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PMG Insights

Secrets for Winning the A/R Battle at Your CHC

At month’s close, Community Health Center (CHC) executives across the country brace themselves as they review the status of their accounts receivable (AR). Dollars owed to the center for services provided, sitting there, just out of reach. Some may meet with billing staff in an effort to get those claims approved; others may just sigh […]

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How the ACA Could Affect Your CHC

Congressional consternation continues in Washington D.C. Too many options from too many interest groups makes it difficult to find commonality to meet the needs of all Americans. Perhaps that is the Achilles’ Heel; i.e., no one plan will meet the needs of all. In the end, the most at risk populations… the poor, marginalized, and […]

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Locum Tenens vs. “Incident to” Billing: Unraveling the Mystery

Too many CHCs are befuddled when it comes to understanding how to bill services under another provider’s National Provider Identifier (NPI). Some CHCs do it every day, others never, and some sporadically while applying different rules or policies often founded in folklore or fantasy vs. payer contract language or government statute. Let’s set the record […]

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PMG’s FQHC Funding Predictions for 2017

2016 was tumultuous to say the least, with the most divisive U.S. election in modern history topping the list. Despite the dire predictions of some pundits, the world didn’t end the day after the election. The sun still came up, and over 75,000 patients were seen at federally qualified health centers (FQHCs) across the United States. […]

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Top 5 Reasons PPS G Codes Need Code Expansion

Coding is a complex topic. So confusing is it that too many in CHC leadership fail to sometimes grasp nuances essential to broadly capturing the full breadth and scope of all services rendered. This misstep results in undervaluation of actual services rendered, diminishes staff morale due to their inability to demonstrate the volume and intensity […]

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What Does EDI Mean for Medical Billing?

I was asked to write a blog post about what I do as the Director of EDI and Business Systems at PMG. If you do not know much about EDI then you are definitely not alone! Many people are unsure about what I do all day and how it helps PMG’s clients. Let’s start with […]

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Improving Self-Pay is Not One Size Fits All for CHC’s

Is your self-pay AR continuing to grow and you just don’t know what to do about it? You are not alone.  Many of our client centers struggle with this same issue. The solutions or “Best Practices” for addressing this are varied – one size does not fit all. What Payment Process is Best for my […]

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Gross vs Net Collections: What Your CHC Needs to Know

At PMG, we encourage our community health center (CHC) clients to familiarize themselves with their financial numbers and to utilize the data reports we provide in order to build a strong financial future for their center. Collection rates are a reoccurring topic and without a doubt, collections are important to CHCs. Collections mean money, and […]

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Claims Denial Reasons and How to Fix It

Are you in denial? Denials are claims that get processed by a payer but are not paid as expected. ‘Denial’ is a word that no Community Health Center (CHC) likes to hear. The word itself conjures up visions of bright red ink stamped boldly across a claim… DENIED… you’ve messed up and now you will […]

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