Medical Billing Services & Revenue Cycle Management (RCM)

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Revenue Cycle Management

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Sign Up for Medical Billing Services and EHR is Included

Join our medical billing expert and PrognoCIS Director of RCM, Kristen Nehk, as she discusses the 10 key financial reports to assist your practice using PrognoCIS medical billing services. View the complete webinar video or jump to the key points listed below. You can also download the 10 Key Financial Reports for Successful Practice Management Webinar Slides.

1. EMR: Daily Collection by User (3:08)
2. Average Reimbursement by Code by Insurance (6:47)
3. Charge Reimbursement Report (8:40)
4. Billing: Daily Collection Report (11:43)
5. Groupable Billing and Collection YTD (13:27)
6. Waterfall Report (15:25)
7. AR Rollover Report (17:48)
8. Denial Report (19:09)
9. Copay Deductible Collection vs. Resp-Detail (21:10)
10. Insurance Paid less than Contract Amount (22:10)
11. Questions (24:05)

PrognoCIS Revenue Cycle Management (RCM) and Medical Billing services combine EHR workflow and payment collections into a simple, single source. While you provide the medical services, we will take care of:

  • Dedicated RCM client services manager
  • Eligibility checking
  • Processing of patient statements
  • Build customized scrubber checks to meet state, specialty and practice specific billing guidelines
  • Claim follow-up to ensure payer acceptance
  • Designated call center to take patient calls
  • Posted updates on insurance payments, patient payments, and denials
  • Denials management, appeals management
  • All claims touched at day 30, if not paid

By using PrognoCIS Medical Billing Services, your practice benefits from combining thousands of man-hours in payment experiences, as well as optimizing returns with proprietary scrubbing algorithms to shorten cycles. And, because the billing data and codes from the assessment are automatically forwarded to claims for billing there is no need to create or pass superbills from the practitioner to the billers. Read our Revenue Cycle Management Solution Brief for more information.

This allows you to focus on connecting with your patients and providing services without having to worry about the nuances of payment collections. In the event there is a billing issue to sort out, the integrated software provides easy communication and assignment of tasks between the clinic and the medical billing services team. And, with PrognoCIS, our ICD-10 submissions are as good or better than with ICD-9, so you can continue practicing with predictable prosperity. Learn more about the payment solutions PrognoCIS offers.

As part of our transparent claim management process, we offer daily/monthly/YTD financial statements and RCM reports. These reports are vital to fine tuning the efforts of a medical practice, and are provided at no extra charge, so you always know where your claims stand. Reports include:

  • Denials management report
  • AR analysis report
  • Month end report
  • Industry standards report
    • First pass rate – 92% or higher
    • Percent AR over 90 days – less than 15%
    • Days in AR – our goal is under 45 days

Medical Account Resolution Services

PrognoCIS Medical Billing Services offer account resolution to manage your billing. Our partners at Transworld Systems will work with you to contact patients to settle statements. Learn more about Medical Account Resolution Services.

When you sign up for PrognoCIS Medical Billing Services, we also offer you a comprehensive package of our Premier features, including:

To learn more about getting PrognoCIS Premier for your practice, contact us.

99% Error Free Claims

When 99% of the claims you submit to TriZetto’s clearinghouse in a quarter are approved, you can qualify for TriZetto’s 99% Club.