The credentialing process is used to evaluate the qualifications and practice history of a provider. This process includes a review of a Medical Providers completed education, training, residency and/or licenses. It also includes any certifications issued by a board in the Providers area of specialty. Pinnacle Medical Billing Solutions undergoes each insurance company and review the qualification required to receive reimbursement for services as an in-network provider.
PMBS Insurance verification process accrue information 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.
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 and that is use for the correct medical specialty.
PMBS Utilization Review Team intensely and vigorously advocate Insurance authorization for all level of care. PMBS undergoes the process of initiating the review, obtaining concurrent days for care provided. PMBS Appealed 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 care the patient deserve based on medical necessity.
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.
Account Receivables 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 medical billing cycle.
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 accreditation and other national accreditation that’s necessary for your company.
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