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Business of medicine

Revenue Cycle Management | PPS

Billing, coding, collections, and denial management for physician practices. Most practices have 5-15% of revenue trapped in unresolved denials. We find it.

Revenue cycle management is the operational engine that turns a billable encounter into deposited cash. Most physician practices are running their RCM at 80-92% of potential — the gap is denial work nobody finished, undercoding by a tired provider at 6 PM, claims that bounced and never got resubmitted, copays not collected at the front desk, and payer contracts paying below market. PPS’s RCM service handles the whole cycle: charge capture, coding review, claim submission, denial management, AR follow-up, patient billing, and monthly reporting that actually shows you where the leak is.

What’s included

  • Charge capture review — ensuring every encounter generates a charge.
  • Coding review — CPT and ICD-10 review for accuracy and appropriate level of service.
  • Claim submission — clean claims to the payer or clearinghouse.
  • Denial management — same-day triage on denials, appeals where indicated, escalation for systemic denial patterns.
  • AR follow-up — work the queue at 30, 60, 90, 120 days.
  • Patient billing — statements, payment plans, collections coordination.
  • Monthly reporting — payer mix, denial rate, first-pass acceptance, days in AR, AR aging.
  • Payer contract review — quarterly look at what’s being paid vs. contracted rates (pairs with Insurance Contract Negotiations).

How it works

We onboard over 4-6 weeks: connect to your EHR and clearinghouse, learn your specialty’s coding patterns, baseline your current metrics. Then we run.

Monthly reporting goes to whoever owns the financial relationship (owner, CFO, or practice manager). Quarterly we do a deep-dive review on payer mix, denial pattern, and contract performance.

Who this is for

  • Established practices whose current billing company has gotten lazy on denial work.
  • Practices in transition (new providers, EHR change, billing company change) needing temporary or permanent RCM coverage.
  • Solo or small-group practices that don’t want to maintain an in-house billing team.
  • Practices whose owner-physician is doing billing work and shouldn’t be.

What we’ll tell you honestly

Not every practice gets a meaningful margin lift from changing RCM vendors. If your current company is running 95%+ first-pass and aged-AR is clean, you don’t need us. The diagnostic is the first conversation: send us a recent denial report and AR aging, and we’ll tell you whether there’s meaningful upside before quoting an engagement.

Get started

Send us your current month’s claim summary, denial rate, and AR aging. We’ll do an initial read.

Start an RCM scope — or read about Practice Consulting if you suspect the issue is broader than billing.