Methodology

For 20 years, PCL has been representing medical doctors and facilities as a medical practice management advocate. Now more than ever, the physicians need this service as the rules are ever-changing and getting more and more difficult to understand. At PCL we strive to provide our physicians with the ability to rest easy knowing we are looking out for their bottom line. Gone are the days where a doctor can just see patients and get paid. Instead, the guidelines can be so difficult that regardless of how many patients a doctor sees he may still not get paid. That’s where PCL comes in; we will make sure you get paid for all of your hard work.

Review

Professional Claims Link reviews each patient encounter to ensure that a "clean claim" is filed. Once a claim has been adjusted, we review the explanation of benefits for proper payment and any insurance exclusions are worked promptly.

• We review all patient encounters and demographics to make certain the medical coding for services is correct and the patient information is complete. Once the patient data and medical charges have been entered, the healthcare claim is scrubbed for exceptions before any healthcare claim is submitted. When you select PCL for medical billing in Florida, insurance claim payments are usually received within seven to ten days.
• We review and respond to all payment exemptions once the insurance companies' explanation of benefits are received. Our medical billing professionals are looking for exceptions to contracted reimbursement rates and denials for medical services that should have been paid.
• Using state-of-the-art medical billing software, we receive most insurance exclusions by electronic download and work those as they arrive. These exclusions generally let us know if the patient is not covered or if the insurance company has differing patient information. This allows our staff to contact the patient and resolve the impending issues in a more expeditious manner than waiting for a paper denial from the healthcare insurance provider.

Knowledge

Our entire staff at PCL is very knowledgeable of the latest medical billing procedures, changes in the healthcare industry and advancements in claims handling technologies.

• To accurately bill a patient's medical claim and receive payment in a timely manner, PCL reviews the claim for what is billable and what is not, what is bundled and what is not, and the proper use of modifiers. We are also aware of contractual allowances from one insurance company to another.
• Additionally, understanding what each insurance company considers correct billing for certain procedures is very important, especially when dealing with Medicaid products. Use of the National Correct Coding Guidelines ensures that bundling and unbundling is not a problem. Coding claims correctly is essential to collecting medical receivables in a timely manner.

Knowing how to get claims paid is the biggest reason PCL is one of, if not the, best medical billing company in Florida.

Determination and Hard Work

PCL is determined to make sure every doctor's office claim that is collectable, gets paid.

• Some claim denials are inevitable, but keeping those numbers low and working to get them paid is another reason PCL is one of the best medical billing service companies in Florida. We aggressively work all denials to collect all the monies due to the physician's practice.
• Our greater than thirty day aging is usually less than .04 percent of the outstanding amount billed. In other words, if your office bills out an average $250,000 then your over 30 day insurance aging would generally not be higher than $10,000 at any given time. Most physician offices not doing business with PCL maintain at least a 20 to 50 percent insurance aging over 30 days. Our staff's determination and hard work guarantees a lower accounts receivable for our physicians.

Our clients generally enjoy an accounts receivable that is lower than one month's billing. This is generally unheard of in the medical billing industry, but is real with PCL's time proven processes for collecting your practice's money.

Medical Billing Technology

PCL has embraced the latest medical billing technology to ensure efficiency and effectiveness in all areas of scheduling, filing, monitoring and collecting for medical services rendered.

• Our web-based medical billing software allows our physicians' offices to be live with us but not tied to us. It also allows us to process claims faster, receive payments faster and get the patient billing out faster.
• We are able to provide our physicians with the best appointment scheduling and reporting software. PCL's software allows more flexibility in encounter generating, recalls, reminders and the tracking of each step from the initial patient encounter to the completion of the appointment.
• We utilize all of our online resources for the verification of benefits, claim inquiries, claim appeals and insurance industry updates. With electronic claims filing and electronic explanation of benefits we don't get bogged down in the "paper" work.
• We also offer our providers the option of having their insurance payments deposited directly into their bank accounts electronically.
• Because of electronic remittance advice, we have the ability to report on money that is going to be received before it actually arrives. This allows our physicians to improve on their practice's financial planning.

Our website allows patients to request an appointment directly with the physician's office, as well as make payments and ask billing questions. The PCL website also provides helpful links for our medical providers and their patients to view relevant medical and insurance articles. PCL client physicians also have the option of attaching some of their own web pages to our site for advertising and/or patient education.

Commitment and Loyalty

PCL is committed to providing our physicians with the best medical billing services in Florida. We want our physicians to focus on treating patients and to sleep easy knowing that Professional Claims Link is taking care of the most important business aspect of their medical practice, collecting their money.

After all, a physician can see hundreds of patients, but if the medical billing is not done correctly the practice will not get paid. PCL is loyal and will "go to the mat" every time for its physicians. We will not walk away from healthcare claims without payment.

Professional Claims Link works for our contracted physicians and that is the bottom line. If our physician does not get paid, then neither do we. That's the best guarantee made by any Florida medical billing service provider.

Thank you for visiting the PCL website and please continue to browse for solutions to your medical billing, insurance claim processing and patient collections problems.