FAQ's

Answers to Frequently Asked Questions

How many years in business?
PBMI has been providing physicians with quality revenue cycle management since 2001.  Combined, our Management team has over 80 years of experience in the healthcare industry.

Are there certified coders on staff?  Several staff members are certified by the American Academy of Professional Coders.

Who is responsible for CPT, ICD--CM and HCPCS code selection?
The provider is always the best source for accurate code identification.  As your billing company, we provide education and will always research your questions and give assistance as needed.

How often are claims submitted to insurance carriers? 
We submit claims daily.

What is the average “front-end” denial rate?  
Our denial rate is less than 5%.

What services are provided to resolve denials? 
Most “front-end” denials are due to changes in patient insurance or insufficient information. We will work with your staff to insure they are familiar with current insurance requirements.  After all, once the patient is treated, there is often little that can be done if the insurance is not active or an authorization is not obtained. A knowledgeable front desk is a practice’s best defense to prevent providing free services.  Our goal is to empower your staff and implement policies and procedures to insure you are reimbursed for the care you provide.

How are rejections tracked and resolved?
PBMI records and reports rejections back to our clients as part of our monthly standard reporting. Again, educating our clients and their staff is key to preventing costly rejections.

From the time data is received, how much time is needed to process a claim? 
“Clean Claims” are processed within 24-48 hours of receipt during normal business hours.

Are payments posted electronically?
Yes.  Medicare, BCBSM, Medicaid and many commercial carriers will be posted electronically.

Can the practice access the practice management system to perform inquiries? 
Yes.

Is there a department that handles patient collections?
Our collection department will work with you to define a collection process that meets your practice criteria.  
PBMI currently manages “soft” collections in our office, and works with an outside collection agency for “hard” collections. 

Who calls the patients with past due balances?
PBMI has a unique past due account management process that has accomplished effective results while protecting our client’s public image and goodwill. 

Using your pre-approved scripted messages, pre-collection calls are placed to patients that have not responded to mailed statements.  PBMI staff can then set up payment arrangements with the patients without using a collection agency, saving you costly collection fees.  We work with your patients to resolve accounts and produce a satisfactory outcome you and your patients.