Build & manage a complete billing & collections system.
3 months + ongoing
Workflow Analysis: Assessing and analyzing the current billing process for leaks.
Protocol Development: Setting up standard "Rules of Engagement" for billing, payments, and appeals.
Billing System Architecture: Implementing a streamlined system to capture 100% of delivered services.
Loop Integration: Connecting the clinical team, the accountant/bookkeeper, and the billing office.
Fee Schedule Optimization: Developing and implementing customized, standard fee schedules.
Reimbursement Monitoring: Auditing insurance reimbursement patterns against billing patterns to identify underpayments.
Provider Feedback: Processing claims and providing direct feedback to the provider to improve future documentation.
Denial Prevention Systems: Creating a system to track, analyze, and reduce future claim denials.
KPI Implementation: Setting up tools to measure billing and collection performance.
Industry Benchmarking: Providing feedback on progress compared to peers and industry standards.
Compensation Support: Setting up physician bonus structures and RVU-based reporting.
Estimate savings from outsourcing denial management to PractiCons.
Total Annual Encounters × Avg. Revenue per Encounter
Total Annual Encounters × Initial Denial Rate %
Denied Encounters × Avg. Revenue per Encounter
Percent of Appealed Overturned
% of Denials Appealed × % of Appealed Overturned
Value of Denied Encounters × Overall Recovery Rate
Denied Encounters × In-House Cost per Denial
Sources: CMS.gov, HealthCare.gov, MGMA, Experian, etactics, PubMed, Premier Survey, Makenzie, American Journal of Managed Care, UnisLink
(includes PractiCons standard service fee)
| Phase | Service Category Name | What We Do (A Summary) |
|---|---|---|
| 1. | Starting a New Medical Practice | Starting a new medical practice requires careful planning, compliance, and operational setup. PractiCons provides full-service startup support including licensing, credentialing, billing, compliance, and systems setup—ensuring your practice launches smoothly, efficiently, and revenue-ready from day one. |
| 2. | Consulting & Practice Management | PractiCons provides expert medical consulting and practice management services to help healthcare providers improve operations, control costs, and increase profitability. We analyze workflows, financial performance, and systems to optimize efficiency, compliance, and long-term practice growth. |
| 3. | Credentialing & Contracting | PractiCons provides comprehensive credentialing and payer contracting services to ensure providers are properly enrolled, compliant, and reimbursed without delays. We manage CAQH, Medicare, commercial payers, and contract negotiations to optimize reimbursement and maintain uninterrupted revenue flow. |
| 4. | HR & Payroll | PractiCons provides comprehensive HR and payroll services designed for medical practices. We manage hiring support, employee documentation, compliance training, payroll setup, and ongoing processing—helping practices reduce risk, support staff performance, and maintain full state and federal compliance. |
| 5. | Marketing & Digital Growth | PractiCons delivers data-driven marketing and digital growth services for medical practices. We help providers attract new patients, strengthen brand visibility, and grow online through SEO, websites, paid advertising, reputation management, and ongoing performance-driven digital strategy. |
| 6. | Virtual Call Center | PractiCons provides virtual call center services for medical practices, delivering reliable front-office and administrative support. We manage patient calls, scheduling, authorizations, documentation, and RPM/CCM coordination to reduce staff burden, improve efficiency, and enhance patient experience. |
| 7. | Revenue Cycle Management | PractiCons delivers end-to-end Revenue Cycle Management services that optimize billing, reduce denials, and accelerate payments. We design compliant workflows, manage claims and collections, and provide financial oversight to help medical practices improve cash flow and long-term revenue performance. |
| 8. | Compliance | PractiCons provides comprehensive compliance and licensing management services to help medical practices meet all state and federal requirements. We manage provider credentials, licenses, permits, renewals, and documentation to prevent penalties, reduce risk, and ensure uninterrupted operations—so providers can focus on patient care. |
| 9. | Closing a Medical Practice (Retirement, Relocation, Disability) | PractiCons provides end-to-end medical practice closure services to ensure a smooth, compliant, and well-managed transition. We handle regulatory notifications, patient communication, records retention, financial closeout, and HIPAA compliance—reducing risk, protecting patients, and easing the administrative burden for physicians. |
| 10. | Special Projects | PractiCons Special Projects provide expert support for high-value, non-routine compliance, IT, and administrative initiatives. We manage audits, coding transitions, HIPAA programs, reporting, and technology coordination—reducing risk, strengthening documentation, and ensuring projects are completed accurately and on time. |
Looking to simplify billing, improve collections, or reduce admin stress? Get in touch for a free consultation with PractiCons — trusted experts in medical billing and healthcare business management.
Disclaimer: PractiCons Inc. is not a law firm and does not provide legal advice. All materials and communications are for informational purposes only. Please consult your attorney for advice specific to your situation.
