Prisco / Solutions
Complete RCM support, built on compliance.
See how we manage the revenue cycle from front-end to back-end, and how we protect PHI at every step.
From the first eligibility check to final resolution.
Our model focuses on preventing avoidable leakage, protecting coding integrity and keeping work queues visible.
Front-end
- Scheduling and registration accuracy
- Eligibility and benefit verification
- Prior authorization
- Demographic and coverage checks
Mid-cycle
- Charge capture and review
- Medical coding with independent QA
- Documentation review and provider queries
- Edit and modifier checks
Back-end
- Claim scrubbing and submission
- Payment posting
- Denial management and appeals
- A/R follow-up to resolution
A measured start, with no long-term commitment.
Discovery conversation
A no-obligation overview of your specialties, target payers and current hurdles.
Pilot
We code and review a representative sample so that you can judge accuracy and productivity first-hand. No long-term contract is needed.
Integration and scale
Dedicated, credentialed professionals (CPC and CCS certified), trained on your EHR platform and payer profiles.
Continuous review
Weekly or monthly calibration on cleanliness, pending logs and recovered revenue, with full visibility.
Metrics with context, ownership and action.
Targets are agreed with each client based on specialty, payer mix, workflow and baseline performance.
- Claim qualityFirst-pass acceptance rate
- The share of claims accepted on first submission, with rejection categories, payer concentration, source workflow and time to correct and resubmit.
- Coding integrityCoding accuracy score
- Sampled chart audits covering code selection, sequencing, modifiers, units and documentation support, with error type, severity and a coaching plan.
- ThroughputCoding productivity
- Turnaround and output by specialty and chart complexity, read together with accuracy so that neither is bought at the other’s expense.
- PreventionDenial and preventable-denial rate
- Total denials separated from operationally preventable causes, shown by payer, reason, specialty, location and responsible process.
- ResolutionOverturn and recovery
- Favorable appeal or reconsideration outcomes and the dollars recovered, with appeal age, timeliness and payer response.
- Revenue velocityDays in A/R and aging
- Average time to payment paired with aging buckets, payer lag, high-value inventory and no-response claims, so the number leads to action.
- Collection effectivenessNet collection rate
- Collectible revenue realized after contractual adjustments, separating avoidable write-offs from payer reductions and patient responsibility.
- DocumentationQuery rate and response quality
- Query reason, response time and outcome, aimed at targeted provider education rather than at query volume.
- OperationsTurnaround and backlog
- Received-to-completed time, oldest item and due-date risk, with client dependencies separated from internal delays.
Compliance is part of the workflow, not an appendix.
We sign a Business Associate Agreement before any PHI is handled and maintain administrative, physical and technical safeguards throughout.