Healthcare providers experience PCH as their cost containcontainment solution for their business. It offers service to address every facet of the provider transactions and processes.
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Healthcare Providers enlist PCH as their cost containment solution for administrative issues from the initial stages of checking eligibility and requesting authorization to analyzing and taking action on underpayment issues at the end of the process.
At the front desk, PCH provides a platform for easy access to patient records and enables demography and charge rate entry. After the visit, PCH manages unstructured EHR, produces accurate coding, and submits claims to the Payer. Once the claim is submitted, PCH manages denials, posts payment, manages AR, handles calling and collections, analyzes underpayment issues, as well as printing and communication.
PCH is a unified portal that connects Providers to Payers and Members for efficient management of claims that allows full visibility at each stage of the claims process accompanied by trackers, reports, and alerts. It enables easy communication between the entities involved in an end-to-end process. PCH significantly reduces cost and improve revenue by simplifying the administrative efforts involved in the claims process.
Remote or Onsite | Domestic & International Services | Experienced with all systems | Electronic Records | Scanned Images | Hybrid Systems | Temporary or Full-time Support | Workflow Management | 3M Preferred Partner | Improved Coding Integrity | Reduced Backlogs & Rebilling
DRG Audits | Outpatient Audits | Comprehensive Code Validation | Specialty Audits
Remote or Onsite | Domestic & International Services | Experienced with all systems | EMR, Scanned Images, or Hybrid Records
Customized Physician and Non-Physician Training | Education on ICD-10 Specificity Concurrent Medical Records Review
Seamless ICD-9 to 10 Transition Support | Prepare Staff on Training & Documentation | Update Documented Audit Control Procedure | Reduce Uncertainty & Eliminate Collections Impact |Optimize Revenue using Big Data Automation | Coding & Compliance Audits | Documentation Improvement
Regular Quality Reviews & Accuracy Assessments | Continuous Education | No Subcontractors | Dedicated Facility Account & QA Managers | RHIT | RHIA | CCS | CCS-P | RN | CPC | CPC-H
Complex Claims Formats | PO Box | Upload | Print Driver Intake | Direct Data Entry | Fax | Email | Mobile Apps | EDI
OCR | Exception Handling | Indexing and Classification | Skip or Key Process | Quality Assurance | Doc Typing Routing
Rejection Management | Denials and Re-pricing Routing | Images, ANSI 837 | FTP Loading | Customer Interaction Management.
Configurable Business Rules | Client-specific Validation | Auto & Manual Corrections.
TAT Report | Audit Report | Aging
Configurable Composition & Editors | Automated Content Generation | Print & Mail | Electronic
Payment Hub | Lockbox | Collections Customer Interaction Management
On Premise and/or Cloud Hosted | Security & Compliance | Redundant | Amendment Tracking | Summarization & Dashboards
Smartphone/Tablet | SMS | Auto-pay | One-time Cash Payment Remittance | ACH | Online Portal
Bill Payment | Check Authorization |Check Image Processing | Auto-adjudication |Collections | Multi-level Approval
Configurable Business Rules | Process 27 Types of Simple & Complex Claims | Same Day Turnaround Time | Deployed in NIST – DoD | Certified by ‘AppSec’
Invoice Consolidation | Expense Management Cash Flow & Liability Visibility | Real-Time Tracking | Revenue Forecasting | Departmental Accounting & Payment Options
Print & Mail | E-Bill Distribution | Standard Forms | Document Composition | Targeted Marketing | Branding
Reconciliation | Misdirected / Incomplete Payments | Transaction Auditing
Foundation for All Services | Expected Reimbursement Contractual Allowance | Technology Based Platform | Business Rules Based Engine Table Driven Architecture Load, Maintain All Payer Agreements | Data Mining and Analytics | Ensures compliance
Calculation Adjudication Engine | Expected Reimbursement | Contractual Allowance | Supplement, Compliment Client System | Daily Comparison | Eliminate False Positives Identify Areas of Risk
Measure Revenue Impact of Contract Terms Develop Market Specific Strategies |Utilize Historical Claim Data | Benchmarking | Rate Comparison and Setting | Multiple Scenarios | Monitor Payer Contract Performance
Identify and Recover Underpayments | Retrospective, Concurrent | All Payer All Products | 2%- 5% Unrecognized, Unrealized Revenue | Root Cause Analysis | Hold Payers Accountable |Avoid Timely Follow-Up Limitations, Penalties
Ambulance(ground and air) – servicing since 1987 Physician Practices – servicing since 1987 Hospitals – servicing since 2002 Retail Vision Centre's – servicing since 2008 Medicaid Reclamation – servicing since 2008 Pathology Labs – servicing since 2010 Medical Supplies – servicing since 2013 Telecom – servicing since 2000 Government Services – servicing since 1997 Financial Services – servicing since 2000
First Party | Post Cancel | Pre collect | Primary Secondary | Tertiary Warehouse Email Web chat | Customer Service.
FDCPA | HIPAA | TCPA | PCI DSS | GLBA | ECOA | FCRA | UDAAP | SCRA | SSAE 16
Natural Language Processing | Live or Virtual Agent | Billing | Scheduling | Q&A | Support | Request | Complaint
Document Design | Interactive Web Tools | Real Time Production | Custom Data Integration | Automated Segmentation & Dispatch Configuration
Electronic Bill Pay & Presentment | Targeted Marketing | Welcome Packages
EOB Correspondence | Checks | Statements Marketing | Disclosures B/W | High-light | Full Color | Skip Tracing | Return Mail
Payments | Routing | Disputes | Rebates
Internal | External | Trigger Configuration | Threshold Monitoring | Reminders | Calls to Action | Tracking
Live Enterprise Data Feeds | Version Control | Upload Notifications | Cloud Collaboration | File Previews | Automated Form & Content Classification
Physical or Electronic | NARA Certified Facility | Analog Film Library Storage & Management | Scan On Demand Film Digitization | Mammography Scanning | Secure Destruction
Rapid Third Party & Legacy System Integration | Individual or Enterprise Registration | Smartphone & Tablet Apps | Any File Type | OS Agnostic | Subscription or Monthly Billing
Define Permissions, Roles & Access | Bulk User Actions | Drag and Drop Uploads | Activity Tracking | Desktop Sync | Self Help & Multi-channel Support
Secure and Multi-industry Compliant Storage | Anti Breach Architecture | User Security Controls |2-step Verification | Encrypted Security Tokens Remote Wipe | Shared File Expiration
Data Aggregation & Analysis | Configurable Dashboards | Threshold Monitoring | Alerts & Notifications | Unified Communication Services
RHIT, RHIA, CCS, CCS-P, RN, CPC, and CPC-H credentialed staffs
ICD-9/10 solutions, migration and training support
Flexible solutions including onsite and remote coding & auditing capability
Effortless claims management with status tracker and reports
Lockbox and AR management ensure the faster cash flow
Revenue integrity solution for accurate revenues and maximize the revenue
Highly secured record management facility to store medical records
Efficient collection process made collection quickerwith less cost
Integrated unified communication services to get informed throughout the life cycle of the process
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