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SERVICES

Practicefirst’s customized solutions are designed to maximize physician revenue and minimize risk through timely credentialing, accurate coding and billing, and daily attention to practice management and compliance issues.​

 

We stay on top of the ever-shifting healthcare regulations and payer contracts so you don’t have to, and we share this knowledge with our clients.

Are Poor KPIs Impacting the Financial Health of your Practice?  

Our expertise will support 6 fundamental areas critical to your revenue cycle management.

Medical Billing

Get paid the first time.

Health care billing statement with steth

Practicefirst's medical billers are the conduit between patients, physicians, and payers, negotiating payment arrangements between all three parties.

Our goal is for every claim to be “clean” and compliant.   A clean claim contains no errors, and will be processed in a timely manner by the payer, ensuring that you receive reimbursement quickly and correctly.  Attention to detail throughout every step of the process is essential.

  • Denial Management/Appeals Payment Posting

  • Lost Revenue Recovery Audit

  • Customized Monthly Financial Reporting

  • Real-time oversight 

Medical Coding

Accurate documentation matters.

International Classification of Diseases and Related Health Problem 10th Revision or ICD-1

We hire only the best! Our medical coding specialists have undergone extensive training and must be certified through AAPC or AHIMA.  These highly focused individuals understand that accurate documentation is crucial to the financial success of your practice. 

The coding team at Practicefirst is required to stay up- to-date on their continuous education and is proficient in a wide range of services including:

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  • Evaluation & Management Principles

  • Specialty Coding

  • Ever-changing Industry Guidelines and Government Regulations

Practice Management

Positively impact your bottom line. 

Financial analysis, accounting, statistics, investment, sales analysis of the company in t

Your medical practice is a complex business. Managing that business can be challenging and takes valuable time away from patient care.  Practicefirst will partner with you to develop a customized approach to identify practice inefficiencies, and determine which operations would benefit from our direct oversight.    

Below are just a few of the practice management services we offer​:

  • Customary Fee Schedule Analysis

  • Payer Contract Consulting

  • Compliance Consulting

  • Payroll and Bookkeeping

Credentialing & Enrollment

Let us take care of the paperwork.

A group of doctors in a modern clinic is planned. The concept of modern medicine and medic

Timely credentialing has a direct impact on your revenue cycle and the success of your practice.  Before a provider is able to bill an insurance carrier, they must first be credentialed by that carrier. 

Our electronic credentialing and enrollment system will track application progress, identify errors, and provide deadline alerts for any required periodic updates.  Early notification of an incomplete application or errors will require quick action.  Our skilled staff will work to resolve these issues and ensure that you to maintain consistent cash flow.

 

Additional services available include:

  • CAQH Enrollment – New applications, application updates and quarterly attestations

  • Payor Enrollment – Commercial, Medicare, Medicaid

  • Managing & Reporting of Credentialing Expirables –  Medical licensure, DEA registration, CAQH provider profiles, and malpractice insurance

Compliance

Know and follow the rules.

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Fraud, waste and abuse happen all too often in the healthcare industry, resulting in growing scrutiny by government regulators.  We take compliance very seriously and can provide dedicated resources to ensure that your practice remains complaint not only today, but also moving forward as future changes occur within the industry.

​Available services include:

  • Coding and Billing Audits 

  • Payer Contract Analysis

  • Development of a Compliance program to meet OIG and OMIG requirements

Chart Audits

Are you being paid accurately for your efforts?

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Accurate documentation is critical to the financial success of any medical practice.  Chart audits provide an unbiased look at the coding activity of your practice.  Our auditors are able to readily identify instances of over-coding and other poor coding practices.

 

Regardless of intent, this may be placing your practice at both a financial and legal risk.

  • Identify missed opportunities for revenue sources

  • Identify and resolve potential compliance issues before they become a problem