| PPS has been providing specialized auditing services
for the 16 years we have been in business. They provide a tangible quantification
of the accuracy of your revenue from managed care and commercial, charge-based
payors. These services include the Managed Care Contract Payment Review, and Omitted
Charge Recovery. Empirically, each service captures 10% and 5% additional revenue
respectively for their portion of the payor mix. PPS normally invoices the payors
and collects the underpayments upon client request. These services provide your
hospital with the best charge based and managed care assistance available.
The benefits of the Managed
Care Contract Payor Review Program include:
- Over 90% successful
collection of underpaid accounts
- Elimination of insurance company errors
- A matrix of current contract terms
- Identification of underpayments
- Rebilling of all identified underpayments
- Identification of overpayments
- Education of billing staff
- Establishment of procedures and quality control methods within the hospital
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- Service can be provided on-site or off-site Our Omitted Charge Recovery Service
analyzes the medical record and corresponding patient bill to identify undercharges
and overcharges. This service applies to all charge-based payors including those
that pay on discounted charges.
The benefits of the Omitted
Charge Recovery Service are:
- Normally captures a net of 5%
additional charge-based revenue
- Can be provided on-site or off-site
- Can analyze cases either
pre-billing or post-billing
- Consultants are RN’s with
more than ten years of expertise
- PPS can re-bill and collect
all net undercharges
- Reports are provided monthly to show
where charges are “lost” both
by patient and by department
- Education is provided to financial
and/or departmental personnel
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