CHC Billing Management Services


The RCM expert for CHCs

PMG works exclusively with CHCs to optimize their revenue cycle and create increased cash flow by identifying and capturing missed revenue. PMG, Inc. has proudly offered CHC billing services for over 15 years. We truly admire the outstanding work that CHCs deliver. We recognize the tremendous need for your services and have made it our mission to assist CHCs in the achievement of their financial goals. We understand the complex CHC billing and reimbursement world, including sliding scale, UDS reporting, cost-based Medicaid reimbursement, school-based health centers, dental claims, substance abuse/detox billing, UGS/NGS Medicare and CHC-centric specialties. CHC billing is what we do, and our processes are designed with only CHCs in mind. Our ultimate goal is to make your CHC billing process worry-free so you can focus on what you do best, care for your patient population.

PMG’s team represents years of experience in the field of CHC billing. Our management team is the best in the industry and is always abreast of the latest CHC billing and coding news and innovating ways to improve your bottom line. Our customer service team is knowledgeable, courteous and always efficient. Our multi-lingual team strives to provide an exemplary experience to each of your patients. From our COO to our call center staff, PMG believes that every member of our team is a key part of our client’s success story. We believe that we succeed only if you do.

How We’re Different

Most billing companies just submit claims, but PMG looks beyond the CHC billing department to get you paid what you deserve. Not only do we take care of CHC billing, but PMG also works to improve every part of your CHC revenue cycle. Our team of experts looks below the surface, identifying and helping you fixes the workflow issues that are negatively affecting your reimbursements including the front desk, provider medical coding, Practice Management (PM) System optimization, and extensive denials management. By going beyond the CHC billing department, we are able to identify the source of cash leaks and then work with your team to stop them at the source.

With the rise of value-based care and quality payment models, medical coding is becoming an even more important part of the medical billing process. While providers must enter the medical billing codes themselves, our revenue cycle/ medical billing services include ongoing provider training. Our team stays up to date on medical coding protocol so that you don’t have to. We continually monitor claims for medical coding issues and can create custom medical coding training for your providers to get them up to speed. The training can be presented face-to-face, or we can create an online medical coding webinar for your team to learn at their own pace. Continually monitoring for medical coding errors allows us to stop medical coding related denials and help you increase your revenue.

Our proprietary medical billing and coding review software is designed to track claim status and allows us to improve your first pass rate drastically. By identifying these medical billing trends, future denials are stopped at the source, and your CHC can collect every dollar you deserve. Our medical billing software works independent of your practice management (PM) system, meaning there is no need to change your current PM system. In fact, PMG is well versed in many of the top PM systems.

Speaking of PM Systems, we all know how frustrating this online medical billing and coding software can actually be. Even pulling reports can be a nightmare. That is exactly why PMG’s medical billing services include comprehensive monthly reporting that provides an executive level view of your billing performance.

Areas that can be improved with Revenue Cycle Management from PMG:

  • Front desk concerns, including eligibility

  • Provider coding accuracy (CPT, ICD-10)

  • EDI challenges and systems interfacing

  • Claim scrubbing and submissions

  • Clearinghouse communications

  • Denial reporting and prevention

  • Charge entry and payment posting

  • Long-term revenue cycle growth strategies

Why Chose PMG as your CHC Billing Partner?

We believe CHC billing and coding should involve using data to make important decisions, from assessment of day-to-day training needs or reducing denials, to sophisticated analysis to decide whether or not to contract with a particular insurance plan. As billing systems vary in the sophistication and level of data tracked and do not produce this information in similar formats, PMG takes these stock reports and develops hybrid reporting options that work for your center. The end result is a seamless delivery of information. PMG’s clients also have the unique advantage of our extensive CHC only reporting and benchmarking against CHC peers. With over 2 million CHC encounters processed annually, PMG’s medical billing reporting and benchmarking allow CHC Administrators and Board Members to see strengths and future revenues opportunities clearly. PMG’s CHC billing service is always innovating and adding additional options as new requirements like healthcare reform, managed Medicaid, Medicare PPS and ICD-10 evolve.

When looking for the right medical billing services for your CHC you need to weigh many factors. Should you go with the same company that offers medical billing software as part of their practice management software? Oftentimes, the medical billing services offered by these companies is not true revenue cycle management. Are they working denials to ensure you get paid? Can they help optimize your Practice Management Software? Do they offer solutions to improve medical coding? Will you get the medical billing and coding reports that you need to plan for success? You must carefully weigh all of these options and ultimately decide which medical billing/ revenue cycle Management Company is right for you and your CHC.

Results of a PMG optimized revenue cycle include:

  • Increased revenue

  • Decreased days in AR

  • Reduced denials

  • Higher average encounter rates

  • Accelerated and steady cash flow

  • Increased clean claim rates

  • Lower processing costs per claim

Find Out About CHC Billing Management Services from PMG