In today’s complex and highly regulated health care environment, maintaining profitability and compliance while continuing to ensure that all patients get the best care is no easy task. 在PCG, we can help your organization understand changes in state and national policy reform and more effectively manage state programs, 包括医疗补助和医疗保险.
Cost Settlement and Supplemental Payment Strategies
Medicaid agencies and public providers are critical to the safety net system of care. To ensure they have the resources needed to provide that safety net, PCG has worked with Medicaid agencies and public providers across the country to optimize Medicaid funding streams through cost settlement and supplemental payment strategies. Our work has covered a broad spectrum of institutional and community-based providers, as well as the introduction of proprietary web-based cost reporting tools to support millions of Medicaid supplemental payments each year. 日博网站服务包括:
- Fire and Emergency Medical Service (EMS) Provider Support Services
- Physician Services Supplemental Payment Strategies
- School-Based Services Cost Settlement Supplemental Payment
Delivery System Reform, Performance Management, And Quality Improvement
PCG provides our health care customers with delivery system reform, quality and performance improvement, and other technical advisory services related to state health reform efforts. Our clients range from Medicaid agencies, to hospital systems, to community based providers.
健康 Information Technology (HIT)
Within the PCG 健康 practice area, the 健康 Information Technology (HIT) team works with state and government agencies, 重点关注医疗补助, Exchanges and health information technology, to help further the advancement of technology in the world of health care.
States regulate their private insurance markets and operate Medicaid managed care and fee-for-service programs to assure healthcare access to residents. This includes access to both physical and behavioral healthcare. States turn to PCG to organize their commercial health insurance regulatory compliance.
Medicare Cost Reporting Services
Since our inception more than 30 years ago, PCG has worked with state agencies and public providers to complete Medicare cost reporting requirements. We will ensure that these important reports maximize revenue streams, provide information on the true cost of operations, and adhere to federal reporting requirements.
收入 Cycle Management Services
PCG has been working with public and other providers to maximize revenue streams to ensure the sustainability of services and programs. Our work includes outsourced billing services, come-behind billing services to optimize revenue 集合s, 编码服务, 法规遵循和审查服务, and revenue cycle management assessment and training services. We have a variety of billing solutions to process institutional, 专业, 和制药索赔.
Value Based Purchasing Design and Implementations Services
Transform your Medicaid program’s payment model – save costs while improving the quality of care and enhancing patient experience. 你们可以帮助. 基于价值的采购 is a payment strategy to measure, report, and reward excellence in health care delivery. Simply put, it is an effort to reward value over volume.
医生团体实践, PCG provides a wide range of accounting and financial management services under the Financial and Business Solutions Schedule (FABS):
Evaluating existing charge capture tools for completeness and comprehensiveness.
Full outsourcing and come-behind billing and 集合 services.
Coding and Documentation Improvement
Identifying potential coding errors that require training and education and/or opportunities for revenue improvement.
Monitoring of operational risks related to billing, 文档, 集合, and other compliance-related matters.
Obtaining relevant information and reports to help manage clinical and financial operations.
Managing your rate structure to ensure optimal results from your charges.
Ensuring all procedures performed are captured and enter the revenue cycle.
Assistance with development and negotiations of reimbursement rates from federal and commercial payers.