Banner Health Among Healthcare Systems Selecting PMMC for Underpayment Reviews

March 31, 2017

PMMC, a leading revenue cycle management company, was recently selected by several hospitals and healthcare systems across the country to conduct a payer underpayment review to return revenue back to the healthcare organizations’ bottom line.

Hospitals selecting PMMC for pricing strategies include Banner Health (Phoenix, AZ), Virginia Mason Medical Center (Seattle, WA), Southeastern Ohio Regional Medical Center (Cambridge, OH), and Covenant HealthCare (Saginaw, MI).

Banner Health (Phoenix, AZ), who recently completed a Chargemaster pricing review with PMMC, is extending that project by going through a comprehensive underpayment review for all 28 of its facilities. Their patient accounts will be profiled across all facilities to highlight billing trends and errors to find lost revenue and prevent future losses.

Additional hospitals engaging with PMMC for underpayment recovery reviews include Pennsylvania Mountains Healthcare Alliance (DuBois, PA), Southeastern Ohio Regional Medical Center (Cambridge, OH), two facilities at OhioHealth (Columbus, OH), and Iredell Health System (Statesville, NC).

“We now have the ability to identify payment variance trends more quickly with our automated variance technology,” said Robby Shaul, Vice President of Revenue Enhancement at PMMC. “This translates to a quicker cash boost for our hospital clients.”

Underpayments are a multi-billion dollar problem in healthcare. In 2015, combined underpayments totaled $57.8 billion from both Medicare and Medicaid (according to the American Hospital Association).

The hit taken due to underpayments from government and commercial payers is typically 1 to 4 percent of a hospital’s net revenue.

PMMC’s hospital contract management software is designed to correct these underpayment issues by identifying trends and sources of payment inaccuracies. PMMC’s team of experienced, revenue cycle experts leverages the software and effectively collects the underpayment from the third party on behalf of the hospital.

“As payer contracts and reimbursement terms constantly change and become more complex, PMMC’s software has adapted machine learning techniques to stay one step ahead of payers and ensure the hospital is paid correctly for the care it provides,” added Robby Shaul.

About PMMC

PMMC provides high value revenue cycle software and services to improve the financial performance of healthcare organizations. Our software and expertise focuses on payment accuracy and identifying more revenue opportunities across the revenue cycle. 

PMMC helps hospitals identify underpayments and denials, increase price transparency, and manage bundled payments. Clients see, on average, a 10 to 1 return on investment with software and services. Additionally, PMMC has earned the Peer Review designation for both its Contract PRO and Estimator PRO solutions.

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