Practicefirst’s customized solutions are designed to maximize physician revenue and minimize risk through timely credentialing, accurate coding and billing, and daily attention to practice management and compliance issues.
Are Poor KPIs Impacting the Financial Health of Your Practice?
We stay on top of the ever-shifting healthcare regulations and payer contracts, so you don’t have to, and we share this knowledge with you.
Our expertise will support seven areas critical to your revenue cycle management.
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Talk to us about how we can help you achieve the financial goals for your practice.
Get paid the first time.
Our medical billers are the conduit between patients, physicians, and payers, negotiating payment arrangements between all three parties.
Our goal is for every claim to be “clean” and compliant. A clean claim contains no errors and receives immediate attention from the payer, ensuring that you receive reimbursement quickly and correctly. Attention to detail throughout every step of the process is essential.
- Timely claim filing and payment posting
- Effective denial management/appeals processing
- Customized monthly financial reporting
- Real-time oversight
Accurate documentation matters.
We hire only the best medical coding specialists who have undergone extensive training and certification through AAPC or AHIMA. These highly focused individuals understand that accurate documentation is crucial to the financial success of your practice.
The coding team at Practicefirst is required to stay up-to-date on their continuing education and are proficient in a wide range of specialties:
- Proper revenue capture
- Documentation feedback
- Compliant coding leading to clean claim submission
Are you being paid accurately for your efforts?
Accurate documentation is critical to the financial success of any medical practice. Chart audits provide an unbiased look at the coding activity of your practice. Our auditors can readily identify instances of over-coding and other poor coding practices.
Regardless of intent, this may be placing your practice at both a financial and legal risk.
- Identify missed opportunities for revenue recognition
- Identify and resolve potential compliance issues before they become a problem
Positively impact your bottom line.
Your medical practice is a complex business. Managing that business can be challenging and time-consuming, pulling your attention away from patient care. Practicefirst will partner with you to develop a customized approach to identify practice inefficiencies and determine which operations would benefit from our direct oversight.
Below are just a few of the practice management services we offer:
- Customary fee schedule analysis
- Payer contract review
- Compliance consulting
- Payroll and bookkeeping
Credentialing & Enrollment
Let us take care of the paperwork.
Timely credentialing has a direct impact on your revenue cycle and the success of your practice. Before a provider is able to bill an insurance carrier, they must first be credentialed by that carrier.
Our electronic credentialing and enrollment system will track application progress, identify errors, and provide deadline alerts for any required periodic updates. Early notification of an incomplete application or error requires quick action. Our skilled staff will work to resolve these issues and ensure that you maintain consistent cash flow.
- CAQH—New enrollment applications, updates, and quarterly attestations
- Payor enrollment—Commercial, Medicare, Medicaid
- Managing & reporting of credentialing expirables—Medical licensure, DEA registration, CAQH provider profiles, and malpractice insurance
Know and follow the rules.
Fraud, waste, and abuse happen all too often in the healthcare industry, resulting in growing scrutiny by government regulators. We take compliance very seriously and can provide dedicated resources to ensure that your practice remains compliant not only today but also moving forward as future changes occur within the industry.
- Coding and billing audits
- Development of a compliance program to meet OIG and OMIG requirements
- Education and training programs, self-study and instructor led sessions
Accounts Receivable Follow-Up
Positively impact your bottom line.
The most valuable and critical phase of the revenue cycle process for any medical practice is the attention paid to following up on unpaid and underpaid claims. A typical practice will experience 90% - 95% correctly paid claims assuming a well “scrubbed” medical claim is filed. The real value in the entire revenue cycle process is capturing that last 5% -10% of cash flow that eludes many practices.
- Assertive, well-educated claim specialists
- Resources to address this important area
- High success rates in this phase ensure optimal A/R turnover
You Have Financial Goals.
We Help You Achieve Them.
Talk to us about meeting your practice’s financial goals with end-to-end RCM solutions.
Don't just take our word for it.
"Practicefirst performs credentialing services for our medical practice, Orthopedics Rhode Island. We have over 70 providers and an ambulatory surgery center. They understand the process and develop relationships with many of the carriers nationwide. The service and results have been excellent. Filings are done timely and follow up with the carriers is ongoing. We receive detailed reports weekly on where providers are in the credentialing process. Highly recommend their credentialing services."
SVP Practice Management at Cynergy Consulting Services
"We have been with Practicefirst for complete Revenue Cycle Services since our Hospitalist group was formed in January 2014 and have experienced excellent support and service while allowing us to grow and achieve our patient focused mission."
John Patti, M.D.
Infinity Medical of WNY, PC
"Practicefirst has been handling our Medical Billing and A/R follow up since January 2011. They have provided above average financial results with excellent customer service affording us the opportunity to focus on our most important goal, patient health!"
Debbie Chapman, Practice Manager
Pediatric Cardiology Associates
"I’ve used Practicefirst ‘s full-service Practice Management solution since 2005, including medical billing, coding, and documentation training. Monthly documentation and financial reports have been invaluable to our practices."
Greg DiFrancesco, M.D.
University Emergency Medical Services, Inc.
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