At Preferred Healthcare Management (PHM) we focus on making starting up easy, for you, and taking the burden of reimbursement off of you and your staff. We partner with you on customizing our services to meet your specific needs. We are HIPAA complaint. From Medical Billing to Collections to Credentialing, Preferred Healthcare Management (PHM) offers Physicians the solution you need to maximize your practice’s A/R.

MEDICAL BILLING

Customized to the provider’s practice and needs, we file your claims electronically and, if necessary, by paper. For seamless billing operations, we post charges, payments and EOBs, execute appeals for erroneous denials, and update all insurance fee schedules. Our internal processes implemented are structured so claims are reviewed, converted to proper EDI formatting, audited for any potential issues, and sent to the insurance carrier for processing within 24-48 hours upon receipt from your office. All claims are carefully audited for accuracy before submission (electronic or paper) utilizing the proper ICD, HCPCS and CPT codes. Our quality assurance during this stage of the process is what gives us the advantage over our competitors.

Our full service billing also includes generating patient statements on a daily basis. We provide a “soft” collection method for patients consisting of letters and telephone calls if necessary. Also provided are customized monthly financial reports that reflect charges, deposits, adjustments and patient balances.

FOLLOW-UP PROCESS (One of the most important steps to the SUCCESS of your Practice!)

Our follow-up on claims is what truly separates Preferred Healthcare Management (PHM) Services from the competition. We are committed to following up on all outstanding claims, no matter the charge or reimbursement. We believe in continually following up with each insurance company until payment or processing is resolved. It is this attention to detail and commitment to our clients that provides an increased level of reimbursement.
Our follow-up methods include:

•Telephoning insurance companies regarding unpaid claims at 30 days for electronic claims and 45 days for paper claims

• Filing secondary and tertiary insurances

• Appeal of incorrectly denied or underpaid claims

•Insurance Inquiries and Appeals to insurance companies for denied services that do not meet the National Correct Coding Policy that have been certified by CMS and approved by the AMA

Preferred Healthcare Management (PHM) will make every attempt to collect payment from insurances companies.

ACCOUNTS RECEIVABLE RECOVERY

Preferred Healthcare Management (PHM) provides services to include contacting the insurance carriers to determine claim status. If a claim was never received, never paid, or is not on file, the claim will be resubmitted to the insurance carrier. Follow-up will be performed per claim status. Claims requiring medical records will have the records attached to it and resubmitted. This is yet another value-added component of our services. Most Physicians discover, to their horror, and often too late, that their in-house staff routinely fails to reconcile aged claims. Don’t wait to find a pile of aged claim reports stuffed in a desk drawer; ask us today how we can eliminate your aged claims.

PRACTICE MANAGEMENT

Preferred Healthcare Management (PHM) provides a variety of consulting from small to medium sized Healthcare Providers the following are a few examples of this service:

•Training the front office staff

•Analyze and update all CPT and ICD-9 codes

•Review and/or create forms for Physicians Credentialing

We work closely with your staff to provide a smooth transition and understanding of all new material.

PHYSICIAN CREDENTIALING SERVICES

Preferred Healthcare Management (PHM) will perform initial credentialing and/or re-credentialing for every provider in your office. Applications for all insurance companies, including 855’s for Medicare, are completed and stored in our database. We attach all relevant documents, such as current license, CME’s, declarations pages, malpractice narratives, certification, etc. to complete applications and then send it to you for signatures.

INSURANCE VERIFICATION

Verifying benefits before a patient is seen in the providers office is an essential step to ensure reimbursement from insurance carriers. Preferred Healthcare Management (PHM) offers this service, if needed.

CONSULTING

Preferred Healthcare Management (PHM) also offers Consulting. We provide a variety of consulting services including:

• Computer systems and software installation

• Staff and Physician training

• Creating master copies of patient forms

• We offer a wide range of additional services, depending on your individual needs.

Out of City/State Providers

With the use of the latest technology, we can offer our services in any City or State. With a toll-free number, toll free fax and email, we are always just a few minutes away. We offer a variety of solutions for getting information to and from your office.

We look forward to working with you and your Practice.. Call Us Today 888-416-4746!