Improved collections, claims follow-up and successful appeal of denials

For a single-physician practice to remain financially viable, it needs to be highly efficient in all areas of its operations, especially medical billing. A small practice cannot afford to risk leaving money on the table or spend a significant amount of time ensuring it is collecting the maximum reimbursement for the services provided to patients.

These were just some of the medical billing challenges facing the urology practice of Dr. Cataldo Cacace in Union City, N.J. A single staff member oversaw the practice’s urology billing, but she was also responsible for many other front office functions.

As the business grew and the office became busier, following up on outstanding claims and interpreting denials became more difficult.

“We were looking for close to 100 percent reimbursement on charges billed, but were not sure how well we were doing,” recalls Dolores Cacace, Practice Manager. “Without a dedicated person for billing, we didn’t have an effective follow-up system. That’s when we started to look for a company that focused on billing, and why we ultimately decided to outsource our billing to experts.”

That was more than 10 years ago, and those experts were the team at PGM Billing.

Getting paid correctly and quickly

PGM’s services were recommended to Dolores by another physician who currently uses its services. Dolores contacted a company representative. “We clicked immediately,” Dolores recalls. “There was a lot of chemistry between us. The recommendations made for their practice along with that chemistry we experienced is the reason we chose to partner with PGM.”

PGM provides a variety of urology billing services for Dr. Cacace’s practice. These services include charge entry, claims submission, payment posting and reconciliation, verification of proper reimbursement, review of denials and appeals submission.

These services have met the billing needs of the practice, which is why the office has never considered switching to another outsourcing company.

“Business-wise, this partnership has been good for us,” Dolores says. “We get the reports we need on a timely basis. Anything we ask for, from reports to updates, we get without any problem. We are very happy with PGM.”

Personalized service

While the urology billing services provided have consistently delivered the results the practice needs to remain successful and financially viable, the personal attention paid by PGM to the office and its specific needs reinforce that PGM has been the right partner for the past decade, Dolores says.

“A very important part of our relationship is that we speak with PGM on regular basis, and it’s not necessarily always about business because there’s a lot of history between us,” she says. “The staff is very pleasant, helpful and friendly. They are always available for our phone calls and eager to help.

“They also have members of the team that speak Spanish, which most of our patients speak, and that’s very important for us,” Dolores continues. “We are very happy with PGM as our medical billing outsourcing partner.”

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