CHARLOTTE, N.C., Feb. 14 /PRNewswire/ -- Harvard Medical Faculty Physicians, a 700-member physician group at Beth Israel Deaconess Medical Center in Boston, has selected Preferred Medical Marketing Corporation to monitor its managed care contractual agreements. PMMC will employ its sophisticated PMMC Physician PRO audit and claims recovery software to automatically review the group’s medical claims and seek underpayment.
The Harvard Medical Faculty Physicians group selected PMMC in December and is currently in the implementation phase of incorporating PMMC Physician PRO into its claims review process. A first priority for the physician group and PMMC will be to audit claims related to its largest managed care contract due for renewal later this year. This information will be valuable to better understand this contract performance.
Nationwide, it is estimated that underpayment from managed care insurers occurs in 2 percent to 10 percent of all claims processed due to complex and ongoing changes in reimbursement rates and terms. PMMC Physician PRO monitors actual payments made against calculated expected reimbursement, models prospective contract reimbursement rates and terms, and reports on insurance payer activity. When underpayments are identified, the insurance payers are notified for reprocessing.
By keeping track of the accuracy of contractual reimbursement, the Harvard physician group will be able to accelerate cash recovery, improve overall contract performance, and identify process improvements that will help improve cash flow and optimize revenue. Importantly, physician groups that have a better understanding of their managed care reimbursement are better able to negotiate future contracts with managed care organizations.
“We feel strongly that incorporating technology helps us to support our clinical, teaching and research missions, said Rick Markello, Chief Financial Officer, Harvard Medical Faculty Physicians. “We have several dozen managed care contracts across our 13 clinical departments. Incorporating PMMC Physician PRO to help us to audit and better analyze our claims was a logical step. After assessing available vendors and systems, we felt PMMC had the most demonstrated experience in this area.”
PMMC, headquartered in Charlotte, NC, is a Microsoft-certified software development and consulting company. Its software and consultants have assisted 300 hospitals and 13,000 physician clients. For more information, call Greg Kay at (704) 543-8103 or go to http://www.pmmconline.com/.
Preferred Medical Marketing Corporation
CONTACT: Greg Kay of PMMC, +1-704-543-8103
Web site: http://www.pmmconline.com/