FAQ's

Procare RCM is a leading provider of Medical Billing Services, designed to improve outcomes, efficiency, and ROI. Our medical billing services let you put more focus on patient care, reduces billing errors, saves money, improves cash flow, and revenues.

It's a Matter of Economics!

Over the last decade or so, medical providers have become buried in paper while it has become more and more difficult to get paid for their services. Today every provider faces the potential of getting paid less for more work. Gone are the days of "submit a bill and get paid." Insurers have deployed "armies" of people, using high-end computers, with sophisticated software in order to find ways to deny providers payment. We call this Revenue Leakage.

At risk is the loss of tens of thousands of dollars in revenue to your practice. Procare RCM can help to substantially lower your costs; increase revenue collected and reverse your Revenue Leakage (lost revenue from denials and poor follow-up).

Lowering Cost

Billing systems and human resources are often difficult to maintain and very expensive. Many billing personnel in a private practice lack experience, training, time and resources to properly manage your billing cycle. Hiring, managing and successfully maintaining in-house billing staff is a challenge in many practices, and can negatively impact your bottom line. Training billing staff to become proficient requires time, money, and resources. Staff vacations, illnesses, medical and family leave, etc. can be disruptive. Attrition and turnover - after you pay for all of the training - can be catastrophic.

In addition, there are computer software and hardware expenditures. Service, training, support, maintenance, and upgrade fees also must be considered. And the cost of not upgrading can be even more expensive resulting in high claim rejections. Then you also have the cost to mail patient statements - envelopes, postage, phone calls coming into the practice, and on it goes!

With Procare RCM managing your revenue cycle you can reduce your billing cost, helping you improve your bottom line.

Increase Revenue Collected

Procare RCM has a proven track record of reversing Revenue Leakage and maximizing the revenue for our clients. Our services and systems are designed to get you paid faster, prevent rejections, track claims efficiently, and follow-up on unpaid claims and patient balances.

Over 95% of charges submitted by Procare RCM are paid on first submission. Our clients experience half the national average of Days in AR. We can improve your cash flow significantly by getting you paid faster and collecting the maximum amount of money possible.

We are the solution that healthcare providers turn to for plugging the revenue leakage problem that plagues their practices. As healthcare providers face ever increasing cost and revenue pressures, the last thing they can afford is to "leave money on the floor" - but that happens all too often in many practices as revenue leakage is significant and widespread across the medical practice landscape. Nobody reverses revenue leakage faster or better than we do - our innovative software and specialized services solutions quickly drive significantly improved results. We can deliver substantial cost savings as well as significant improvements in revenue and cash flow. Our powerful combination of technology, expertise, and people quickly delivers unmatched results.

No, we are transparent about all of our charges. We don’t charge any set-up fee and there are no hidden costs.

Yes, we can help process client Provider Medicare Revalidation applications. And we offer to our clients a free a review of their documentation when responding to a Medicare or any Insurer's Audit requests.

Procare RCM utilizes state-of-the-art scanning technology and can accept billing data on paper or electronically via sFTP, efax, fax, USPS, UPS, or FedEx.  CMB is a paperless office.

Over 96% of our clients now send data electronically. However, any paper documents sent to Procare RCM are scanned into digital files within 24 hours for processing. All paper is then either returned to the client or shredded.

We employ:

• A continual replication system on two separate servers,
• Data is backed up to separate off-site storage devices, and
• Have an advanced automated backup electrical generator to insure systems continue to function during a loss of electric.

Yes, Procare RCM will provide a detailed analysis of charge practices to determine your deficiencies. We then recommend changes to your billing process (Charge forms, etc.) to ensure prompt payment.

Yes. Procare RCM receives the required data from your office, and handles the rest: From billing insurance and patients, answering patient questions, to final resolution of each account.

Procare RCM will work with you and your staff to make sure the necessary documentation is collected and sent to Procare RCM for billing.

Procare RCM has 2 options:

1. We can do the billing from your EHR if it is robust enough to collect as well as our software, or
2. If your EHR vendor will export your data using an HL7 or other format, then we can work with them. Procare RCM offers a comprehensive medical billing option that can interface with Electronic Medical Records (EMRs) to integrate your patient demographic, insurance and charge data with our medical billing software to save you money by reducing your operational cost. Often it will increase your revenue by vastly improving the efficiency of your billing cycle.

iSolve RCM can integrate your patient demographic, insurance and charge data with our medical billing software to save you money by reducing your operational cost and often will increase revenue by vastly improving the efficiency of your billing cycle.

Yes, Procare RCM sends a monthly newsletter to clients highlighting important billing changes. When necessary we will email, fax or call with time-sensitive issues. We stay on top so you can focus on your patients!

Absolutely! Procare RCM experienced staff will automatically review and resubmit as needed. If additional documentation is needed by an insurer, we will work with your staff to obtain and send it.

We are experts in our field and have a proven track record of increasing physician’s reimbursements. We do it by ensuring the ICD–9 and CPT codes are up to date, assisting in the capture of proper patient demographics for accurate data entry. We are detail oriented, which is essential for proper billing practices. We Follow–up. We call insurance companies on a continual basis to see where your money is! We constantly strive to meet the high performance goals we have set for ourselves. Plus, we have certified professional coders on staff.

We will have your patient statements printed and mailed out for you. We process patient statements weekly and automatically resend unpaid statements after 30 days with a reminder for payment. Upon receipt of the EOB, we will follow–up on any denied or rejected claims. We work on each claim until it has been paid or a valid response for non–payment has been given. This is where Procare RCM excels, by continuously following up to ensure you receive the revenue due to you!

By taking on the burden of your billing and giving you more time to run your practice! Not only do our medical billing experts take the heavy burden of insurance claim submission, coding and patient billing and replace it with improved cash flow and more time for patient care; but you will no longer have to worry and watch over your in-house billing staff. We are responsible for hiring, training and supervision. You don’t have to provide office space for a medical billing department. We even help your front desk staff “capture” the demographic information properly to assist in the billing process!

We want you to continue using our service because you want to – because you have found that it is in your best interest to continue working with us. Therefore, we do not bind you to a long–term commitment. Our initial contract is for 3 months, then you are free to cancel at the beginning of any month with a minimum of 30 days notice. Fees vary according to the practice, the size, specialty and volume of claims. But we do not get paid unless you get paid first! We are paid once a month on a percentage basis. We only bill you once a month for the EOB’s and superbills we have processed. It may be two months before you get your first invoice. Depending on the size of the practice a start up fee may apply.

We can start immediately after we receive information from your staff. The data set up will only take a few days and we can process your superbills right away. Processing your claims electronically, however, may take up to six weeks. You will have to complete registration forms and receive your electronic provider numbers, but while we wait for the insurance companies, we will process your claims by paper. To get started, you will receive a welcome packet containing forms for your completion and detailed instructions regarding all paperwork. We need information about you and all the insurance companies you participate with.

Procare RCM employs advanced security and certified business

• Access Authorization
• Role-Based Access Control
• Release of Information
• Activity Monitoring
• Audit Trails
• 128-Bit SSL Encryption
• Security & Privacy