The 14 Elements of Optimal Revenue
At pH Claimworks, our core objective is singular: Reducing Accounts Receivable and Increasing Revenue. We achieve this through our comprehensive 14-task methodology. While every practice is different, our rigorous adherence to these core elements ensures no claim is left behind.
Core Specialties:
* Aggressive AR Follow-Up & Reduction: Aging accounts are the enemy of growth. Our seasoned AR callers possess the tenacity and technical knowledge to systematically work through 30, 60, 90, and 120+ day buckets, recovering funds that other agencies write off.
* Strategic Denial Management: We don't just resubmit claims; we dissect them. By identifying the root causes of rejections, we fix systemic errors, appeal unjust denials, and prevent future revenue leaks.
The 14 RCM Tasks We Manage
Patient Registration & Demographic Entry
Insurance Eligibility & Verification
Prior Authorization Management
Medical Coding (ICD-10, CPT, HCPCS)
Charge Entry & Audit
Claim Scrubbing & Quality Assurance
Electronic & Paper Claim Submission
Payment Posting (ERA/EOB Processing)
Denial Analysis & Re-working
Appeals Management
Accounts Receivable (AR) Calling & Follow-up
Patient Statement Generation
Patient Helpdesk & Inquiry Resolution
Custom Financial Reporting & Analytics
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