Are you bleeding money? Call (888) 461-7001 to find out now!

OUR LOCATION

220 Standiford Ave. Ste. F, Modesto, CA

(888) 461-7001

Give our Medical Billing specialists a call

Frequently Asked Questions (FAQ)

Here are some of our most Frequently Asked Questions. If you have a question not listed here please feel free to contact us.


What is the main advantage of using your billing service?

  • Professional Billing & Management Services Inc. celebrates over 31 years of medical billing and coding experience, representing 300+ clients across the country. We are the Medical Billing experts! The foundation of our reputation is built on service excellence and TRUST. We achieve through teamwork, becoming an extension of your office and working with your staff to increase your revenue.
  • Just see what our providers have to say. Click on testimonials and we’ll let our clients do the bragging.

What about patient owed-balances? Do billing services contact patients who fail to pay their bills or ignore the payment plans they agreed to?

  • Professional Billing & Management Services Inc. celebrates over 31 years of medical billing and coding experience, representing 300+ clients across the country. We are the Medical Billing experts! The foundation of our reputation is built on service excellence and TRUST. We achieve through teamwork, becoming an extension of your office and working with your staff to increase your revenue.
  • Just see what our providers have to say. Click on testimonials and we’ll let our clients do the bragging.

Is there a minimum revenue that I must generate to qualify for your billing service?

We evaluate our clients based on the size of their practice, growth potential, and other factors. We specialize in medium to large sized physician groups (Hospitalists, Orthopedic Surgery, etc.) but can accommodate multiple specialty practices across the spectrum.


How do we justify paying your company more than what we are paying for our in-house billing staff?

  • You should consider all billing-related expenses that could (and most likely will) increase. Staff salaries may increase, benefits costs may rise, software and hardware support fees escalate, and you may need to upgrade hardware or software. You should consider postage, statements, CMS-1500 forms and other office items may increase and when your practice grows, you will incur additional costs.
  • At PBMS Inc., your expenses are fixed for the duration of the agreement and may be reduced if your volume increases. As your practice grows, PBMS will absorb the staffing and additional cost requirements while you pay the same rate.
  • Examples:
    • Consider the fact that in-house employees are paid the same salary and benefits and other costs remain fixed (PC’s, phones, etc.), even if your practice generates less revenue month-to-month. If a provider takes two weeks off in the month of July and their gross charges decrease by 50% (example: $100,000 to $50,000), the following month’s net receipts decline by 50%. Your overhead as an in-house biller remains the same. As your billing service, PBMS Inc. rate is based on posted collections for the previous 30 days. Consistent with the above example, your August bill will decrease by the same percentage as your gross charges. Therefore, instead of paying your usual percentage of $100,000, your costs will be based on the $50,000.
    • Seasonal variation (flu season etc.)Staff Turnover: The cost associated with staff turnover is substantial which includes the market variable expenses of replacing and training new staff.
    • By Insourcing PBMS Inc., you’ll free up phone lines for patient care and scheduling. You no longer need to spend valuable time managing inquiries associated with claims status or balances owed.

I feel like I would lose control over my billing through outsourcing. How can I be assured that PBMS Inc. is doing a good job?

  • Let us first answer a few other questions:
    • How much money did you lose from billing errors? (Charges entered incorrectly, timely filing limits missed, misuse of modifiers, revenue lost due to subpar coding etc.)
    • How much control do you have now?
    • How accountable is your in-house staff to you now? How compliant are you?
    • How do you know that your in-house staff is doing a good job?

What benchmarks should I look for from a billing service?

  • Turnaround time from date of service to posting should be no longer than 45 days. This assures a clean claim.
    • PBMS Inc. utilizes the technology of electronic remittance which has proven to significantly decrease the turnaround time for many of the larger carriers, including Medicare by two weeks and in some cases less. Seldomly, isolated problems arise with claims requiring further review, redetermination or appeal, that can add 30 to 90 days or more to the payment cycle.
  • Over-90-day outstanding insurance claims should not regularly exceed 10 percent of your gross charges.
    • In the example above, if your total insurance A/R is $100,000, the over-90-day outstanding revenue should not exceed $10,000.
    • In addition, those claims that fall into the over-90-day category should be in some review, appeal or redetermination status.

PBMS Inc. surpass all benchmarks!


What about patient owed-balances? Do billing services contact patients who fail to pay their bills or ignore the payment plans they agreed to?

PBMS Inc. is not a collections agency. Collection of bad debt is regulated by federal statute, the Fair Debt Collection Practices Act, and is enforced by the Federal Trade Commission. The regulations under the Act are complicated and arduous. Infractions are severely fined and could result in prison time. Therefore, PBMS Inc. only bill patients, answer patient questions regarding their bills and forward patient accounts to collection entities as authorized by our clients. No collections are initiated by our billing services.


Are you familiar with Mid-Level billing?

Yes! PBMS Inc. regularly bill for services in both incident-to and general supervision settings.


Can PBMS Inc. help in the credentialing process for our providers?

Yes! PBMS Inc. will assist with physician credentialing. Please contact us for more details.