Shrinking margins make timely and accurate payment of your medical services critical.
Our goal is to afford our clients more time for providing services and less time worrying about the administrative headaches every practice encounters. PRS-Urology, part of the growing PRS network, can help your practice succeed with our practice management solutions which provide urologists with quickly installed, reliable, secure and economical applications to manage the business of a medical practice.
Full billing service includes ASP Practice Management Software, Claims Scrubber, Scheduler and Reporting Modules. Clients may post patient information co-pays or scan the information and PRS will enter.
PRS enters claims into the system, posts line item payments, challenges insurance company denials , files appeals, sends out patient statements, works insurance and patient collections.
Full Billing Service
- Complete Data Entry including: patient information, charges, payments and adjustments.
- HIPPA compliant access codes and passwords for each provider and designated employees to MedBillCorrect Practice Management Information System and Scheduling modules.
- Coding support from PRS including training and access to CodingToday.com with all the rules and regulations on billing with additional regional telephone support by PRS certified Business Reimbursement Managers where available.
- Pre-submission screen to confirm billing conforms to payer specific rules* for each claim. Pre-submission screen is based on a dataset which will be constantly updated with EOBs and data experience from multiple payers. Recommendations provided by claim scrubbing program entitled ClaimCorrect™ are based only on codes submitted by the client and any claim changes (or lack thereof) are the sole responsibility of the practice as determined by the documentation of the service.
- Post- payment review to determine accuracy of payments for the payer based information in the database of ClaimCorrect™ and contract information provided by the practice.
- Post all insurance payments in the Practice Management Information System.
- Follow-up on all insurance denials or improper payments as well as delayed payments and take appropriate actions as dictated by contract and situation.
- Oversee Appeals and Resubmission with input from the practice, including processes required by payer to accomplish such Appeals and Resubmissions.
- Send Patient Statements and follow up on unpaid patient accounts per PRS standard collection protocols including dunning messages, written letters as set up per clients instructions. Phone calling of patients on delinquent balances is not provided.
- Provide reports and practice management information.
- Interpretation of management reports and recommendations regarding problematic areas within practice.
- Compliance reports on payers as data permits.
- Collective data from other urologist and payers.
- Oversight by the “Painters” with all the expertise of PRS.
- Data to assist with contracting.
- Client will acquire and maintain a high speed line (connection) to the internet as specified and agreed to by PRSURO.
- Client will acquire and maintain all telephone and computer hardware as needed (computers, printers, etc), except for those needed at a secure central internet server site which will be the responsibility of PRSURO or its assigns.
- Client will provide patient information promptly as needed for billing purposes as required by Practice Management Information system.
- Client will identify and code correctly all services provided.
- Client will provide the correct code(s) with the appropriate diagnosis and needed modifiers for services rendered via lock box service and, or secure scanning and uploading of data.
- Client will provide information as requested to assist in appeals of denied claims as requested.
- Client will be responsible for obtaining payment as required by contract and situation from the patient as co-payments.
- Client will provide copies of all communications with payer in regard to payment for all patients for whom PRSURO is involved in payment, including EOBs, written records of telephonic communication and other communications. If Client at its option elects to enter EOB information into Practice management information system, the Client must provide copies of EOB to PRSURO.
- Client will adhere to PRSURO’s standard operating procedures of prompt transporting data from Client’s office to Company for working claim data, payer payments and account receivables.