PPS offers a myriad of services to support the revenue cycle and daily operations of the practice. These support services include but are not limited to:
This includes activity from data entry to claims filing to patient balance billing. This can be done on the client’s practice management software or on PPS’ Allscripts PM System used by PPS.
PPS can do any component of the revenue cycle with special pricing for the services provided. For instance, we may do only the portion that resolves problem insurance claims and denials. We have a model for back-end services when the client is using EMR software which performs some of the revenue cycle such as charge entry that is being moved from EMR to the PM software. PPS deals with the problem claims and denials from the PM software, the clearinghouse, and the payer. In this model, PPS also manages the patient balance billing.
PPS has a staff of Certified Procedural Coders who not only can do coding at a complex level but also work to resolve denials giving them advanced knowledge of problem patterns identified by payers or clearinghouse software. Thus their knowledge is contemporary and specific. PPS can also do chart audits looking for substandard coding patterns or practices. We also offer a coding hotline as a resource to those who work with coding but occasionally need affirmation of their code selection. PPS also offers coding services through which our staff of certified coders will code for services based on information provided by the client.
The SGR repeal of 2015 created more specific legislation that will drive the move to alternate compensation models or other ways of paying providers rather than by fee-for-service alone. This will add to the plans already in place such as PQRS and the EMR incentive plans. PPS can help with registration, selection, submission, and tracking of submissions.
PPS has data analysts on staff. Most standard medical billing software allows data to be downloaded into Excel or a similar type of software. This allows PPS’ analysts to work with the data to produce results in a format that is customized for the Client’s use. As the reimbursement methods change for physicians and other providers, the need for data will increase some of which will support planning for the providers or their employers and some of which will be required by the payers or other users. PPS can facilitate or do this process.