Medical Billing Services Claims Review

The PGM Medical Billing Process

Claim Review

PGM’s reimbursement specialists compile and review all client patient and charge data. Billing uploads and batches are balanced, and our medical claims process software is used to ‘scrub’ claims for errors and omissions. PGM’s software performs thousands of checks, including CPT/ICD-9 validations, modifier checks, demographic comparisons and payer-specific edits.

The claims review process ensures that practice billing data is being accurately captured and that claims are clean prior to being submitted for payment. Clean claims greatly increase the rate of payment, helping to maximize the amount collected and reduce accounts receivable.