Payer Reimbursement Services & Modeling
Maximize revenue with a full reimbursement solution that integrates payer contract management with underpayment collections, denial management, and contract modeling.
Learn more about how accurate reimbursement services can improve your healthcare organization's bottom line.
Efficiently monitoring each payer’s expected reimbursement is critical. Calculating payer balances continues to grow in complexity. PMMC delivers an integrated process for modeling prospective payer contracts to improving future reimbursement and accurately assessing, measuring and capturing all revenue contractually owed with current contracts.
Revenue Cycle Experts understand the differences between physician (professional) and hospital (technical) billing. PMMC delivers unique applications for both scenarios. PMMC PHYSICIAN PRO calculates the expected reimbursement and contractual adjustments for each line on a claim versus total claim-oriented results.
Ever wonder what financial impact the new payer contract will have on your bottom-line? Ever feel like you are negotiating your payer contracts in the dark? As hospital contracts become more and more complex, negotiating payer contracts becomes harder and harder. PMMC delivers a hospital reimbursement modeling software and consulting combination that helps insure your organization models the thousands of various reimbursement code combinations to understand the anticipated impact the proposed payer contractual terms will have on your bottom-line.
Historically, denial management was more of a nuisance issue, but today denial management aggressively competes among CFO’s highest priorities. The consensus is an effective denial management strategy is vital to minimizing a healthcare provider’s revenue shortfalls. PMMC offers an integrated denial management monitoring process with contract management for a full-reimbursement monitoring system.