Consulting Case Study 2: Large PPMC

PPMC requested that PMRG analyze two of their multi-specialty practices (85 physicians in each practice) to assess the financial performance. The review was limited to the "front-end" of the reimbursement process (charge-capture, coding, and fees).

In the year following the analyses and implementation of PMRG recommended methodologies each practice increased their collections by over $1,000,000 at constant volume of clinical services.

The gains were made by capturing all services as charges (22%), correcting "undercoding" of evaluation and management services (patient visits) (65%), and correcting fees that were below the level of Medicare and Managed Care reimbursement (13%)

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