Industries, Healthcare
For independent medical, dental, therapy and behavioral health practices, the work behind the desk runs on one coordinator, a stack of payer portals and whoever has a spare minute between patients. We take that work remotely, inside your own systems and under a signed business associate agreement: eligibility, authorizations, claims and denials, patient billing, credentialing and the books. Your front desk and your clinicians stay with your patients. Nobody from us is ever in the building.
The person who verifies benefits, files, posts and follows up is usually one person. When they give notice, claims stop going out within days, the aging report climbs, and the rest of the team covers work they don't fully understand.
Prior authorization requests pile up between visits, get chased between patients, and get lost in a portal queue. When one lapses, the visit is either rescheduled or delivered unpaid.
A rejected claim is cheap to fix in the first week and expensive after ninety days. Without a person assigned to the denial queue, the easy ones sit next to the hard ones until the timely filing window closes and the revenue is gone.
The person greeting patients is also the person verifying benefits, chasing an authorization and posting yesterday's remits. The patient in front of them wins, so the screen work slips, and an empty slot next week costs the same to staff as a full one.
Deductibles are higher and more of the bill is the patient's share. A copay missed at check in becomes a statement, then a second statement, then a balance that's cheaper to write off than to chase.
Deposits don't match remittances, contractual adjustments get booked as write offs, provider pay depends on collections nobody has reconciled, and the accountant sees the year in April. The owner can't tell which location or provider made money.
Intake forms processed, demographics and insurance details entered and checked, referrals logged, and reminders, recalls and confirmations set to run from your scheduling system, so the person at the desk can look up from the screen.
Benefits verified for every scheduled visit, authorizations opened, tracked against the payer's clock and escalated, with the outcome recorded where your clinicians can see it.
Charges reviewed, claims scrubbed and submitted, remits posted, denials assigned by reason and worked the week they land, appeals filed with the documentation attached, and a weekly aging report you can read in five minutes.
Statements with a payment link sent the day the remit posts, good faith estimates prepared on the required timeline for self pay patients, and payment plans set up and watched so balances stop aging.
CAQH kept current, payer applications submitted and followed up on a schedule, expirables tracked, and a start date for each new provider that you can plan around.
Deposits reconciled to remittances, adjustments booked correctly, payroll for clinical and admin staff including provider compensation, sales tax where retail applies, and a monthly close by location and provider.
A practice runs on more systems than it has staff to watch. Most of the trouble we find isn't the software but the gaps between it, where a benefit check, an authorization or a remittance was supposed to move from one screen to another and didn't. Our team works inside your systems, under your logins and your rules, and writes down how each handoff runs so it survives a change of person.
No. Everything we do happens remotely, inside your own systems, under your logins and your rules. Nobody from us is ever in the building, and your front desk, your clinicians and your patients stay yours. What we take is the work that sits behind the desk and gets done between patients today: the benefit checks, the authorizations, the claims and denials, the statements, the credentialing and the books. If you want patient facing phone coverage as well, say so on the call and we'll tell you plainly what we would and wouldn't take on.
Yes, before anyone on our team is given access to anything. You receive the signed agreement, a roster of every person on your account with their role, and the date each login was created. When someone leaves the account, access is removed the same day and the roster is updated.
Only the people on your roster, each with their own login in your systems, scoped to what their role needs. Work happens inside your EHR, practice management and clearinghouse accounts on managed desktops. Nothing is downloaded, exported or sent by email, and nothing lives on a personal device. We review access and audit logs with you every quarter. Our delivery team works from a global talent pool under the agreement. Some Medicare Advantage plans require you to attest to offshore arrangements and some state Medicaid programs restrict them, so we check your payer contracts before we scope the work and tell you plainly if a payer rules something out.
Either. If you have a biller, we take the denial queue, the aging report and the follow up calls they never get to, and you keep them on charge entry. If your biller has left, we take the whole cycle. In both cases you get a written description of every task we own, a named account lead, and a weekly report showing AR by bucket and payer, denials by reason and appeals in flight.
Day one, the agreement is signed and access is set up. Week one, we pull your AR aging, your top denial reasons, your credentialing status and your call and no show numbers, and give you a one page baseline. Weeks two to four, we take over the daily queues, write the procedure for each task, and hold a thirty day review where you see the baseline next to the current numbers and decide what we take on next.
We don't make clinical decisions or coding judgments that belong to your providers. We don't move patient information outside your systems. We don't log in to payer portals under a provider's personal credentials. We don't take work a payer or state program prohibits. If we find a gap in your own setup, such as shared logins or no risk analysis, we tell you and offer to help fix it, but the responsibility stays yours as the covered entity.
Book a call and we'll read your aging report, your denial reasons and your phone log, and tell you where we would start.
Or write to hello@pptcgroup.com
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