"End-to-End Tech-Driven Revenue Cycle Management Solutions"
ABOUT US
PRS Healthcare is the trusted leader in Tech-driven RCM Solutions.
We manage our clients' cash flow through our expertise. With a focus on innovation and expertise, we are committed to optimizing our clients' collections and revenue cycles, ensuring maximum efficiency and profitability. Our mission is to drive success for Providers, Payers, and the broader Healthcare industry.
With a commitment to integrity and honesty, we ensure excellent revenue generation and optimal financial outcomes for our clients. We are dedicated to empowering our clients through top-tier medical billing and coding services.
At PRS, we pride ourselves on delivering top-notch services tailored to optimize the operational efficiency and financial performance of healthcare practices/providers.
Our Vision
Our Mission
Our Vision
"To be the leading partner in transforming healthcare revenue cycle management by delivering exceptional accuracy, efficiency, and innovation, ensuring our clients thrive in an ever-evolving healthcare landscape."
Our Team
Our Mission
Our Vision
Our team of industry experts is dedicated to providing comprehensive
healthcare management and Revenue Cycle Management (RCM) solutions. With
a focus on innovation and expertise, we are committed to optimizing our clients
collections and revenue cycles, ensuring maximum efficiency and profitability.
Our Mission
Our Mission
Our Mission
"To empower healthcare providers in the US by delivering efficient, accurate, and innovative revenue cycle management solutions, ensuring optimal financial performance while upholding the highest standards of integrity, compliance, and patient confidentiality".
OUR SERVICES
PRS Healthcare provides comprehensive Revenue Cycle Management (RCM) solutions, delivering a diverse array of business process services designed to enhance efficiency and optimize financial performance for healthcare providers.
Provider Credentialing and Enrollment
- Documentation : Collect, validate, and store necessary documents.
- Payer Submission : File applications with top payers in their required format.
- Ensure Enrollment : Timely follow-ups to secure enrollment.
- Updates & Re-Credentialing : Regularly update payer documents for recredentialing.
Eligibility & Benefits Verification and Prior Authorization
Inadequate verification leads to issues like delayed payments, reworks, and decreased patient satisfaction. Our team efficiently initiates prior authorization requests, securing treatment approvals through online portals and direct communication with payers.
Demographics
Our precise data processing minimizes denials by ensuring clean claims. Our skilled team accurately registers patient information and selects the correct insurance codes from the master list.
Medical Coding & Scrubbing
Our AAPC and AHIMA-certified coders take care of specific Specialties and ICD-10 coding. They assist in documenting with appropriate CPT and ICD codes and Modifiers.
Key aspects of claim scrubbing include :
- Verifying patient information – Ensuring details like name, date of birth, insurance ID, and policy number are correct.
- Correct coding – Checking that procedure (CPT, HCPCS) and diagnosis (ICD) codes are accurate and match the services provided.
- Ensuring compliance – Confirming that the claim follows payer-specific guidelines and policies, including coverage rules and medical necessity.
- Checking for duplication – Avoiding submission of duplicate claims for the same service.
By scrubbing claims before submission, healthcare providers reduce the risk of claims being denied, leading to faster reimbursement.
Charge Entry/Claim Submission
Our team efficiently processes both manual and electronic charge entries from EHR/EMR systems.
Payment/Denial Posting
Payments received via ERA/EOB are posted within 24-48 hours, with daily reconciliation of reports. Denials are promptly captured and forwarded to the Denial Analysis team.
Denial/Rejections Management
Claim Denials are analyzed carefully, and the root cause is defined for each problem. It is then escalated to the concerned teams to make sure the Denials are fixed & also ensured they don’t recur in the future. Denial analysis is shared with the client once a week.
Accounts Receivables Management and Follow-Up
PRS Healthcare’s objective is to improve your cash flow by reducing days in A/R and improving profitability by increasing your collections ratio. We analyze all underpayments and work with stakeholders to prevent them in the future.
Patient AR & Collections
Patient AR (Accounts Receivable) refers to the outstanding balances that healthcare providers are owed by patients for medical services rendered. These unpaid balances typically result from patients not paying their portion of the bill after insurance, such as co-pays, deductibles, and coinsurance, or due to patients being self-pay (uninsured).
Patient Collections is the process of recovering these unpaid balances. This involves a series of steps to collect payments from patients, including:
- Billing: The healthcare provider sends an invoice to the patient for the amount they owe after insurance.
- Follow-up: If payment is not received within a certain timeframe, the provider may follow up with reminders.
- Payment Plans: Sometimes, patients are offered installment plans to pay off their balance over time.
- Third-party Collection Agencies: If the provider is unable to collect the amount directly, the debt may be referred to a collection’s agency.
- Legal Action: In extreme cases, legal action may be taken to recover the debt.
Patient AR and collections are a critical part of the healthcare revenue cycle management (RCM), ensuring that providers receive the payment they are owed for services delivered.