Use Cases

Rush Health Models All Commercial Payer Contracts and Generates Millions

Rush Health, a clinically integrated health system, models more than 100 commercial payer contracts annually to validate the expected reimbursement from its payers.

Catholic Medical Develops Pricing Strategy to Stay Revenue Neutral and Market Competitive

With price transparency becoming a more important topic as patient deductibles rise, Catholic Medical Center is seeing a bigger push to make charges more accessible to their patients.

Enhancing Operational Efficiency and Financial Health with PMMC’s Revenue Recovery Software

Moffitt Cancer Center partnered with PMMC to enhance their revenue recovery process, addressing claim denials and underpayments. By leveraging PMMC’s contract management and analytics tools, Moffitt streamlined operations with custom reports and automated tasks, allowing the team to identify high-value opportunities and improve workflow efficiency.

Increase Reimbursements and Upfront Collections

A hospital located in the Southeast, USA identified opportunities to collect underpayments from its contracted payers and improve point-of-service collections.

Recovery Services - Increase Collections & Improve Reimbursement

With limited staffing time to review claims and variances occurring due to complexity and ongoing changes in contractual rates and terms, one mid-west hospital sought to increase cash flow through a retrospective recovery engagement. This would build on their successful internal review process and their current contract management system.

Streamline Workflow & Optimize Cash Flow with RecoveryAIᵀᴹ

PMMC’s progressive Artificial Intelligence (AI) solution, RecoveryAIᵀᴹ, is an advanced AI solution that prioritizes accounts based on collectability, giving team members a clear starting point when contacting payers about outstanding bills.

Enhanced Solutions for Improved Financial Management and Patient Experience

Faced with regulatory changes and the adoption of Enhanced Ambulatory Patient Groups (EAPGs), a healthcare organization partnered with PMMC to enhance patient estimations, streamline recovery processes, and ensure compliance. By leveraging PMMC’s advanced tools, the organization expanded into a multi-hospital system, improved productivity, and achieved sustainable growth.