Coding, Compliance & Revenue Cycle Services

Pinnacle Healthcare Revenue Solutions (PHRS) is an expert in managing the healthcare revenue cycle for specialty medical practices and nephrology practices nationwide.

We understand what it takes to successfully navigate changes in healthcare, provider requirements, and the nuances of specialty medical practices. PHRS has spent the last 20+ years focusing on the unique needs of the most complex medical specialties including: nephrology, obstetrics, gastroenterology, urology, dermatology, cardiology, orthopedic surgery, and internal medicine.

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Provider Enrollment & Credentialing

  • Initial set-up with payers – government & commercial
  • Track expiration date & renewal
  • Medicare re-validations
  • Hospital/ASC/dialysis unit enrollment

Medical Billing & Coding

  • Certified Professional Coders and Auditors
  • Code to highest level of documentation for maximum reimbursement and compliance
  • Implement processes to recover lost income

AR / Denial Management

  • Claims management
  • Denial/appealsmanagement
  • AR prevention
  • Patient statements and collections
  • Process improvements / training

Healthcare Analytics

  • Customized revenue cycle reporting package
  • Benchmarking and comparative analysis
  • Specialized reports for negotiations / meetings
  • Value-based care reports