Expert Billing &
For physicians, professional (specialty or primary care) or facility billing, our tried and true technology platform is accessible by PC, iPad, or iPhone. We are cloud based, fully secure, and scalable. We document all actions for transparency and aggressively perform the hard work, which comes down to collection follow up and pursuit of unpaid and/or underpaid claims. A portal for patient interaction is built-in and EMR/EHR is available and integrates with our system.
Our service is geared to fix/resolve problems, work in and out-of-network claims, negotiate, and to maximize reimbursement. Reporting is detailed and very accessible. On occassion and after an assessment, PSB can sometimes work from an existing or other system already within your practice/facility, when feasiable.
While PSB has years of experience negotiating out-of-network claim payment, PSB is also well positioned and experienced with handeling and collecting Liens on Personal Injury cases
& Build Software
Billing and EHR systems are not always a one-size fits all solution. Some practices and facilities have unique requirements or business rules that when managed and integrated into the billing system, drastically increase performance and the ability to get claims paid the first time billed. PSB uses a programmable database system in addition to its billing system, to enable complex task management, statusing, exception reporting, and other valuable features not available to most.
What do you wish a billing/collection system could do for you?
What information and informatics are you missing and what would you like to have?
What processes in your practice need tracking and administration that are beyond the billing system capability?
In and Out-of-Network
Out-of-network billing is a very strategic process. PSB's approach has been honed over the past two decades. With the aid top legal minds and a rigorous approach, we created the process and procedures to challenge unpaid and underpaid claims, mounted numerous recoupment efforts, and have managed to maximize payment in a reasonable way. Our goal is to be your advocate and to work through issues to find solutions and get results. With the onset of Obama Care and more federal regulation, ERISA became a dominant process in collecting on unpaid and underpaid insurance claims. Proper consents and information, fair health fees, patient acknowledgement of balance billing, charity and indigent policies, specific payor requirements, and attempts to collect from patients are all processes that PSB will implement and make sustainable.
In-network billing is just another defined process requiring patience and time to thoughtfully identify the right contract terms along with a system that can measure expected allowable amounts and and assure payment compliance when comparing to contractual allowances. Questions to ask yourself:
Are you being paid what you expect to be paid?
Are you being underpaid?
Is there a plan that should be terminated and renegotiated?
If for new venture, do you want to get it right from the onset?
Personal Injury Cases &
P.I. is an interesting subset of services provided to the insured or liable party under auto or other liability insurance coverage resulting from an accident or injury. While the policy limit is the key to recovering fees for services rendered, the amount paid is typically subject to a negotiation after the legal case settles. While settlement may take several months to a few years, the payout rate can be far in excess of standard PPO and/or Govermental allowance rates. Working with reputable attorneys is one important factor while attempting to understand each treatment plan and the policy benefit to total monies spent on care is another important factor. PSB would be pleased to make this assessment for you and manage this financial segment of AR. Uniquely, another AR approach is to sell or non-recourse factor the lien or receivable for a 30 day guaranteed payment typically at a rate of 1 to 2 times the Medicare allowable.
Qualified Medical Evaluations ("QME") is another niche within our healthcare system whereby medical providers become licensed by the State to perform QME, AME, or IME evaluations that are non-treating, but require a review of records and preparation of a Med Legal report in answer to questions posed by Applicant and Defense Attorney's. If your already augumenting your practice with this opportunity, PSB can help you. If your not a QME, PSB's can bring you into a related service that can do it all for you.
Ambulatory Surgery Center
"ASC" Creation, Management,
PSB will plan, develop, build, and/or manage an ASC venture with you or will be pease to take over what you have and where you are with it. Perhaps you just need assistance with selecting a functioning ASC to join. Whatever the case, PSB is here to help. For a new ASC, PSB will oversee site selection, set up and plan for governance, recruit surgeons, oversee accreditation, seut up appropriate staffing levels, set work & purchasing standards, buy at the right price, set proper inventory controls and profitability management by case, maintain metrics, and many other factors that go into a well run ASC. Our hands-on approach will help you manage overhead and drive lower operating costs. Let us guide the formation of your entity from start to finish, and take your vision to reality. PSB is often the part-time Administrator/CFO, negotiator, and trusted advisor. Other times PSB is just the billing and collection vendor. You get to choose! Common areas of concerns found upon assessment include:
No contracted compensation method for expensive implantable or disposable supply items
Poor reimbursement rates on frequent services not carved out for better reimbuesement
Lingering and unresolved issues that effect reimbursement
Poor execution of the revenue cycle process
& Merger/Acquisition Support
Tell us your dreams, concerns, or issues, and we will design a solution and provide consulting services to get what's needed accomplished. PSB has been very effective in the following areas:
Agreement facilitation and pre-legal consultation for joining a practice, medical related entity, or a surgical facility
Valuing your practice, medical entity, or surgical facility for acquisition or for tax or other purposes
Reviewing and tuning private equity "PE" type acquisition deals to best accommodate risk mitigation strategies along with other needs
Pro forma calculations and assistance with financing and funding options for operations and new ventures
New venture or business line creation to augment or best leverage your practice or facility
Redesign and/or restructuring of practices and/or facilities to improve cash flow