A Healthcare Operations Consulting Company, Coding and Documentation Reviews Audits, Utilization Prior Authorization, Credentialing, Patients Access and Healthcare Financial Management Consulting Company | GoHealthcare Consulting and Business Development,
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RULE NUMBER ONE

We strive so you can THRIVE!

Leverage our Expertise and our years of Experience!

READ Real Testimonials

Service locations we proudly serve.

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Medical Offices

Single and Multi-specialty Medical and Surgical Groups
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Hospitals

Small, Medium to Large Institutions & Hospitals
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Facilities

ASC, FQHC, RHC, Nursing Homes, Rehab, Hospice and Diagnostic Centers
Our company's culture, ethics and our values sets us apart from all other company. We care for our Clients' patients ultimate outcome of care, that their services or surgeries getting approved or getting paid will be the least they have to worry. We make sure our physicians can focus more on the highest patient quality care. And we will take care of everything from the front desk to the back-end ~ Rafael T. Pescasio, Chief Operations and Finance Officer


Maximize Reimbursement

​Focus more on Quality Care

Reduce Patients Complaints

Increase Patients Satisfaction


STAY COMPLIANT


READ WHAT OUR CLIENTS SAY ABOUT US

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

We consistently have exceeded our Clients' Goals with their
​Outcome and Result!



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Reduce patients complaints and increase patients satisfaction.
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OUR EXPERTISE

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Healthcare Operations Consulting Company















​Prior Authorization Process
  • Coordination of surgical orders management
  • Prior-to-insurance eligibility and coverage verification
  • Utilization and medical policy review
  • Medical necessity evaluation and screening
  • Financial clearance process
​Patients Access ​
  • ​Patients Registry and Initial Demographic Entry
  • Patients Scheduling and Confirming Appointments
  • Coordination of prior-to-encounter orders management
  • Prior-to-encounter insurance verification
  • Obtaining Referral 
  • Obtaining Prior Authorization
  • Obtaining Peri Operative Orders
  • Financial Counseling
Full Revenue Cycle Management
  • 98% of the time your claims can get paid
  • Cash flow increase up to 35% in 90 days
  • Accounts Receivables Management
  • Denial Management
  • Charge Capture
  • Utilization Review
  • Codes Scrubbing
  • Claims Submission
  • Claims Follow up
  • Patient Statements
  • ​Remittance Processing
SPECIALTY Expertise
  • ​Interventional Pain Management 
  • Orthopedic and Spine Surgery
  • Anesthesiology
  • MRI and All Radiological Orders
  • Bariatric Surgery
  • Hospitals Cases
  • Nursing Homes and Hospice Facilities
  • Motor Vehicle Cases
  • Workers Compensation Cases

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  • Insurance Credentialing and Contracting
  • Payers Contract Fees Negotiations
  • Developing Compliance Program for your Organization
  • Developing Best Practices on Policies and Procedures

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Coding and Documentation Audit Review
  • Our goal is to provide our clients the confidence that their billing and coding practices are following best practices and eliminates the risk of inadvertently committing fraud and being fined up to triple the damages.
  • Ensuring that the Provider understands how to maximize reimbursement while they remain compliant  and following the documentation and coding guidelines;
  • We perform a thorough review of at least 12 charts per rendering provider by means of an audit in which the provider documentation is evaluated for completeness, accuracy and compliance of coding and the proper level of evaluation and management coding
​E/M & Surgical Coding Education and Training
  • To optimize the provider’s understanding of medical coding and reporting the proper level of E/M and appropriate Surgical Coding as specified by the coding guidelines;
  • To optimize the provider’s understanding of the Utilization and Reimbursement guidelines and policies
  •  We help you understand bundling/unbundling guidelines and the proper reporting of Modifiers and HCPCS Codes
  • We can go back 3 to 6 years of reviewing your coding and documentation


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READ OUR BLOG

 We strive, so you can thrive and GROW more!

We have an incredible 99% Retention Rate! 

READ WHAT OUR CLIENTS SAY ABOUT US

Compliance

We take it very seriously.
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  • Standards
  • Practices
  • Laws
  • Risks
  • Audits
  • Regulations
  • Strategy
  • Policy
  • Control
  • Requirements
Revenue Cycle Management Company in New Jersey
20+ Years of Well-Kept Promise
  • ​You can trust a Team of Highly Skilled and Knowledgeable Medical Coders, Billers, Utilization Analysts and Project Management Consultants serving in the Medical Practice Industry, Hospitals and Facilities
  • ​Reduce patients complaints and increase patients satisfaction
  • ​You have 100% in-control of your data

read testimonials & praises

We are different in the Medical Practice and Hospital Industry

CALL US FOR A FREE ASSESSMENT
PATIENT ACCESS MANAGEMENT USA
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Your Benefits.

