RCM Revenue Cycle Management and Practice Billing Coding Consultants

Maximize Reimbursement.

Stay Compliant.

Focus More on Patient Quality Care.

Our Expertise

Our Mission is to Serve the Medical Practice Industry with Integrity, with our Unlimited Knowledge and Expertise

We consistently exceed our Clients' Goals with their
Outcome and Result!

Call Us Today! 609-481-3494

Our Expertise

Full Revenue Cycle Management
Prior Authorization Process
- (we process 1000s of surgical cases a month for prior authorization and precertification)
Office Workflow Optimization
Business Development Strategies
Insurance Credentialing and Contracting
Payers' Contract Fees Negotiations
Documentation Review
Evaluation and Management Coding Review
Surgical Coding Review
Compliance Program
Office and Surgical Scheduling
- (small or huge organization we can easily help you!

READ OUR BLOG

We thrive... so you can thrive and GROW more!

Our Company's Culture and the Values sets us apart from all other company.

We have an incredible 99% Retention Rate!

read our BLOG

Our 3 Core Values

Compliance

We take it very seriously.

15+ Years Well-Kept Promise to our Providers:

You can trust a Team of Highly Skilled and Knowledgeable Coders, Billers and Consultants serving in the Medical Practice Industry
> 30% increase in collections in the first few months
Use your Existing Practice Management Software and EMR System
You have 100% in-control of your data
Clean claims on first submission with 95% of the time are going to get paid
FREE Coding and Billing Guidance from our Consultants' Team to make sure you maximize your reimbursement based on your documentation of rendered services;
Aged Accounts Receivables will decrease significantly
We Follow-up on your claims consistently from day 7 after submission of claims

Our Focus of Specialty

Orthopedic and Spine Surgery
NeuroSpine Surgery
Interventional Pain Management
Anesthesiology
Physical Medicine and Rehabilitation
General Surgery
Laboratory, Diagnostic and Radiology Facility
Obesity Medicine and Bariatrics Medicine
Multi-Specialty Ambulatory Surgery Centers
Durable Medical Equipment
Workers Compensation
Motor Vehicle Claims

READ OUR BLOG

We are different in the Medical Practice Industry

We are a Team of Dedicated and Experienced Medical Practice Consultants
So Obsessed to Achieving only at 100% Accuracy, Avoid Denials and Focused on Maximized Reimbursement

CALL US FOR A FREE ASSESSMENT

"We can help you Increase Cash Flow ... Guaranteed."

Let's Start with your Practice Set Up

Credentialing Review (many claims are being rejected because of this!)
Contracting Review and Fee schedule Analysis
Assistance with Provider Enrollment
Internal Compliance Program Review
Place of Service
Incident To Billing Review
Ancillary Services Review
EOBs Review (are you properly paid by your payers?
Superbill/Charge Slip Review
- Are your codes and charges up to date?
Practice Audit and Review
Office and Surgical Scheduling (in-bound and out-bound)

We Streamline the Process for you ...

Eligibility and Benefit Verification
Assistance with Provider Enrollment
Fee Schedule Review and Analysis
Primary/Secondary/Tertiary Insurance Billing
Prior Authorization Process
Referrals and Authorization Tracking
Charge Entries
Scrubbing
Electronic Submission
Follow Up claims 14-30 days (depends on the insurance)
Patient Statements Processing and Mailing
Electronic and Paper Claims Submission

Our Strengths

Documentation Review
Medical Coding Accuracy Review
100% Accuracy is always the goal
Account Receivables Management
Denial and Rejection Management:
- Denial Review
- Appeals
- Recover Underpayments
Payments Entry
- Insurance Payments Posting
- Patient Payments Posting
Practice Analytics Reporting
- Productivity
- Receipts
- Adjustments
- Unpostables
- Zero Pays

Maximize Reimbursement.

Stay Compliant.

Focus More on Patient Quality Care.

Just think about it ...

> 30% increase in collections in the first few months
Use your Existing Practice Management Software and EMR System
You have 100% in-control of your data
Clean claims on first submission with 95% of the time are going to get paid
FREE Coding and Billing Guidance from our Consultants' Team to make sure you maximize your reimbursement based on your documentation of rendered services;
Aged Accounts Receivables will decrease significantly
Denials and Rejected Claims can be recovered for payments if there's time;
We Follow-up on your claims consistently from day 7 after submission of claims

Your Benefits and Advantages:

You can keep your current front desk, support and billing team if you would like
No new employees hiring
No employee benefits and vacation time
Increased Cash Flow
RCM Focused Full Time Employee Hours Allocation
Guaranteed more COST-EFFECTIVE
Guaranteed faster reimbursement payments' turnaround time
Guaranteed Maximized Profitability
Compliant.

READ OUR BLOG

CODING AND BILLING
ORTHOPEDIC SPINAL FUSION

When to use Medicare's ABN Advanced Beneficiary Notice Claim Reporting Modifiers

When to use Medicare's ABN

Still confused with Coding and reporting medial and lateral branch nerve blocks and understanding Pain Management procedures?

Pain Management Nerve Blocks Coding

Chronic Care Management Services and the New Changes for 2017 CMS Medicare recognizes the Chronic Care Management (CCM) as a critical component of primary care services that contributes to better health and care for individuals. So in 2015, Medicare began paying separately under the Medicare Physician Fee Schedule for CCM services furnished to Medicare patients with multiple chronic conditions.

Chronic Care
Management Billing

2019 New CPT Codes Medicare Payments for Virtual Services Remote Monitoring Interprofessional Consultation In the Final Rule, CMS noted “[i]n recent years, we have sought to recognize significant changes in healthcare practice, especially innovations in the active management and ongoing care of chronically ill patients. . . .” However, CMS’ efforts to promote these innovations have been limited by its interpretation of the statutory restrictions on Medicare reimbursement for telehealth services.

Medicare Guideline on Virtual Services

(1) Incorrect demographic information (insurance ID , date of birth, even the gender!) Always scan a copy of your patient's primary and secondary insurance card. Make sure to get a copy of their new card (if there is a change) (2) Patient's non-coverage or terminated coverage at the time of service may also be the reason of denial. That is why, it is very important that you check on your patient's benefits and eligibility before seeing the patient (unfortunately, I have seen practices who does not check benefits and eligibility on their patients so they end up being not paid for the service they have rendered for the patient

10 Common Reasons Claims Get
Denied and Rejected

Our Team

Ms.Pinky Maniri - Pescasio, MSc, BSc, CRCR, CSPPM

Lead Consultant | Physician Advocate

You will be amazed on how much she knows about the Medical Practice Industry. Pinky Maniri-Pescasio is a renowned and highly educated Professional Medical Practice Consultant, a sought-after National Speaker on Physician Billing, Coding and Reimbursement. A well-respected Revenue Cycle Management Expert and Compliance Expert. She was a University a Professor in her Past Life and you can feel and learn how passionate of a teacher she is. She has always believe, that every Medical Provider MUST get paid for their rendered services based on Medical Necessity. There is no reason for unnecessary claims denial and rejection. It is just knowing the Clinical, Utilization, Documentation and Reimbursement Guidelines and Policies.
She blogs all about the Medical Practice Industry. Visit her BLOG here.
Physician Advocate | Reimbursement National Speaker | Practice Consultant
Certified Specialist in Practice Management
Certified Specialist in Revenue Cycle Management
Certified Specialist in Managed Care
Professional Affiliations:
Medical Group Management Association
American College of Healthcare Executives
American Health Information Management
Health Financial Management Association