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How we work

The Pinnacle Way


Whether you are a new or an existing medical provider, Pinnacle Medical Billing will provide you with a gratis consultation and an evaluation of your business needs. PMBS will work with you to devise your business development plan to remain compliant with industry standards and amplify reimbursement potential.

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Insurance Verification

PMBS Insurance verification process accrue information in the beginning that is important for establishing the insurance criteria for the patient admission process, medical services and your recognition of revenues. PMBS directory of insurance payer and reimbursement rates for your use in determining the first decision in accepting patient’s insurance benefits. PMBS conducts Verification of Benefits twice a month for all Provider patients. 

Billing and coding

PMBS uses the most up-to-date Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), ICD 10-CM, ASAM and DSM-5. PMBS focus on the billing standards that are unprecedented in the medical billing industry. PMBS matches your clinical documentation to the claim for reimbursement. 

Utilization Management 

PMBS Utilization Management Team intensely and vigorously advocate Insurance authorization for all level of care. PMBS undergoes the process of initiating the review, obtaining concurrent days for the Level of care provided and Appealing cases to support the Patients Medical care. PMBS strictly abide by ASAM Dimension 1-6 and DSM-IV, we take our Clients’ Patients medical needs seriously. It’s our duty to go beyond our job description in achieving insurance authorization for the correct level of care the patient deserve based on medical necessity.

Claims Management 

PMBS monitors your claim daily and provides you with the ability to track the activity of your claims. PMBS provides claims in a timely manner with comprehensive evaluations. We do more than just handle the claims we manage them.

Collection Management

PMBS fiercely collects outstanding funds that are due to you, with assisting you in maintaining financial stability, tackling what’s owed on the Account receivable and appealing what’s allowed to you by the insurance company. We want to help you provide quality healthcare for your patients while magnifying services for your company growth potential.


PMBS is embodied by a team of professionals, who are qualified to train your staff their position in the revenue cycle management.


PMBS take the initiative in preparing your facility for licensure compliance, passing DCF audits and/or local licensing body. We aid you and your staff members in completing accreditation process for instance CARF or JACHO accreditations and other national accreditation that’s necessary for your company.
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