Claim Management Pricing

Increase collections, reduce denials and reach performance goals with our integrated data-driven Claim Management Services and technology.

Average of 4-10% in Operational Costs
Increases Collections up to 30%
Client Satisfaction
  • OFFICE
  • 0 to 25 Providers
    or
    0 to 3,000 claims per month
  • 4.5 to 9% net collections
  • ENTERPRISE
  • 25+ Providers
    or
    0 to 3,000 claims per month
  • 2.99 to 6.5% net collections
What’s Included?

All Other Services Included (for Free)

  • Payer Enrollment Services
  • Performance Management
  • Consulting & Analytics

Services

  • Eligibility and Benefits
  • Create and scrub charges
  • Denial management and resolution
  • Remittance and payment posting
  • Outstanding insurance AR management and resolution
  • Patient statement and call management
  • Scheduled performance calls

Support

  • Direct access to your dedicated experience and skilled Account Manager
  • Direct access to our Certified Professional Coders (CPC)
  • Direct access to our Certified Professional Medical Auditors (CPMA)

Reports & Dashbaords

  • Performance reports and dashboards
  • Denial dashboards
  • Compliance dashboards
  • Payer enrollment dashboards

Optional Add-Ons

  • Advanced eligibility and benefits
  • Custom dashboards
  • Coding services
  • Documentation and coding education
  • Patient payment feature
FAQ’s

Do you perform coordination of benefits (COB) verification?
Yes, accurate data from the on-set is one of the first vital steps to a cleanly streamlined claim life-cycle. COB verification is the best tool to verify the validity of the patient demographic information and insurance coverage data. We have the technology tools and proven workflow to quickly and easily perform either a standard or an advanced COB.

Do you review charges before sending them to the payer?
Yes, we do. If we see areas for improvement such as CPT, ICD-10 and modifier coding we will inform the client and put together a pro-active plan so that we minimize the possibility of the same error occurring again. This is not a chart audit but if you wish this is a service we offer along with coding services.

Do we have to change clearinghouses?
No, not necessarily. We have relationships with the most common clearinghouses so we can keep your existing payer connections. Both EDI and ERA. As a result, this expedites the transition process and eliminates any potential delays in cash-flow. New practice clearinghouse connections can be set-up with most payers within 5 business days. Clearinghouse fees are included within our monthly % of net collections.

Do you manage and track denials?
While competitors can manually manage denials they do not have the technology and systems in place to quantifiable track and display denials. With constant changes in payer regulations and increased red tape to get claims paid accurately manual processes will simply not improve RCM performance. Clearinghouses have denial management tools but are costly and do not track all the claims so only giving you a partial picture by tracking only ERA denials and not any paper EOB correspondence. Nor does their technology allow you to implement a human that can add an extra level of understanding to whether the denial is a true denial and is the denial categorized correctly. The only way to manage and track denials that gives a clear complete picture are our handcrafted denial dashboards, only available at Phoenix Healthcare Services. These dashboards are included within the Claim Management fee based on a % of monthly net collections.

Who receives the payments from insurances and patients?
All EFT’s, checks and patient online payments are sent directly to you. We do not receive or touch any funds.

How do you manage patient balances?
We understand the patient relationship is an important component to the health of your organization and take patient balance billing very seriously and affiliate it as an extension to the care of services you provide. While we stay within payer guidelines, we have best practice protocols and technology to maximize the patient balance collections performance and at the same time give you comfort we are equally caring towards your valued patients.

When do I see reports and how often can I see them?
Reports can be valuable and we provide a monthly closing packet of pre-elected reports. Custom one-off reports can be created also and typically delivered within 48 hours upon request. As a data-driven organization we don’t necessarily like to rely on monthly flat reports but instead, empower our clients with on-demand access to the data that matters to them most. We deliver this through our technology where each dashboard is handcrafted to your specific requirements by our Revenue Cycle Management experts. That way you don’t have to waste time creating and analyzing reports but instead see yours when you wish and focus on your KPI’s with drill-down capabilities. All viewed in a way that makes sense to make those informed business decisions.

Are there scheduled performance calls with Phoenix?
We welcome scheduled performance calls. Typically they are more frequent during the start of our partnership until we get into a weekly then monthly rhythm. Your account manager leads the call and depending on the topics invites Phoenix team members such as Enrollment Specialist to a Certified Professional Coder to join the call. That way we have all the expertise available to collaborate to improve your RCM performance. Something which most RCM companies and in-house organizations can’t do. Also do feel shy to wait for the scheduled call to ask questions. Feel free to email or call your account manager whenever your wish.