  • First and foremost is PEACE OF MIND (which the ROI is incredible!)
  • ​No new employees hiring
  • No employee benefits and vacation time
  • Increased Providers Confidence
  • Increased Patients Satisfaction
  • Increased Surgical Procedures Approval
  • Increased Cash Flow
  • Decreased Denials
  • Decreased waiting time for patients getting the procedures
  • Focused Full Time Employee Hours Allocation
  • Guaranteed more COST-EFFECTIVE
  • Guaranteed faster reimbursement payments' turnaround time
  • Guaranteed Maximized Profitability
  • Compliant.
Don't just take our word... read what our clients have to say.
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READ OUR BLOG

Who we are as a Team.

We always take pride with our clients' patients outcome.
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Educational Background

89% Nurses (BSN)
5%    Information Technologists (BSc)
4%   Business Management (BSc)
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Years of Work Experience

75%   with 5+ years 
20%  with 12+ years 
5%    with 15+ years 


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Job Roles

40%   Experts in Surgical Prior Authorization & Patients Access
55%   Experts in Full Revenue Cycle Management

5%     Experts in Coding and Documentation Audit/Compliance Review
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Ms. Pinky Maniri - Pescasio, MSc, BSc, CRCR, CSPPM​

Chief Executive Officer, President & Founder | Physician Advocate

Backed by her 26 long years experience, you will be amazed on how much she knows about the Healthcare and Medical Practice Industry. Ms. 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

Our Founder's Professional Affiliations & Industry Commitment

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Gohealthcare Practice Consultants HFMA Business Partner Member 2022
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Meet Our Operations and Management Team

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Mr. Ralph Pescasio, Sr., MSc

CFO / COO
​30+ years in Renal and Hemodialysis Facility Technical Operations

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Mr. Patrick Pescasio

Director of Human Resources and Talent Acquisition
Mr. Patrick has years of experience in HR Management and Talent Acquisition. ​He oversees all stages of candidate experience (including application, interviews and communication).

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Miss Kristine

Executive Office Administrator

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Mr. Jai Maniri, BSc Engineering

Director of IT Engineering and Technical Support

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Miss Jeanne Dearley, MSN, BSN, RN

Senior Vice President of Business Development
and Utilization Clinical Review Team

30+ years experience as Clinical Instructor and as an OR Charge Nurse

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Miss Maya 

Director of Credentialing and Contracting Services

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Mr. Adam Anschel

Consultant for Ancillary Products and Services
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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

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​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 

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(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

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

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Need Pricing?

CALL US TODAY!  (732) 982-4800
CLICK HERE AND CALL NOW

Just a few of the Practice Management Software and/with

​EMR System that we are 100% an Experts 

We are Experts in all of these system! 
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GE Centricity Practice Solution
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AdvancedMD EMR EHR Practice Management Software GoHealthcare
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Cerner
Kareo EMR EHR Practice Management Software GoHealthcare
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Modernizing Medicine EMR EHR Practice Management Software
WebPT EMR EHR Practice Management Software GoHealthcare
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EPIC EMR EHR Practice Management Software GoHealthcare
EPIC EMR EHR Practice Management Software
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Clinicient EMR EHR Practice Management Software GoHealthcare
Clinicient EMR EHR Practice Management Software
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CollaborateMD EMR EHR Practice Management Software GoHealthcare
CollaborateMD EMR EHR Practice Management Software

Contact us if your system is not listed!

Drop us a line...

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Need Immediate Assistance?  CALL US TODAY:  1 (800) 267-8752                                         Send Us a Fax: (732) 982-4800

We are located at 45 East Main Street, Suite 203, Freehold, NJ 07728

Services:
Full Revenue Cycle Management 
98% of the time your claims can get paid
Cash flow increase up to 35% in 90 days
​Accounts Receivables Management
Denial Management
Motor Vehicle Cases
Workers Compensation Cases
Prior Authorization Process
Coordination of surgical orders management
Prior-to-insurance eligibility and coverage verification
Utilization and medical policy review
Medical necessity evaluation and screening
Financial clearance process
Patients Access ​
​Patients Registry and Initial Demographic Entry
Patients Scheduling and Confirming Appointments
Coordination of prior-to-encounter orders management
Prior-to-encounter insurance verification
Obtaining Referral 
Obtaining Prior Authorization
Obtaining Peri Operative Orders
Financial Counseling
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!

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CALL US TODAY:  1 (800) 267-8752
© COPYRIGHT 2019 GoHealthcare Consulting and Business Development LLC. ALL RIGHTS RESERVED.
  • About Us
  • JOIN WEBINAR
  • Events
  • BLOG
  • Testimonials
  • CONTACT US
  • Readers Questions
  • Read More
  • Resources