle efficiency and support valuation of current accounts receivable to predict income.

Assessment of total physician compensation as a percentage of net revenue.

 

PRMS will run reports to demonstrate ability to afford physician compensation in relation to revenue of the physician enterprise.

PRMS will tracks payer denials and impact on cash flow and trends payment and process improvement opportunity.

Identify opportunities to decrease collection costs, accelerate cash flow, and increase collections

efficiency and identify delays in cash.

Measure percentage of patient schedule occupied

Identifies opportunity to maximize slot utilization and improve practice productivity.

About Us

PRMS LLC has a professional staff qualified healthcare professionals that will properly manage your Accounts Receivables which will increase your cash flow and decrease your denials from the insurance companies. Moreover, PRMS is well versed in other forms of payment systems such as capitation, and global or block payments. In addition, our ability to manage your receivables will be evident in the reduction of the aging of your accounts Receivables.

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Health Care Finance And The Mechanics Of Insurance And Reimbursement.