Charlotte, NC, October 26, 2008 --(PR.com
)-- Preferred Medical Marketing Corporation is pleased to announce prominent Oklahoma Cardiovascular Associates has selected PMMC Physician PRO, an audit and claims recovery software, to monitor its managed care contracts. PMMC Physician PRO software has been engineered to allow physician groups the ability to review their patient claims against payer reimbursement to assess the accuracy of payments received.
National estimates suggest managed care insurers regularly underpay claims due to complex reimbursement methodologies and frequently changing rates and terms. Because PMMC Physician PRO monitors actual payments made against calculated expected reimbursement and reports on insurance payer activity, clients can confidently analyze payment accuracy and notify their insurance payers for reprocessing. Additionally, PMMC Physician PRO can be used to model prospective contract reimbursement rates and terms, affording physician groups greater standing in assessing the financial impact of negotiation decisions.
With several start-up options available, Oklahoma Cardiovascular Associates has opted to successfully incorporate PMMC Physician PRO by modeling and monitoring their high volume payers. Although Preferred Medical Marketing Corporation will begin the process by establishing the reimbursement terms of each selected payer contract within the PMMC Physician PRO application, Okalahoma Cardiovascular Associates will be able to maintain and update contract rates and terms for future financial review. Like all PMMC Physician PRO clients, their contracts and claims data will be loaded into a secure database that will house their specific contract terms, fee schedules and payment policies to ensure the claim is accurately priced. By including complex contract terms and methodology, Oklahoma Heart Associates will be able to focus on their goal of monitoring reimbursement accuracy.
Mark Klakulak of Oklahoma Cardiovascular Associates had this to say regarding their decision to contract with Preferred Medical Marketing Corporation: “We performed a due diligence assessment of Contract Audit Management companies and decided to go with PMMC for three reasons. First, PMMC’s pricing was competitive with the other companies we evaluated. Two, they were the only company willing to do a “trial run” with a couple of our payers before proceeding with an agreement. Since we have never used a Contract Audit Management company before, it was an important advantage in selling the idea to our Board. Thirdly, the data we have been able to sit down with the payers has been very enlightening both to us and the payers. For the first time, we now have the data to challenge the payers on underpayments and in negotiating improved reimbursement rates.”
Cyndi Davis, Vice President of PMMC Physician PRO services said, “PMMC Physician PRO allows our clients the ability to monitor payer contract performance, identify payment issues, and pursue claim appeal opportunities in an efficient manner. Our client goals are two-fold: first, we assist our clients in leveraging their financial resources by developing a better understanding of what they are being reimbursed. Secondly, we encourage our clients to utilize those findings to strengthen payer relationships by developing a cohesive and thoughtful process for claims submission based on the contractual reimbursement terms.”
PMMC, headquartered in Charlotte, N.C., is a Microsoft-certified software development and consulting company. Its software and consultants have assisted 400 hospitals and 20,000 physician clients. For more information, call Greg Kay at (704) 543-8103 or go to www.pmmconline.com.